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Overview

 


What Is Osteoporosis?

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Osteoporosis is an illness that thins and weakens the bones to the extent of fragility and susceptibility to breakage. The word "osteoporosis" literally means "porous bone." People with osteoporosis are most likely to break bones in the hip, spine, and wrist.

Osteoporosis is sometimes referred to as a silent illness because there are no outward symptoms in the early stages. People are often diagnosed with osteoporosis only after a fall or bump causes a bone to break or fracture.


As the illness progresses, symptoms may include:

  • Back pain, which can be severe if you have a fractured or collapsed vertebra
  • Loss of height over time, with an accompanying stooped posture
  • Fracture of the vertebra, wrists, hips, or other bones




What Causes Osteoporosis?

Osteoporosis Treatment India, Osteoporosis Treatment Side Effects India, Osteoporosis Prevention, Osteoporosis Medications, Osteoporosis Treatment Center, Osteoporosis Surgery Clinic, Osteoporosis Treatment Clinic Osteoporosis is a condition of significantly reduced strength in bone. The strength of your bones is dependent on various factors, including their size, density, and amount of bone remodeling. When your bones do not have a significant amount of calcium, vitamin D, and other minerals, they become weaker and their internal structure deteriorates.

The leading cause of osteoporosis in women is the drop in estrogen levels that occurs during menopause, leading to rapid bone loss. Bone density levels can be compared with a savings account: accumulate as much bone mass as possible early on to generate highest levels of peak bone mass, so you will have more bone density to "spend" as your bones regenerate more slowly with age.

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Risk factors


  1. Female gender - Women are twice as likely as men to suffer fractures due to osteoporosis. Women have lower bone mass than men and they tend also to live longer. The sudden drop in estrogen levels that occurs at menopause accelerates bone loss. Small-framed women are particularly at high risk. Men who have low levels of testosterone are also at an increased risk. Beginning at age 75, osteoporosis is as common in men as it is in women.

  2. Age - The older you become, the higher your risk of osteoporosis, because your bones become weaker with age.

  3. Race - White and Southeast Asian people have a greater risk of osteoporosis. African-American and Hispanic men and women have a lower but still significant risk.

  4. Family history - Osteoporosis is hereditary. If you have a parent or sibling with osteoporosis and, especially if you also have a family history of fractures, you are at greater risk.

  5. Frame - Men and women who are exceptionally thin or who have small body frames tend to have a higher risk because they may have less bone mass to draw from as they age.

  6. Tobacco use - The role tobacco plays in the development of osteoporosis is unclear, but researchers know that tobacco use contributes to weak bones.

  7. Chronic alcoholism - Excess consumption of alcohol reduces bone formation and interferes with the body's ability to absorb calcium.

  8. Low calcium intake - People who have never consumed sufficient calcium have an increased risk for osteoporosis. Low calcium intake contributes to low bone mineral density, early bone loss, and an increased risk of fractures.

  9. Medical conditions that decrease calcium absorption - Stomach surgery (gastrectomy) can affect your body's ability to absorb calcium. Conditions such as Crohn's disease, Cushing's disease, hyperparathyroidism, and anorexia nervosa, can also inhibit your body's ability to absorb calcium.

  10. Inactivity - Bone health begins in childhood. Children who are physically active and take in sufficient amounts of calcium have the greatest bone density. Any weightbearing exercise is beneficial and can increase your bone density at any age.

  11. Lifetime exposure to estrogen - The greater a woman's lifetime exposure to estrogen, the lower her risk of osteoporosis. For example, if a woman enters menopause later or if she begins menstruating at an earlier than average age, she has a lower risk of developing osteoporosis.

    The risk for osteoporosis includes the following:

    • A history of abnormal menstrual periods
    • Menopause that begins earlier than one's late 40s
    • Ovaries that have been surgically removed before age 45 and you don't receive hormone therapy

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  12. Corticosteroid medications - Long-term use of corticosteroid (oral steroid) medications, such as prednisone, cortisone, prednisolone, and dexamethasone, damage the bones. These medications are common treatments for chronic conditions such as asthma, rheumatoid arthritis, and psoriasis. If you need to take a steroid medication for long periods, your healthcare professional will monitor your bone mineral density.

  13. Thyroid hormone - An excess of thyroid hormone produced by a hyperactive thyroid or an excessive amount of thyroid hormone medication to treat an underactive thyroid (hypothyroidism) can cause bone loss.

  14. Eating disorders - Women and men with anorexia nervosa or bulimia are at higher risk of lower bone density in their lower backs and hips.

  15. Some diuretics - Drugs that prevent buildup of fluids in your body—diuretics—cause the kidneys to remove more calcium, leading to weakened bones. Diuretics that cause calcium loss include furosemide (Lasix®), bumetanide (Bumex®), ethacrynic acid (Edecrin®), and torsemide (Demadex®). If you currently use one of these diuretics, talk to your healthcare professional about monitoring your bones and blood calcium level.

  16. Other medications - Long-term use of the blood-thinning medication heparin, the drug methotrexate, some antiseizure medications, and aluminum-containing antacids also can cause bone loss.

  17. Breast cancer - Postmenopausal women who have had breast cancer are at increased risk of osteoporosis, especially if they were treated with chemotherapy or aromatase inhibitors to suppress estrogen. This isn't true for women treated with tamoxifen, which may reduce the risk of fractures.

  18. Excess soda consumption - The link between osteoporosis and caffeinated sodas isn't clear, but caffeine may interfere with calcium absorption and its diuretic effect may increase mineral loss. In addition, the phosphoric acid in soda may contribute to bone loss by changing the acid balance in the blood. If you do drink caffeinated soda, be sure to get adequate calcium and vitamin D from other sources in your diet or from supplements.

  19. Depression - People who experience serious depression have higher rates of bone loss.


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Diagnosis


Healthcare professionals can diagnose or confirm osteoporosis (significant bone loss) or osteopenia (mild bone loss which is a warning of impending osteoporosis) using various tests that can measure bone mineral density. Bone mineral density represents the strength of your bones and their resistance to fractures. As well as measuring bone mineral density, osteoporosis can also be confirmed by the presence or history of osteoporosis-related fracture.

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Bone mineral density is measured using a dual energy X-ray absorptiometry (DEXA). DEXA, otherwise known as bone densitometry or bone mineral density testing. The test is quick, simple, noninvasive, and it simply involves your lying on a padded table while an X-ray is taken to measure the density of the bones either in your spine, hip, or wrist. Measuring bone density in healthy people, also known as screening, can also help to predict risk of fractures as well as to monitor response of bones to osteoporosis treatments.

Recommendations in the United States for bone density screening include all women 65 years and older as well as postmenopausal women younger than 65 years who have one or more risk factors. In addition, women who present with fractures and women who are considering therapy for osteoporosis should have a bone mineral density test. These two latter groups of women already have the condition of osteoporosis and, therefore, bone mineral density is no longer called screening—it is a necessity. Your bone mineral density test results will be in the form of two scores and your healthcare professional will be able to explain to you the significance of your scores. Here is a general explanation of the scores.

T-score—This is the amount of bone you have compared with a young adult of the same gender with peak bone mass. A score above -1 is considered normal. A score between -1 and -2.5 is classified as osteopenia, the first stage of bone loss. A score below -2.5 is defined as osteoporosis. The T-score is used to estimate your risk of developing a fracture. In other words, if your T-score indicates osteoporosis, then you have a high risk of developing a fracture.

Z-score—This is the amount of bone you have compared with other people in your age group and of the same size and gender. If this score is unusually high or low, it may indicate a need for further medical tests.

The purpose of bone mineral density testing includes the following:

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Detect low bone mineral density before a fracture occurs
Confirm a diagnosis of osteoporosis if you already have had one or more fractures
Predict your chances of fracturing in the future
Determine your rate of bone loss, and/or monitor the effects of treatment if the test is conducted at intervals of a year or more


Prevention of osteoporosis


The prevention of osteoporosis aims to maximize peak bone mass up to the age of about 30. Therefore, the aim is to minimize the rate of bone loss, with the goals of maintaining bone strength long-term and preventing fractures. The time of maximum peak bone mass is estimated in the third decade of life in most individuals. Bone loss is significantly increased after menopause (most women will loose about 1% of their bone mass per year after menopause), which is when your healthcare professional will start recommending regular screening with bone mineral density testing so the disease can be diagnosed as early as possible.

Ten steps follow for preventing osteoporosis: five steps to maximizing your peak bone mass during the bone forming years and five steps to minimizing your bone loss, especially after menopause. One step alone is not enough to prevent osteoporosis entirely, but addressing all steps together may certainly reduce your chances of developing it.



Treatment


Women with established osteoporosis will be recommended to use both nonmedication-and medication-based treatments for their condition. The nonmedication-based treatments are similar to some of the steps or strategies needed to prevent osteoporosis (see section above).


Nonmedication-based treatment


Good nutrition :

The foods we eat contain a variety of vitamins, minerals, and other important nutrients that in a balanced diet, help keep our bodies healthy. In particular, calcium and vitamin D are needed for strong bones. (See prevention section for recommended amounts of calcium and foods that are good sources of calcium.)


Regular exercise :

Exercise, particularly weightbearing physical activity is an important part of an osteoporosis treatment program. Exercise not only improves your bone strength but it increases muscle strength, coordination, and balance, and leads to better overall health as well as a reduced risk of frailty and falls (a major problem in the elderly). Exercise has been associated with improvements in and maintenance of bone mineral density and a reduced risk of hip fractures.

Benefits of exercise are quickly lost if you stop exercising, therefore, choose an exercise regimen that you really enjoy to ensure long-term continuity of your program. Try different exercises to find out what you enjoy most. On the other hand, excessive exercise should be avoided because it can lead to weight loss and amenorrhea (loss of menstrual periods), which may in turn increase bone loss.

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Sunlight exposure :

Getting at least 15 minutes of sunlight exposure twice a week to your face, arms, or legs is one of the best ways to get vitamin D, which is important for making your bones as strong as possible; otherwise you may need to take a vitamin D supplement. Some medications for the treatment of osteoporosis are available fortified with vitamin D. Your healthcare professional will be able to check your vitamin D levels with a blood test and advise whether you should take a supplement.


Stop smoking :

Smoking cigarettes accelerates bone loss, therefore, quitting is beneficial for keeping your bones as strong as possible.


Preventing falls :

All women with osteoporosis should avoid the risk of falling. Falls can increase the likelihood of fracturing a bone in the hip, wrist, spine, or other part of the skeleton. Reducing falls involves maximizing certain physical attributes including your balance, flexibility, and strength, as well as minimizing internal and external factors that can increase your risk of falling.

Recurrent falls are particularly common in the elderly, a population at high risk of osteoporosis and fractures. If you or your relatives are experiencing recurrent falls, it is important that you discuss this with your healthcare professional. Sometimes an undiagnosed medical condition, such as cardiovascular or neurological disease, can be the underlying cause, and if treated, you may stop accidentally falling over.





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