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Osteoporosis

What is Osteoporosis?

Primary osteoporosis is an age-related disorder characterized by decreased bone mass and by increased susceptibility to fractures in the absence of other recognizable causes of bone loss.

How can I tell if I am at risk for Osteoporosis?

An ordinary x-ray of your bones will not reveal any abnormality until you have lost over 25% of your bone mass. At that point you are already at significant risk for severe, life-threatening fractures. Putting bone mass back on, after it is lost, is difficult, requiring long-term use of expensive, poorly tolerated medicines. Fortunately, preventing bone loss is relatively easy for most women, as long as you know if you are at risk. Fortunately, quick and inexpensive test are available for determining your bone mineral density (BMD).

Who Is at Risk for Developing Osteoporosis?

Women are at higher risk than men in that they have less bone mass and, for several years following natural or induced menopause, the rate of bone mass decline is accelerated. Early menopause is one of the strongest predictors for the development of osteoporosis. Women who are underweight also have osteoporosis more often than overweight women. Cigarette smoking may be an additional predictor of risk. Calcium deficiency has been implicated in the pathogenesis of this disease.

Immobilization and prolonged bed rest produce rapid bone loss, while exercise involving weight bearing has been shown both to reduce bone loss and to increase bone mass.

What Are the Possible Causes of Osteoporosis?

Osteoporosis is histologically, biochemically, and kinetically heterogeneous; rapid bone turnover or reduced rates of bone formation have been documented in patients with primary osteoporosis. Multiple etiologies would not be surprising, considering the complex factors regulating normal bone metabolism. Among the many possible etiologies of primary osteoporosis, current data point to two probable causes: deficiency of estrogen and deficiency of calcium. Rapid bone loss often accompanies menopause, and premature osteoporosis follows bilateral oophorectomy. Estrogen replacement prevents bone loss in both conditions. The following observations support a causal relationship between calcium deficiency and osteoporosis: Calcium deficiency in experimental animals causes osteoporosis; a low calcium intake is common among the elderly and calcium supplementation reduces bone loss.

How can Osteoporosis be prevented and treated?

  • Hormone Replacement Therapy: HRT replaces the estrogen that your body no longer produces, thereby slowing down and even stopping the loss of bone mass.

  • Calcium Intake: Include more calcium-rich foods, such as milk and yogurt, in your diet, or consider taking a daily calcium supplement. Peri and postmenopausal women taking estrogen need 1200 mg of calcium per day, and postmenopausal women not on estrogen require about 1500 mg per day (the average menopausal women only gets about 750 mg per day).

  • Vitamin D: Vitamin D is activated by the liver and kidneys to boost calcium absorption. Women age 51-70 require 400 units of vitamin D per day, and women over the age of 70 need 600 units.

  • Exercise: Exercise can't stop bone loss, but the activity, especially walking, can slow down the pace of osteoporosis. In addition, exercise keeps muscles toned and strong, making falls less damaging. Just 30 minutes of brisk walking several days a week is all you need to increase strength and overall fitness.

 

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