OSTEOPOROSIS

Osteoporosis is a silent disease condition in which the density of the bones reduces resulting in fragile bones. The disease is called the silent disease because there are no symptoms for osteoporosis and the disease is recognized only after the patient break his/her bone. Osteo means bone and porous means thin and literally Osteoporosis means ‘thin bones’. Annually more than two million people have fractures due to Osteoporosis. Most commonly the fractures occur at the spine, wrist and hip. Fractures of spine and hip may lead to chronic pain, long-term disability and even to death. The aim of treating osteoporosis is to prevent such fractures. This is a common disease which affects both men and women normally as they become older. By mid-30s, most of the people gradually lose the strength of the bone as the balance between the bone restoration and bone formation shifts. So more bone is lost than can be restored or replaced and resulting in the thinning of bones and weaker structurally. It is now recognized that other than aging, there are other factors that cause osteoporosis and it can be treated effectively. One in every three women and one in every twelve men all over the world are above the age of 50 and they are prone to develop osteoporosis. The women are four times more likely to develop this condition than men.

Causes of Osteoporosis

To take steps to prevent osteoporosis from developing or treat it before becoming worse is to recognize the person’s own risk factors. The major risk factors such as:

(a) Old age (from the mid-30s, but accelerating after 50 years of age)

(b) Races such as non-Hispanic white and Asian ethnic background.

(c) Small bone structure.

(d) Family history or parent or sibling having fractures associated with osteoporosis.

(e) Any history of fracture followed by a low-level trauma, mainly after the age of 50.

(f) Deficiency in sex hormone, especially deficiency of estrogen both in women and men.

(g) Anorexia nervosa.

(h) Smoking cigarette.

(i) Alcohol abuse.

(j) Intake of low dietary or absorption of calcium and vitamin D.

(k) Immobility or sedentary lifestyle.

(l) Medicines such as prednisone or prednisolone, excess thyroid replacement drugs, heparin, and certain anticonvulsant medications.

(m) The bone can be affected by certain diseases such as endocrine disorders and inflammatory arthritis.

(n) Lack of exercise.

(o) Chemotherapy which causes early menopause due to its adverse effects on the ovaries.

(p) Hyperthyroidism and hyperparathyroidism.

Diagnosis

To identify osteoporosis, a simple test can be conducted to measure bone mineral density (BMD) at different parts of the body such as the spine and the hip. The best test to measure BMD is Dual energy x-ray absorptiometry (DEXA). The test is similar to x-ray with less radiation, painless and can be done quickly. The DEXA score is compared to the BMD of young and healthy individuals resulting in a measurement called T-score. If the score is -2.5 or lower, the person is having osteoporosis and is at a high risk for a fracture. The scores between -1.0 and -2.5 are generally considered to have “osteopenia”. The osteopenic people are at a lower risk of fractures compared to those with osteoporosis. But, in people with osteopenia, if the bone loss continues, the risk for fracture increases.

Treatment

A number of medications are also used for the prevention and treatment of osteoporosis such as Biphosphonates, Calcitonin, Estrogen or Hormone replacement therapy, Selective Estrogen Receptor Modulators (SERMs), Teriparatide, Strontium ranelate (Protelos). For the maintenance of bone health of the body makes sure there is enough calcium in the diet i.e. 1000 mg per day of calcium for women before menopause and 1500 mg per day for women who are postmenopausal, get adequate vitamin D intake which is important for calcium absorption and to maintain muscle strength and the doses should be adjusted to the blood levels of vitamin D, exercise regularly mainly weight bearing exercise.

Prevention

Some of the best ways to prevent osteoporosis are:

(1) Make sure that there is enough calcium in the diet.

(2) Make sure there is enough vitamin D.

(3) Smoking should be stopped.

(4) Avoid alcohol intake.

(5) Do weight bearing exercise.

(6) Take treatment for the underlying medical conditions that can cause osteoporosis.

(7) Reduce or change the medicines that can cause osteoporosis under the prescription of a physician.

(8) Use hip protectors, if the person is at high risk for falls.