Osteoporosis

Osteoporosis, or porous bone, is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and increased risk of fractures of the hip, spine, and wrist. Anyone can develop osteoporosis, but it is common in older women.

Sign and symptoms
In the early stages of bone loss, there usually no pain or symptoms. But once bones have been weakened by osteoporosis, signs and symptoms will come up, including:

Back pain, which can be severe if there is a fractured or collapsed vertebra Loss of height over time Fracture of vertebrae, wrists, hips or other bones Risk factors A number of factors can increase the likelihood of developing osteoporosis, including: Risk factors that cannot be changed: Gender: the chances of developing osteoporosis are greater if we are a woman. Women have less bone tissue and lose bone faster than men because of the changes that happen with menopause. Age: the older we are, the greater our risk of osteoporosis. Body size: small, thin- boned women are at greater risk. Ethnicity: Caucasian and Asian women are at highest risk. Family history: osteoporosis runs in families. Having a parent or sibling with osteoporosis puts us at greater risk, especially if we also have a family history of fractures. Risk factors that can be changed: Sex hormones: abnormal absence of menstrual periods, low estrogen level (menopause), and low testosterone level in men can bring on osteoporosis. Calcium and vitamin D intake: a lifelong lack of calcium plays a major role in the development of osteoporosis. Low calcium intake contributes to poor bone density, early bone loss and increased risk of fractures. Vitamin D plays an important role in calcium absorption and in bone health. Thus, vitamin D deficiency results in impairment in calcium absorption and contributes to poor bone health. Medication use: long-term use of steroids and some anticonvulsants can lead to loss of bone density and fracture. Lifestyle: Bone health begins in childhood. Children who are physically active and consume adequate amounts of calcium-containing foods have the greatest bone density. An inactive lifestyle or extended bed rest tends to weaken bones. Exercise throughout life is important, any weight bearing exercise is beneficial. Cigarette smoking: tobacco use contributes to weak bones. Prevention Calcium: an inadequate supply of calcium over a lifetime contributes to the development of osteoporosis. Good sources of calcium include low fat dairy products, such as milk, yogurt, cheese, and ice cream; dark green vegetable, such as broccoli, bokchoy, and spinach; sardines and salmon with bones; tofu; almonds; and food fortified with calcium, such as cereals and breads. Depending upon how much calcium we get each day from food, we may need to take a calcium suplement. Vitamin D: vitamin D plays an important role in calcium absorption and in bone health. It is made in the skin through exposure to sunlight. While many people are able to obtain enough vitamin D naturally, studies show that vitamin D production decreases in the elderly and in people who are housebound. Depending on our situation, we may need to take vitamin D supplements to ensure a daily intake of between 400 to 800 IU of vitamin D. Exercise: weight-bearing exercise is the best for our bones because it forces us to work against gravity. Examples include walking, hiking, jogging, stair climbing, tennis, and dancing. Smoking: smoking is bad for the bones as well as for the heart and lungs women who smoke have lower levels of estrogen compared to nonsmoker. Smoker also may absorb less calcium from the diets. So, stop smoking !!! Medication: the long-term use of glucocorticoids ( medications prescribed for a wide range of diseases, including asthma, arthritis, lupus, etc) can lead to a loss of bone density and fractures. Long-term treatment with phenytoin (Dilantin), barbiturate, alumunium-containing antacids, certain cancer treatments, and excessive thyroid hormone can also result in bone loss. It is important to discuss the use of these drugs with doctors. Don’t stop or change medication dose without consultation with the doctor. Detection of osteoporosis A bone mineral density (BMD) test is the best way to determine our bone health. BMD test can identify osteoporosis, determine risk for fractures, and measure the response to osteoporosis treatment. The most widely recognized bone mineral density test is called a dual-energy x-ray absorptiometry or DXA test. It is painless- a bit like having an x ray, but with much less exposure to radiation. Treatment Nutrition: the foods we eat contain a variety of vitamins, minerals, and other important nutrients that help keep our bodies healthy. Calcium and vitamin D are needed for strong bones, and for the heart, muscles, and nerves to function properly. Vitamin D can be obtained by 15-30 minutes of sun exposure, 3 times a week. Exercise: Exercise not only improves bone health, but it increases muscle strength, coordination, and balance, and leads to better overall health. Any weight-bearing exercise is beneficial, but jumping and hoping seem particularly helpful for creating healthy bones. Therapeutic medications: There are several medications which can be used to treat osteoporosis such as Biphosphonate (risedronate, alendronate, ibandronate), Raloxifene, Calcitonin, Estrogen. Discuss the various options with the doctor to determine which might be best for you. Good information about the dosage, indication, contraindication, side effects of drugs should be obtained from the doctor.