More men diagnosed with osteoporosis

Osteoporosis is a common problem among women as they get older. However, men need to know more about the disease as well.

Eighty-five-year-old Bill Dodds is a regular at the fitness center these days and has been, ever since he learned he has a disease without any apparent symptoms.

"Here I am, 85, never knew, never knew, never had a sign that I had osteoporosis, but I'm walking around with it," said Dodds.

Bill Dodds and most other Americans believe that osteoporosis is a woman's disease, but more than 2 million American men have it and many more are at risk.

Dodds does not notice any signs of osteoporosis, and that is not unusual. Very often, people learn they have it after they suffer a debilitating hip or spinal fracture.

Dodds was lucky because his doctor tested him before that happened, and now he is part of a National Institute of Health Study on men and osteoporosis.

"There's a lot that we don't know but I think one of the major problems that men have is that not only they themselves but their physicians don't even recognize it as a threat. And yet, about 25 percent of the cost of fractures in this country are fractures in men," said National Institute of Health's Dr. Joan McGowan.

The N.I.H. has studied 6,000 men over the past seven years and Dr. McGowan believes it will answer a lot of questions.

In the meantime, she says older men and their doctors need to pay attention to warning signs.

"Any fracture in an older person is really a sentinel event. And although an orthopedic surgeon can certainly fix it and they do, it should get attention," said Dr. McGowan.

Men should have a bone density test for starters to identify the problem early.
source:kob.com

More Men Are Being Diagnosed With Osteoporosis

Osteoporosis is a common problem among women as they get older. However, men need to know more about the disease as well.

85-year-old Bill Dodds is a regular at the fitness center these days and has been, ever since he learned he has a disease without any apparent symptoms.

"Here I am, 85, never knew, never knew, never had a sign that I had osteoporosis, but I'm walking around with it," said Dodds.

Bill Dodds and most other Americans believe that osteoporosis is a woman's disease, but more than 2 million American men have it and many more are at risk.

Dodds does not notice any signs of osteoporosis, and that is not unusual.

Very often, people learn they have it after they suffer a debilitating hip or spinal fracture.

Dodds was lucky because his doctor tested him before that happened, and now he is part of a National Institute of Health Study on men and osteoporosis.

"There's a lot that we don't know but I think one of the major problems that men have is that not only they themselves but their physicians don't even recognize it as a threat. And yet, about 25% of the cost of fractures in this country are fractures in men," said National Institute of Health's Dr. Joan McGowan.

The N.I.H. has studied six thousand men over the past seven years and Dr. McGowan believes it will answer a lot of questions.

In the meantime, she says older men and their doctors need to pay attention to warning signs.

"Any fracture in an older person is really a sentinel event. And although an orthopedic surgeon can certainly fix it and they do, it should get attention," said Dr. McGowan.

Men should have a bone density test for starters to identify the problem early.

Then the same strategies that prevent bone damage in women can help men.

"They should have enough calcium and vitamin D. Vitamin D becomes increasingly important as we age and even as we stay more in our offices than outside. And also physical activity because the less active you are, the less your bone perceives they really need to be there," said Dr. McGowan.

Bill Dodds and his son Jeff are learning about osteoporosis together now because they know that a family history raises your risk.

"It would certainly be in my best interest to get screened but the thing is that I know there are many things I could be doing now by eating well, following a healthy diet, and getting regular exercise, that I can do to prevent or stave off this problem of osteoporosis," said Jeff Dodds.

Doctors already have guidelines about when women should be screened for osteoporosis and how to prevent bone damage, but those kinds of recommendations do not yet exist for men.

The National Institutes of Health Study hopes to produce some soon.
source:www.firstcoastnews.com

Men and Osteoporosis-- The Risk is Greater than You May Think

Osteoporosis is a common problem among women as they get older, but men need to know about the disease as well.

85-year-old Bill Dodds is a regular at the fitness center ever since he learned he has a disease without any symptoms.

"Here I am, 85, never knew, never knew, never had a sign that I had osteoporosis, but I'm walking around with it," said Dodds.

Dodds and most other Americans believe osteoporosis is a woman's disease. But more than 2 million American men have it and many more are at risk.

But Dodds was lucky he caught it early before a fracture. Now, he's part of a National Institutes of Health study on men and osteoporosis.

"There's a lot that we don't know, but I think one of the major problems that men have is that not only they themselves but their physicians don't even recognize it as a threat. And yet, about 25 percent of the cost of fractures in this country are fractures in men," explained Dr. Joan McGowan with the National Institutes of Health.

A bone density test can identify the problem early.

McGowan said, "They should have enough calcium and Vitamin D. Vitamin D becomes increasingly important as we age and even as we stay more in our offices than outside."

What else can help? McGowan says, "...physical activity--because the less active you are, the less your bone perceives they really need to be there."

Dodds knows the importance of caring for your bones early in life. He says, "If you don't take care of your bones when you're young, you may not have such good bones later on."
source:www.nbc29.com

Men At Risk for Osteoporosis

Most men believe it is a woman's disease.

However, more than 2-million American men have it and many more are at risk for osteoporosis.

Eighty five year-old Bill Dodds is a regular at the fitness center ever since he learned he had osteoporosis.

Dodds does not notice any signs of osteoporosis, and that is not unusual.

Very often, people learn they have it after they suffer a debilitating hip or spinal fracture.

Dodds was lucky, his doctor tested him before that happened, and now he is part of a National Institute of Health study on men and osteoporosis.

Dr. Joan McGowan of the National Institutes of Health says, "There's a lot that we don't know but I think one of the major problems that men have is that not only they themselves but their physicians don't even recognize it as a threat. And yet, about 25% of the costs of fractures in this country are fractures in men."

Doctors already have guidelines about when women should be screened for osteoporosis, but those kinds of recommendations do not exist for men.

The National Institutes of Health study should produce some, soon.
source:www.wndu.com

Steady intake of vitamin D a must for adults

My 78-year-old father, who lives with me, has been diagnosed with osteopenia, described by his doctor as a mild thinning of the bones -- not as severe as osteoporosis but perhaps the first step toward it.

The doctor told me to try to increase his calcium intake, but then a friend told me that Dad may need more vitamin D. The doctor didn't mention this to me and has not returned my call. Do you know where I could find good information on this?
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A: Based on the information we have found, it appears that your friend is correct. Because vitamin D promotes the absorption of calcium, a vitamin D deficiency contributes to osteoporosis.

According to the National Institutes of Health (NIH), people with vitamin D insufficiency absorb less than 10 percent of available calcium. In other words, even if you have an adequate intake of calcium (which for men and women over 50 is 1,200 mg daily), you might not absorb it effectively if you have low levels of vitamin D.

Vitamin D deficiency is most often seen in post-menopausal women and older adults. (It's estimated that as many as 30 to 40 percent of older adults with hip fractures are vitamin D insufficient. The insufficiency rate is especially high among the elderly living in nursing homes.)

While most people know that women are at risk for osteoporosis, only 39 percent of Americans believe the same to be true for men, according to a recent study brought to our attention by Tropicana, the orange juice maker that sells calcium enriched juices. But 20 percent of those affected by osteoporosis are men. So while your Dad doesn't yet have osteoporosis, he could be at risk for the disease, defined as having low bone density and therefore having bones that are prone to shatter.

How much vitamin D is enough? At the moment, most medical authorities say that average adults need 200 IU (International Units) of vitamin D daily, while adults over age 50 need 400 IU and people over 70 years of age need 600 IU daily. (The upper safe level of vitamin D, according to Dr. Mark Andon, director of nutrition for Tropicana, is 2,000 IU daily.)

How does one get an adequate amount of vitamin D? Sunshine is a significant source, and 10 to 15 minutes of sun exposure at least twice a week to the face, arms, hands or back is usually sufficient to provide adequate vitamin D, says the NIH. But if you slather on sunscreen with a sun protection factor (SPF) of 8 or greater to block the sun's UV rays -- and this is very important to protect against skin cancer -- the ability of the body to synthesize the rays into vitamin D is blocked. So, if you choose the sun route to get enough vitamin D, follow the 10 to 15 minutes of sun exposure with a sunscreen of at least 15 SPF to protect yourself from the sun's negative effects.

Something else to know about the sun and vitamin D: As we age and our skin thins, our body's ability to make vitamin D from sunlight decreases, says Dr. Andon. He adds that people living in northern climes will not be able to get as much vitamin D from exposure to the sun as, say, people living near the equator.

So, how else to obtain vitamin D? There are food sources, such as fortified orange juice, cod liver oil, fatty fish (salmon, tuna, mackerel and sardines), fortified milk and fortified breakfast food products such as yogurt and cereal. But it's often difficult to obtain enough vitamin D from natural food sources. So vitamin D supplements, which you can buy over the counter at pharmacies, health food stores, and supermarkets, are often recommended.

One final note: NIH warns that high caffeine intake (defined as more than 300 mg per day of caffeine, equivalent to approximately 18 ounces of caffeinated coffee) may accelerate bone loss, because caffeine is thought to inhibit vitamin D receptors.

A new study released earlier this month out of Creighton University indicates that high amounts of vitamin D may well reduce the risk of several types of cancer for older women by 60 percent. The amount of vitamin D used in the study was 1,000 IU daily, and more studies are needed to determine whether the study holds true for large groups of men as well as women, researchers say. Still, the study results are considered significant.
source:www.post-gazette.com

Actress takes a lesson, shares another

The two-time Academy Award winner was at Mid Pines Inn & Golf Club on Saturday afternoon speaking about osteoporosis.

Earlier in the day, she received her first golf lesson from Pine Needles matriarch Peggy Kirk Bell and renowned instructor Dana Rader of Charlotte.

“It was fabulous,” Field said.

A witness to her lessons added: “She hit them far ... and they got air.”

Field was visiting the Sandhills to talk about something she is much more knowledgeable about: “Rally With Sally for Bone Health.”

She spoke along with Dr. Robert Littleton, a Raleigh doctor who gave information and tips on how women can improve their bone health.

Field, who is 60, was diagnosed with osteoporosis more than a year ago. She emphasized to her mostly women audience the importance of asking your doctor to schedule bone-density tests.

“If the doctor doesn’t want to give it, get another doctor,” Field said.

She said that because of her age, petite body, family history and race, she was a prime candidate for the disease. However, she still was surprised when her family practitioner told her she was at risk of easily fracturing a bone if she did not get treatment.

Now, she said, with the aid of medication, she has stopped the progression.

Field also is the spokeswoman for the osteoporosis drug Boniva.

Osteoporosis threatens more than 44 million Americans age 50 and older. It is estimated that 10 million people have the disease and that nearly 34 million more have low bone mass, a condition that puts them at increased risk for osteoporosis
source:www.fayobserver.com

Vitamin D: Sun exposure no guarantee

NEW YORK: In many people, vitamin D levels can remain low despite abundant exposure to sunlight, research shows.

Inadequate Sun exposure is often blamed for the high prevalence of low vitamin D status, the authors explain, but the truth of this has been unclear.

Dr Neil Binkley with the University of Wisconsin Osteoporosis Clinical Research Program, Madison, and colleagues investigated the vitamin D status of people living in Sun-drenched Hawaii.

Despite this abundant Sun exposure, 51% of these individuals were found to have low vitamin D levels, the researchers found. “This implies that the common recommendation to allow Sun exposure for 15 minutes may not ensure vitamin D sufficiency,” Binkley said.
source:timesofindia.indiatimes.com

Only elderly people get osteoporosis? I was just 22

A Co Antrim man diagnosed with osteoporosis at the age of 22 has spoken out about his debilitating condition - in a bid to debunk the myth that only elderly ladies are affected.

Ian Scroggy, from Carnlough, urged people not to risk their health by falling into the trap of thinking they are the wrong age or gender to develop the chronic bone disease.

And the 35-year-old urged anyone who might be at risk of the disease to ask their GP for testing.

"It's known as a silent disease because it's usually too late by the time someone realises they have it," he said.

"The earlier the diagnosis, the better it is for getting the right treatment to try to stop progression."

Mr Scroggy, a horticulturalist, was diagnosed with osteoporosis after falling while working in an orchard in New Zealand. He was sent for a scan which showed up the condition.

He returned to Northern Ireland when he recovered from his fall and has since been diagnosed with fibromyalgia as well.

Mr Scroggy managed a garden centre until he was forced to retire because of his ill health. He now occasionally helps out at his parents' garden business.

"When I was diagnosed, I had never heard of osteoporosis. I didn't really know where to turn when I came home as support services here are practically non-existent," Mr Scroggy said.

Osteoporosis affects half of women and one in five men in the UK over the age of 50 and is a painful and debilitating condition which affects the bones.

June is National Osteoporosis Month and this year the National Osteoporosis Society (NOS) has been raising awareness of the disease among men.

People at risk include smokers, heavy drinkers, people with a low body weight or family history of osteoporosis, any condition which leaves you immobile for long periods of time, or those taking high level of corticosteroid tablets for conditions such as asthma and arthritis.
source:www.belfasttelegraph.co.uk

Bisphosphonates for osteoporosis treatment in women

A class of drugs called bisphosphonates has become the new mainstay treatment for postmenopausal women diagnosed with osteoporosis in the post-hormone-replacement era.

Taking just one pill a week, or even one a month, may prevent, slow or stop the breakdown and progress of this bone-thinning condition, according to the May issue of Mayo Clinic Women's HealthSource.

An estimated 10 million Americans, mostly women, have osteoporosis, where bones become weak and highly prone to fractures. Millions more have low bone density (osteopenia), which can increase the risk of fractures.

Bone -- a living tissue -- is constantly remodeling, with old bone breaking down and new bone replacing it. Bisphosphonates work by slowing the breakdown and reabsorption of old bone, an ongoing process that accelerates as estrogen levels fall during the first few years after menopause. By slowing the process, bisphosphonates help preserve bone density and reduce the risk of fractures.

Estrogen once was commonly prescribed to reduce bone loss. But when the landmark Women's Health Initiative Study, released in 2002, showed that long-term estrogen use increased the risk of breast cancer, heart attacks, strokes and blood clots, hormone therapy fell out of favor.

Bisphosphonates have filled the void and perform as well as estrogen in preventing bone loss. Bisphosphonates available to treat osteoporosis include alendronate (Fosamax), ibandronate (Boniva) and risedronate (Actonel).

Patients should talk with a doctor about the best ways to prevent and treat osteoporosis. Bisphosphonates have potential side effects, most commonly heartburn and abdominal pain caused by irritation of the esophagus or stomach. Even when taking medications, patients should take steps to protect bones, including consuming adequate calcium and vitamin D; engaging in regular weight-bearing exercise such as walking and weight training; and avoiding smoking and excessive use of alcohol.
source:www.news-medical.net

Osteoporosis and Paget's Disease Drug Database

Osteoporosis and Paget's Disease Drug Database


Osteoporosis is a common condition in the United States. In simple terms, osteoporosis is a weakening of the bones whereby they become brittle and easily fractured.

Osteoporosis mostly affects post-menopausal Caucasian women although all women can be affected. Osteoporosis is less common in men than in women.

There are conflicting theories about what causes osteoporosis. It is known that the chronic administration of certain drugs, such as corticosteroids like prednisone, may increase a person's risk of developing osteoporosis.

If you are a woman taking prednisone or any steroid medication (including inhaled steroids for asthma or COPD) it is important that you get extra calcium in your diet. Most experts agree that a woman of child-bearing age should ingest 1,000 mg - 1,500 mg of calcium per day to reduce the risk of developing osteoporosis. If you already have osteoporosis it is unlikely that ingesting lots of calcium will reverse the disease.

Paget's disease is similar to osteoporosis in that it is characterized by a weakening of the bones. Paget's disease is a metabolic condition that causes bone cells to become weaker and have more blood vessels than normal bone. In Paget's disease the bone's structure is irregular which makes it prone to fracture even after a minor injury.
source:www.coreynahman.com

Osteoporosis

What is osteoporosis?

Osteoporosis is a disease that causes very weak bones that break easily. Women are five times more likely to get osteoporosis than men. There is no way to stop or cure it, but there are things you can do to it slow down.
What causes osteoporosis?

* It can run in families
* Not enough calcium and vitamin D in the diet
* Not getting enough exercise
* Women who’ve gone through menopause are more likely to have it.

Who is at risk for osteoporosis?

Anyone can get osteoporosis, but some people have a higher chance than others:

* Women
* People with a thin, small frame
* Others in your family have had a lot of broken bones or a stooped posture
* Went through menopause before age 45.
* Have or had an eating disorder.
* People over age 50.
* People who have used certain medicines for a long time, like:
o Some hormones.
o Medicines for seizure.
o Some medicines for asthma, arthritis, or cancer.

How do I know if I have osteoporosis?

* There are tests that use either x-rays or sound waves to measure bone density.
* Ask your doctor about which test you might need.

How can I lower my chances of getting osteoporosis?

* Get enough calcium. Women under 50 years old need at least 1,000 mg of calcium each day. Women over 50 need at least 1,200 mg of calcium.
* Get enough vitamin D. Women under 50 years old need at least 200 IU of vitamin D. Women over 50 need at least 400 IU of vitamin D.
* Get exercise everyday, like walking or biking.
* Don’t smoke.
* If you drink alcohol, don’t drink more than one glass per day.

How can I make sure I have the right diet?

Read the food label to make sure you are eating the right foods.

* Eat foods that have calcium
o Low-fat dairy products like milk, cheese, and yogurt
o Green, leafy vegetables like kale and turnip greens
o Tofu
o Canned fish (eaten with bones)
o Orange juice, cereal, and other foods that have calcium added
source:www.fda.gov

osteoporosis

A group of diseases characterized by a reduction in bone mass due to bone reabsorption outpacing bone deposition. The disease is usually associated with loss of weight. Other symptoms include feelings of lassitude, bone pains, and acute back pain. However, the most harmful effect of the disease is that bone becomes porous, brittle, and inclined to fracture. Over 250 000 Americans, most of them elderly, fall and break their hips each year, resulting in a $10 billion medical bill. Worldwide, the disease affects 1.7 million people each year. The number is expected to grow to over 6 million a year by 2050. A quarter of these people are expected to die within six months because of complications, usually linked to hip fractures.

Osteoporosis is an age-related disease, primarily affecting post-menopausal women, although it can occur much earlier in life (figure 47). There is always some degree of bone weakening with age, but insufficient exercise and a low calcium diet (especially in early life) may exacerbate this. Excessive exercising and weight-loss dieting are also linked with development of the disease. Development of the disease may be determined to some extent by a single gene. A gene affecting Vitamin D metabolism has been found in Australians which may be responsible for more than 75 per cent of the genetic variation in their bone density. If this gene occurs in a broader population, it may not be long before genetic screening can be used to identify those who are predisposed to the disease, so that preventative measures can be taken.
Physical exercise reduces the risk of osteoporosis. Moderate weight-bearing exercises, such as leisurely cycling, dancing, walking, and tennis, stimulate the deposition of calcium, strengthen bones, and reduce the risk of osteoporosis. However, young people benefit most from exercise; strong and healthy bones are more easily established in adolescents and young adults. A modest amount of jumping (as little as 50 jumps a day) can increase the density of hips in premenopausal women by as much as 3 per cent. Although exercise may offer some protection against acquiring the disease, those already suffering from osteoporosis should avoid contact sports and exercise that put undue stress on bones and joints. In particular, flexion exercises of the spine (e.g. sit ups) should be avoided because of the risk of vertebral fractures. Swimming is an especially good exercise for those with the disease.

Slightly overweight post-menopausal women are less likely to suffer from brittle bones than slim women. Possible reasons are that fat acts as a protective cushion; bones of plump women may be heavier and stronger; and the extra fat of plumper women enables them to produce more oestrogen which offers some protection against demineralization of bones.

A diet that includes a good intake of calcium-rich food (e.g. milk, yogurt, and cheese) may help prevent and minimize problems associated with this disease. It appears that it is particularly important for pre-menopausal women to have adequate calcium intakes so that they can achieve maximum peak bone densities. At present, the UK Reference Nutrient Intake is thought by The National Osteoporosis Society (UK) to be too low. They recommend the following calcium intakes:
• children 7-12 years 800 mg per day
• teenagers/adults 1000 mg per day
• women over 45 (not on HRT) 1500 mg per day
• women over 45 (on HRT) 1000 mg per day
• pregnant and lactating teenagers 1500 mg per day
• pregnant and lactating adults 1200 mg per day
• men over 45 years 1500 mg per day


Some doctors believe that the best way to prevent osteoporosis in post-menopausal women is hormone replacement therapy (see menopause), but this treatment is not suitable for all women. See also amenorrhoea and parathyroid hormone.
source:/www.answers.com

Osteoporosis

Osteoporosis makes your bones weak and more likely to break. Anyone can develop osteoporosis, but it is common in older women. As many as half of all women and a quarter of men older than 50 will break a bone due to osteoporosis.

Risk factors include

* Getting older
* Being small and thin
* Having a family history of osteoporosis
* Taking certain medicines
* Being a white or Asian woman
* Having osteopenia, which is low bone mass

Osteoporosis is a silent disease. You might not know you have it until you break a bone. A bone mineral density test is the best way to check your bone health. To keep bones strong, eat a diet rich in calcium and vitamin D, exercise and do not smoke. If needed, medicines can also help.
source:www.nlm.nih.gov

Osteoporosis

Pathogenesis

The underlying mechanism in all cases of osteoporosis is an imbalance between bone resorption and bone formation. Either bone resorption is excessive, and/or bone formation is diminished. Bone matrix is manufactured by the osteoblast cells, whereas bone resorption is accomplished by osteoclast cells. The mechanisms influencing the formation of the disease are complex. Most cases do not result from inadequate calcium intake, but include other factors affecting bone matrix formation and reabsorption. These include: (1) cigarette smoking, which inhibits the activity of osteoblasts; (2) sedentary lifestyle with little weight bearing exercise, such as walking; (3) a family history of osteoporosis; and being age 30 or older. Trabecular bone is the sponge-like bone in the center of long bones and vertebrae. Cortical bone is the hard outer shell of bones. Because osteoblasts and osteoclasts inhabit the surface of bones, trabecular bone is more active, more subject to bone turnover, to remodeling. Long before any overt fractures occur, the small spicules of trabecular bone break and are reformed in the process known as remodeling. Bone will grow and change shape in response to physical stress. The bony prominences and attachments in runners are different in shape and size than those in weightlifters. It is an accumulation of fractures in trabecular bone that are incompletely repaired that leads to the manifestation of osteoporosis. Common osteoporotic fracture sites, the wrist, the hip and the spine, have a relatively high trabecular bone to cortical bone ratio. These areas rely on trabecular bone for strength.

Low peak bone mass is important in the development of osteoporosis. Bone mass peaks in both men and women between the ages of 25 and 35, thereafter diminishing. Achieving a higher peak bone mass through exercise and proper nutrition during adolescence is important for the prevention of osteoporosis.

Bone remodeling is heavily influenced by nutritional and hormonal factors. Calcium and vitamin D are nutrients required for normal bone growth. Parathyroid hormone regulates the mineral composition of bone, with higher levels causing resorption of calcium and bone. Glucocorticoid hormones cause osteoclast activity to increase, causing bone resorption. Calcitonin, estrogen and testosterone increase osteoblast activity, causing bone growth. The loss of estrogen following menopause causes a phase of rapid bone loss. Similarly, testosterone levels in men diminish with advancing age and are related to male osteoporosis. In addition to estrogen, follicle-stimulating hormone (FSH) affects BMD. In mice, lower levels of FSH mean less resorption by osteoclasts.[5]

Those who suffer certain auto-immune and inflammatory disorders are prone to have a higher level of cytokines in the body. The presence of these proteins increase the body's inflammatory response which may upset the process of the osteoblast and osteoclast cycle.

Physical activity causes bone remodeling. People who remain physically active throughout life have a lower risk of osteoporosis. Conversely, people who are bedridden are at a significantly increased risk. Physical activity has its greatest impact during adolescence, affecting peak bone mass most. In adults, physical activity helps maintain bone mass, and can increase it by 1 or 2%. However, excessive exercise can lead to constant damages to the bones which can cause exhaustion of the structures as described above. There are numerous examples of marathon runners who developed severe osteoporosis later in life.

Lastly, osteoporosis on its own would not be a significant disease, were it not for the falls which precipitate fractures. Age-related sarcopenia, or loss of muscle mass, loss of balance and dementia contribute greatly to the increased fracture risk in patients with osteoporosis. Physical fitness in later life is associated more with a decreased risk of falling than with an increased bone mineral density.

[edit] Epidemiology

[edit] Disease burden

It is estimated that 1 in 3 women and 1 in 12 men over the age of 50 worldwide have osteoporosis. It is responsible for millions of fractures annually, mostly involving the lumbar vertebrae, hip, and wrist. Fragility fractures of ribs are also common in men.

[edit] Natural history

Today, many cases of osteoporosis in developed countries are diagnosed before symptoms develop. This is due to widespread screening for osteoporosis using the DXA scan. With treatment, bone mineral density increases, and fracture risk decreases.

In the absence of treatment, overt osteoporosis is heralded by a fracture. Some fractures, like vertebral compression fractures or sacral insufficiency fractures, may not be apparent at first, appearing to patient and physician as a very bad back ache or completely without symptoms. Hip fractures and wrist fractures are more obvious.

Hip fractures are responsible for the most serious consequences of osteoporosis. In the United States, osteoporosis causes a predisposition to more than 250,000 hip fractures yearly. It is estimated that a 50-year-old white woman has a 17.5% lifetime risk of fracture of the proximal femur. The incidence of hip fractures increases each decade from the sixth through the ninth for both women and men for all populations. The highest incidence is found among those men and women ages 80 or older.

An estimated 700,000 women have a first vertebral fracture each year. The lifetime risk of a clinically detected symptomatic vertebral fracture is about 15% in a 50-year-old white woman. However, because symptoms are often overlooked or thought to be a normal part of getting older, it is believed that only about one-third of vertebral compression fractures are actually diagnosed.

Distal radius fractures, usually of the Colles type, are the third most common type of osteoporotic fractures. In the United States, the total annual number of Colles' fractures is about 250,000. The lifetime risk of sustaining a Colles' fracture is about 16% for white women. By the time women reach age 70, about 20% have had at least one wrist fracture.
source:en.wikipedia.org

Osteoporosis

Osteoporosis is a disease of bone in which the bone mineral density (BMD) is reduced, bone microarchitecture is disrupted, and the amount and variety of non-collagenous proteins in bone is altered. Osteoporotic bones are more at risk of fracture. Osteoporosis is defined by the World Health Organization (WHO) in women as a bone mineral density 2.5 standard deviations below peak bone mass (20-year-old sex-matched healthy person average) as measured by DXA; the term "established osteoporosis" includes the presence of a fragility fracture. While treatment modalities are becoming available (such as the bisphosphonates), prevention is still considered the most important way to reduce fracture. Due to its hormonal component, more women, particularly after menopause, suffer from osteoporosis than men. In addition it may be caused by various hormonal conditions, smoking and medications (specifically glucocorticoids) as well as many chronic diseases.
Risk factors

Risk factors for osteoporotic fracture can be split between modifiable and non-modifiable:

* Nonmodifiable: history of fracture as an adult, family history of fracture, female sex, advanced age, European or Asian ancestry, and dementia
* Potentially modifiable: prolonged intake of the prescription drug prednisone or any other glucocortioid, tobacco smoking, low body mass index, estrogen deficiency, early menopause (<45 years) or bilateral oophorectomy, premature ovarian failure, prolonged premenopausal amenorrhea (>1 year), low calcium and vitamin D intake, alcoholism, impaired eyesight despite adequate correction, high risk of falls or recurrent falls, inappropriate physical activity (i.e. too little or also if done in excess), poor health/frailty. Coeliac disease can lead those with an otherwise adequate calcium intake to develop osteoperosis due to the inability to absorb calcium. Osteoporotic fracture may indeed be the event that leads to diagnosis that coeliac disease (which affects around one in a hundred people in the West) has affected the patient for many years. The effects of soft drinks (containing phosphoric acid) are debatable; soft drinks may merely displace calcium-containing drinks from the diet.

A strong association between cadmium, lead and bone disease has also been established. Low level exposure to cadmium is associated with an increased loss of bone mineral density readily in both genders, leading to pain and increased risk of fractures, especially in elderly and in females. Higher cadmium exposure results in osteomalacia (softening of the bone).[1][2][3] An association with proton pump inhibitors has also been found: it is thought that reducing the level of stomach acid interferes with calcium absorption.[4]

[edit] Etiology

Family history of fracture or low bone mass are probably the most important etiological factors of primary osteoporosis. The heritability of the fracture as well as low BMD are relatively high, ranging from 25 to 80 percent. Estrogen deficiency following menopause is correlated with a rapid reduction in BMD. This, plus the increased risk of falling associated with aging, leads to fractures of the wrist, spine and hip. Other hormone deficiency states can lead to osteoporosis, such as testosterone deficiency. Glucocorticoid or thyroxine excess states also lead to osteoporosis. Lastly, calcium and/or vitamin D deficiency from malnutrition increases the risk of osteoporosis.

Other significant factors leading to the onset of osteoporosis include smoking cigarettes, low levels of physical activity (weight bearing exercise), and family history. Osteoporosis can be thought of as analogous to sarcopenia, which is the age-related loss of skeletal muscle. The combination of sarcopenia and osteoporosis results in the significant frailty often seen in the elderly population.

List of disorders associated with osteoporosis:

* Hypogonadal states - Turner syndrome, Klinefelter syndrome, Kallmann syndrome, anorexia nervosa, hypothalamic amenorrhea, hyperprolactinemia
* Other endocrine disorders - Cushing's syndrome, hyperparathyroidism, thyrotoxicosis, hypothyroidism, insulin-dependent diabetes mellitus, acromegaly, adrenal insufficiency
* Nutritional and gastrointestinal disorders - malnutrition, parenteral nutrition, malabsorption syndromes (e.g. coeliac disease, Crohn's disease), gastrectomy, severe liver disease (especially primary biliary cirrhosis)
* Rheumatologic disorders - rheumatoid arthritis, ankylosing spondylitis
* Hematologic disorders/malignancy - multiple myeloma, lymphoma and leukemia, mastocytosis, hemophilia, thalassemia.
* Inherited disorders - osteogenesis imperfecta, Marfan syndrome, hemochromatosis, hypophosphatasia, glycogen storage diseases, homocystinuria, Ehlers-Danlos syndrome, porphyria, Menkes' syndrome, epidermolysis bullosa, Gaucher's disease.
* Medication:
o Steroid-induced osteoporosis (SIOP) due to use of glucocorticoids - analogous to Cushing's syndrome and involving mainly the axial skeleton
o Barbiturates (due to accelerated metabolism of vitamin D) and some other antiepileptics
* Other disorders - immobilization, scoliosis
source:en.wikipedia.org

Osteoporosis

Definition

The word osteoporosis literally means "porous bones." It occurs when bones lose an excessive amount of their protein and mineral content, particularly calcium. Over time, bone mass, and therefore bone strength, is decreased. As a result, bones become fragile and break easily. Even a sneeze or a sudden movement may be enough to break a bone in someone with severe osteoporosis.

Description

Osteoporosis is a serious public health problem. Some 28 million people in the United States are affected by this potentially debilitating disease, which is responsible for 1.5 million fractures (broken bones) annually. These fractures, which are often the first sign of the disease, can affect any bone, but the most common locations are the hip, spine, and wrist. Breaks in the hip and spine are of special concern because they almost always require hospitalization and major surgery, and may lead to other serious consequences, including permanent disability and even death.

To understand osteoporosis, it is helpful to understand the basics of bone formation. Bone is living tissue that's constantly being renewed in a two-stage process (resorption and formation) that occurs throughout life. In the resorption stage, old bone is broken down and removed by cells called osteoclasts. In the formation stage, cells called osteoblasts build new bone to replace the old. During childhood and early adulthood, more bone is produced than removed, reaching its maximum mass and strength by the mid-30s. After that, bone is lost at a faster pace than it's formed, so the amount of bone in the skeleton begins to slowly decline. Most cases of osteoporosis occur as an acceleration of this normal aging process. That's referred to as primary osteoporosis. The condition can also be caused by other disease processes or prolonged use of certain medications that result in bone loss—if so, it's called secondary osteoporosis.

Osteoporosis occurs most often in older people and in women after menopause. It affects nearly half of all those, men and women, over the age of 75. Women, however, are five times more likely than men to develop the disease. They have smaller, thinner bones than men to begin with, and they lose bone mass more rapidly after menopause (usually around age 50), when they stop producing a bone-protecting hormone called estrogen. In the five to seven years following menopause, women can lose about 20% of their bone mass. By age 65 or 70, though, men and women lose bone mass at the same rate. As an increasing number of men reach an older age, there's more awareness that osteoporosis is an important health issue for them as well.

Causes and symptoms

A number of factors increase the risk of developing osteoporosis. They include:

* Age. Osteoporosis is more likely as people grow older and their bones lose tissue.
* Gender. Women are more likely to have osteoporosis because they are smaller and so start out with less bone. They also lose bone tissue more rapidly as they age. While women commonly lose 30–50% of their bone mass over their lifetimes, men lose only 20–33% of theirs.
* Race. Caucasian and Asian women are most at risk for the disease, but African American and Hispanic women can get it too.
* Figure type. Women with small bones and those who are thin are more liable to have osteoporosis.
* Early menopause. Women who stop menstruating early because of heredity, surgery or lots of physical exercise may lose large amounts of bone tissue early in life. Conditions such as anorexia and bulimia may also lead to early menopause and osteoporosis.
* Lifestyle. People who smoke or drink too much, or don't get enough exercise have an increased chance of getting osteoporosis.
* Diet. Those who don't get enough calcium or protein may be more likely to have osteoporosis. That's why people who constantly diet are more prone to the disease.

Osteoporosis is often called the "silent" disease, because bone loss occurs without symptoms. People often don't know they have the disease until a bone breaks, frequently in a minor fall that wouldn't normally cause a fracture. A common occurrence is compression fractures of the spine. These can happen even after a seemingly normal activity, such as bending or twisting to pick up a light object. The fractures can cause severe back pain, but sometimes they go unnoticed—either way, the vertebrae collapse down on themselves, and the person actually loses height. The hunchback appearance of many elderly women, sometimes called "dowager's" hump or "widow's" hump, is due to this effect of osteoporosis on the vertebrae.

Diagnosis

Certain types of doctors may have more training and experience than others in diagnosing and treating people with osteoporosis. These include a geriatrician, who specializes in treating the aged; an endocrinologist, who specializes in treating diseases of the body's endocrine system (glands and hormones); and an orthopedic surgeon, who treats fractures, such as those caused by osteoporosis.

Before making a diagnosis of osteoporosis, the doctor usually takes a complete medical history, conducts a physical exam, and orders x rays, as well as blood and urine tests, to rule out other diseases that cause loss of bone mass. The doctor may also recommend a bone density test. This is the only way to know for certain if osteoporosis is present. It can also show how far the disease has progressed.

Several diagnostic tools are available to measure the density of a bone. The ordinary x ray is one, though it's the least accurate for early detection of osteoporosis, because it doesn't reveal bone loss until the disease is advanced and most of the damage has already been done. Two other tools that are more likely to catch osteoporosis at an early stage are computed tomography scans (CT scans) and machines called densitometers, which are designed specifically to measure bone density.

The CT scan, which takes a large number of x rays of the same spot from different angles, is an accurate test, but uses higher levels of radiation than other methods. The most accurate and advanced of the densitometers uses a technique called DEXA (dual energy x-ray absorptiometry). With the DEXA scan, a double x-ray beam takes pictures of the spine, hip, or entire body. It takes about 20 minutes to do, is painless, and exposes the patient to only a small amount of radiation—about one-fiftieth that of a chest x ray.

Doctors don't routinely recommend the test, partly because access to densitometers is still not widely available. People should talk to their doctors about their risk factors for osteoporosis and if, and when, they should get the test. Ideally, women should have bone density measured at menopause, and periodically afterward, depending on the condition of their bones. Men should be tested around age 65. Men and women with additional risk factors, such as those who take certain medications, may need to be tested earlier.
source:www.answers.com

Osteoporosis Center

Osteoporosis is a very common condition that increases with age and is more common in women than men. It is characterized by a gradual loss of bone density due to minerals leaving the bone matrix. Osteoporosis dramatically increases the risk of bone fractures and can lead to compression of the spine. Many factors are thought to increase the risk of bone loss or ?thinning of the bones?. Dietary and lifestyle factors such as smoking, excessive alcohol consumption, high animal protein intake, inadequate calcium, too much phosphorus, and lack of exercise are all contributors. Genetics and race seem to also play a key role as to who may be more likely to develop this debilitating disease.

Conventional medical treatment for osteoporosis in women centers mainly on hormone-replacement therapy, however recent concern about the increased risk of breast cancer has caused many women to rethink the use of this therapy. This concern has lead the medical field to look more closely at nutrition as an additional modality of treatment. There is good evidence that calcium supplements may be able to slow the progression of osteoporosis. A combination of calcium, vitamin D, and magnesium may be able to produce even better effects. Calcium supplements also help adolescent girls reduce their risk of developing osteoporosis later in life. Additional supplements such as ipriflavone, which seems to stimulate bone mineralization, and various trace minerals such as zinc, copper, boron, and manganese are also useful in ensuring good bone health. Soy isoflavones and red clover extract may also be helpful. Essential fatty acids, such as fish oil and GLA from evening primrose oil, may also enhance the effectiveness of calcium.

Helping the body maintain proper bone density is important. Optimal bone health may best be achieved by combining healthy lifestyle choices of proper diet and regular exercise with appropriate nutrient supplementation. By utilizing conventional medical treatments along with a comprehensive nutritional support program for healthy bones, we can prevent or reduce the severity of this debilitating disease.
source:www.drmamae.com