Osteoporosis

Osteoporosis is condition that features loss of the normal density of bone and fragile bone. Osteoporosis leads to literally abnormally porous bone that is more compressible like a sponge, than dense like a brick. This disorder of the skeleton weakens the bone leading to an increase in the risk of breaking bones (bone fracture). Normal bone is composed of protein, collagen, and calcium. Bones that are affected by osteoporosis can fracture with only a minor fall or injury that normally would not cause a bone fracture. The fracture can be either in the form of cracking (as in a hip fracture), or collapsing (as in a compression fracture of the vertebrae of the spine). The spine, hips, and wrists are common areas of osteoporosis-related bone fractures, although osteoporosis-related fractures can also occur in almost any skeletal bone area. Osteoporosis can also accompany endocrine disorders or result from excessive use of drugs such as corticosteroids.

Signs and Symptoms

Bone loss can occur without symptoms. In fact, people may not know they have brittle bones unless a sudden strain, bump, or fall causes one of their bones to fracture or a vertebra (one of the 33 bony segments that form the spine) to collapse. Signs of a collapsed vertebra include: back pain, loss of height, Kyphosis—a spine deformity, characterized by a hump back.

More about Osteoporosis

Causes

The strength of your bones depends on their size and density; bone density depends in part on the amount of calcium, phosphorus and other minerals bones contain. When your bones contain fewer minerals than normal, they're less strong and eventually lose their internal supporting structure.

After 35 age, the bones lose increasing amounts of protein and minerals—more than they can build up—and the bones become thin and porous.
Menopause also causes osteoporosis, because without the protective effects of estrogen is lost.

Other causes:
Long term use of certain medications, particularly steroids and thyroid medications
Cushing's syndrome (a condition caused by an excess of a steroid hormone called cortisol)
Kidney failure
Diseases of the thyroid or adrenal glands
Deficiencies in calcium, vitamin D, vitamin A, vitamin K, and/or magnesium (it is important to note that very high intake of vitamin A may actually increase the risk of osteoporosis)
Anorexia nervosa
Hypogonadism (abnormally diminished function of the sexual organs, such as the testes in men)
Elevated levels of prolactin (a hormone responsible for lactation)
Alcoholism
Rheumatoid arthritis
Epilepsy
Kidney failure
Rare genetic disorders such as osteogenesis imperfecta, Ehlers-Danlos syndrome, and Marfan's syndrome
Depression

What keeps bones healthy?
Three factors are essential for keeping your bones healthy throughout your life:

• Regular exercise
• Adequate amounts of calcium
• Adequate amounts of vitamin D, which is essential for absorbing calcium
  

Risk Factors

A number of factors can increase the likelihood that you'll develop osteoporosis, including:

• Your sex. Being female
• Advanced age (50 years or older)
• Being of European or Asian ancestry
• Living a sedentary lifestyle
• Being thin
• Anorexia nervosa
• Family history of osteoporosis
• Never having menstruated or given birth to a child
• Late onset of menstruation or early menopause
• Heavy caffeine use, smoking cigarettes and/or drinking alcohol regularly
• Low exposure to sunlight
• Excess of soda consumption
• Diets low in calcium or high in sodium
• Diabetes
• Depression
• Breast cancer
• High exposure to heavy metals (such as cadmium, copper, and lead)
• Long-term use of certain medications including corticosteroids, antibiotics, drugs that suppress the immune system, thyroid medications, some diureticus, other medications - heparin, methotrexate and some anti-seizure medications.
• Medical conditions and procedures that decrease calcium absorption.

Diagnosis

Osteopenia refers to mild bone loss that isn't severe enough to be called osteoporosis, but that increases your risk of osteoporosis. Doctors can detect osteopenia or early signs of osteoporosis using a variety of devices to measure bone density. The best screening test is dual energy X-ray absorptiometry (DEXA). This procedure is quick, simple and gives accurate results. It measures the density of bones in your spine, hip and wrist — the areas most likely to be affected by osteoporosis — and it’s used to accurately follow changes in these bones over time. Other tests that can accurately measure bone density include ultrasound and quantitative computerized tomography (CT) scanning.

If you're a woman, it is recommended that you have a bone density test if you aren't taking estrogen and any of the following conditions apply to you:

You use medications such as prednisone that can cause osteoporosis.
You have type 1 diabetes, liver disease, kidney disease or a family history of osteoporosis.
You experienced early menopause.
You're postmenopausal, older than 50 and have at least one risk factor for osteoporosis.
You're postmenopausal, older than 65 and have never had a bone density test.
Doctors don't generally recommend osteoporosis screening for men because the disease is less common in men than it is in women.

A bone mineral density test (BMD) is recommended to determine whether an individual's bone mass is below, at, or above normal levels. BMDs are painless, noninvasive, and safe. They typically measure bone density in the spine, wrist, and/or hip (the most common sites of fractures due to osteoporosis). Prior to BMD tests, osteoporosis was only diagnosed after an individual suffered a bone fracture. Today, however, BMD tests allow physicians to identify people at risk for osteoporosis before a fracture occurs.

Treatment Approach

The goal of osteoporosis treatment is the prevention of bone fractures by stopping bone loss and by increasing bone density and strength. Although early detection and timely treatment of osteoporosis can substantially decrease the risk of future fracture, none of the available treatments for osteoporosis are complete cures. In other words, it is difficult to completely rebuild bone that has been weakened by osteoporosis. Therefore, prevention of osteoporosis is as important as treatment. Osteoporosis treatment and prevention measures are:

1.Life style changes including quitting cigarette smoking, curtailing alcohol intake, exercising regularly, and consuming a balanced diet with adequate calcium and vitamin D;

2.Medications that stop bone loss and increase bone strength, such as alendronate (Fosamax), risedronate (Actonel), raloxifene (Evista);

Medications

Osteoporosis Medications

• Actonel
• Evista
• Fosamax