Wednesday, January 16, 2008

Osteoporosis

Osteoporosis

Osteoporosis is a disease that causes bones to degenerate and decrease in mass. It affects millions of men and women worldwide, with more than 10 million currently struggling with osteoporosis in the United States alone. 50% of women and 12% of men will be affected by osteoporosis in their lifetime. Though there is currently no cure for osteoporosis, several treatments are available that can help to increase bone density and prevent potential fractures. If you are currently suffering from osteoporosis or are at risk for osteoporosis, it will help you to know the choices that are out there so that you can choose the right treatment for you.

What is Osteoporosis?
Osteoporosis occurs when your bones lose a certain percentage of their mineral density. It can lead to severe fractures, including those in the hip and spine. These fractures can be very painful and may limit your independence and freedom. Osteoporosis is most common among the elderly and women, though osteoporosis in men and young people can occur. Osteoporosis is a lifelong disease but can be reversed through careful treatment. The causes of osteoporosis are numerous and can include: estrogen loss during menopause, eating disorders, disease, or genetic factors.

Symptoms of Osteoporosis
Osteoporosis is called the "silent epidemic" because it is accompanied by no symptoms. If you are suffering from osteoporosis, you likely will not know about it unless you have been diagnosed by a doctor. Eventually, your bones will become so brittle that you will probably experience a fracture or a break. Commonly, fractures result from everyday falls. Fractures of the spine and hip are very common and consequences of osteoporosis can be severe. 20% of people with osteoporotic spine fractures die within the first year.

How Do Bones Grow?
Our bones are comprised of two major ingredients: minerals (including calcium and phosphorous) and bone cells (consisting of osteoblasts and osteoclasts). Large amounts of calcium and other minerals are laid down during our teenage years, in preparation for adult growth. In order to stay strong and healthy, our bones constantly regenerate themselves. The bone cells work together to reabsorb and then regenerate our bones. Osteoclasts eat away at our bones, while the osteoblasts help to recreate the bones. Our peak bone mass is reached somewhere between the ages of 20 and 30.

After the age of 30, our bones do not regenerate in the same way. For some reason, the osteoclasts begin to eat more bone than the osteoblasts can replace, causing a net loss in bone mass. Most women and men lose about 1% of their bone mass throughout a year - this is part of the natural aging process. However, during menopause women begin to lose much more bone than their male counterparts. If you are a menopausal woman, you will probably lose between 2% and 7% of your bone mass every year. This can cause great health risks, as your bones are susceptible to breaks and fractures.

Osteoporosis and Menopause
Menopause can wreak havoc on your bones. During menopause, estrogen levels in your body drop rapidly. Unfortunately, it seems that estrogen plays an important role in bone health. Estrogen keeps the osteoclasts in check, allowing the osteoblasts to build more bone. Unless the estrogen that you lose is being replaced, your bones can become thin and brittle quite rapidly.
Sometimes these brittle bones can lead to a from of arthritis called gout. Gout can be a very painful condition, so if you are suffering from gout it is important to look for appropriate gout relief.

Osteoporosis Treatment
Your doctor will probably check you for osteoporosis once you enter menopause. In order to do this, he will perform a bone density scan, which measures the amount of minerals in your bones. This determines whether or not you are entering the stages of osteoporosis.

Bone density is measured on a point scale, called a T score. Normal bone density has a T score of 0 to –1. If your T score measures between –1 and –2.5 you will probably be diagnosed with osteopenia, a milder form of osteoporosis. A T score of less than –2.5 indicates osteoporosis. Osteoporosis treatment can be quite effective, especially when taken quickly after diagnosis. A variety of new treatments for osteoporosis have also been introduced into the market.

Calcium Supplements: Calcium is a mineral that is integral to healthy bones and is a natural medication for osteoporosis. If you have mild osteopenia or if your family has a history of osteoporosis, calcium supplements can help reduce your risk of bone fractures. 1000 mg supplements are recommended daily, in addition to a diet rich in calcium.

Calcitonin: Calcitonin is a hormone found naturally in your thyroid. This hormone shrinks your osteoclasts, stopping them from absorbing any bone. Calcitonin may be taken by injection or through a new nasal spray. However, calcitonin is not effective in producing new bone mass.

Estrogen Replacement: Estrogen replacement is the most effective treatment for osteoporosis. Women suffering from osteoporosis or osteopenia can take estrogen in order to prevent further reabsorption of bone and to boost the creation of new bone mass. Estrogen therapy, also an effective treatment for menopause, helps to increase bone mass by at least 5% over two years. At least 5 years of estrogen therapy is recommended to protect against serious fractures, including those of the hip and spine. Once estrogen therapy is stopped, though, its benefits will begin to disappear. Estrogen can be taken orally or transdermally via a patch.

Selective Estrogen Receptor Modulators (SERMS): SERMS work by manipulating estrogen receptors in your body. Estrogen receptors are located in various different parts of your body, including the bones. SERMS block estrogen from working at certain receptors, while increasing their activity at receptors located inside of your bones. This allows new bone mass to be formed.

Biophosphonates: Biophosphonates may be suitable for you if your osteoporosis is accompanied by bone fracture and you cannot take estrogen. Biophosphonates work to reverse osteoporosis by stopping the reabsorption of bone. Biophosphonates enter your bones and prevent osteoclasts from eating the minerals in your bone. Taken daily or weekly, biophosphonates can reduce fractures by up to 70%.

Osteoporosis Prevention
Preventative action is the best way to avoid getting osteoporosis. Osteoporosis at a young age can have severe consequences. Women should be especially concerned about their bone health, and take active measures to keep their bones strong.

Osteoporosis and nutrition are closely linked. Particular attention to diet and exercise should be taken during adolescence and the teen years, and in women, during pregnancy and after menopause. A diet rich in calcium and vitamin D will help your bones stay strong and regenerate effectively. 15 to 20 minutes of sun exposure every day will also help the vitamin D in your body produce healthy bone.

Prevention of osteoporosis and exercise often go hand in hand. Weight bearing exercise, such as swimming or walking, can help strengthen your bones. Ask you doctor for more information on osteoporosis and on preventative measures.

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