Concerning Osteoporosis

Osteoporosis is a major health problem that affects more than 25 million Americans. Persons with osteoporosis suffer from a loss in bone mass and bone strength. Their bones become weak and brittle which makes them more prone to fracture. Any bone can be affected by osteoporosis, but the hips, wrists, and spine are the most common sites. Peak bone mass is reached between the ages of 25 and 35 years. After 35, everyone's bones lose density.

The actual causes of osteoporosis are unknown. Certain risk factors, however, increase the likelihood of developing osteoporosis.

Women are four times more likely to develop osteoporosis than men. The reasons are as follows:

* Their bones are generally thinner and lighter.
* They live longer than men.
* They have rapid bone loss at menopause due to a sharp decline of estrogen. (The risk also increases for women who experience menopause before age 45 naturally or as a result of surgery which removes the ovaries, and for women who experience a lack of or irregular menstrual flow).

Risk factors for women and men are:

* Having a thin, small framed body.
* Race - Caucasians and Asians are at a higher risk than African Americans.
* Having red or blond hair or freckles may also increase the risk.
* Lack of physical activity especially activities such as walking, running, tennis, and other weight-bearing exercises.
* Lack of calcium - adequate calcium intake throughout life helps to insure that calcium deficiency does not contribute to a weakening of bone mass.
* Heredity - the risk increases if there is a history of osteoporosis and/or bone fractures in your family.
* Smoking cigarettes.
* Alcohol - regularly consuming alcoholic beverages, even as little as two to three ounces per day, may be damaging to bones. Heavy drinkers often have poor nutrition and may be more prone to fractures because of their predisposition to falls.
* Taking certain medications, such as corticosteroids (anti-inflammatory medicines used to treat a variety of conditions such as asthma, arthritis, lupus, etc.) can lead to bone tissue loss. Some anti-seizure medicines and inappropriate overuse of thyroid hormones may also increase the risk.
* Other disorders such as hyperthyroidism, hyperparathyroidism, and certain forms of bone cancer can also increase the risk.


Prevention
To prevent or slow osteoporosis, take these steps now:

* Be sure to eat a balanced diet including adequate daily intakes of calcium. The National Osteoporosis Foundation recommends 1,000 milligrams a day for adults, and 1,500 milligrams a day for women who are not on hormone replacement therapy. The Recommended Dietary Allowance (RDA) is 800 milligrams a day for adults over 24 years of age.

Other age groups should get the following RDAs:
Birth-6 months - 400 mg calcium a day.

6 months-1 year - 600 mg calcium a day.

1-10 years - 800 mg calcium a day.

11-24 years - 1200 mg calcium a day.

To get your recommended calcium:

* Choose high calcium foods daily.
o Skim and low-fat milks, yogurts, and cheeses. [Note: If you are lactose intolerant, you may need to use dairy products that are treated with the enzyme lactase or you can add this enzyme using over-the-counter drops or tablets.]
o Soft-boned fish and shellfish such as salmon, sardines or shrimp.
o Vegetables, especially broccoli, kale or collards.
o Beans and bean sprouts as well as tofu (soy bean curd, if processed with calcium).
o Calcium-fortified foods such as some orange juices, apple juices, and ready to eat cereals.
o Check with your doctor about taking calcium supplements if necessary.
* Follow a program of regular, weight-bearing exercise at least three or four times a week. Examples include walking, jogging, low-impact or non-impact aerobics.
* Do not smoke. Smoking makes osteoporosis worse and may negate the beneficial effects of estrogen replacement therapy.
* Limit alcohol consumption.
* Check with your doctor regarding medical management to prevent and treat osteoporosis especially if you are at a high risk for getting the disorder. He or she may prescribe hormone replacement therapy (HRT), if you are female.
* This can prevent fractures from osteoporosis if started during or soon after menopause and taken for several years. There are risks with ERT, though, so you need to check with your doctor to see how they apply to you.


Signs and Symptoms
Osteoporosis is a "silent disease" because it can progress without any noticeable signs or symptoms. Often the first sign is when a bone fracture occurs. Symptoms include:

* A gradual loss of height.
* A rounding of the shoulders.
* Gum inflammation and loosening of the teeth.
* Acute lower backache.
* Swelling of a wrist after a fall.


Treatment and Care
Medical tests, such as the dual energy X-ray, absorptiometry (DEXA), and densitometry can measure bone mass in various sites of the body. They are safe and painless. These tests can help doctors decide if and what kind of treatment is needed. Treatment for osteoporosis includes:

* Dietary measures: A balanced diet rich in calcium and calcium supplementation if necessary.
* Daily exercises approved by your doctor.
* Fall prevention strategies.
o Use grab bars and safety mats or non-skid tape on your tub or shower.
o Use handrails on stairways.
o Don't stoop to pick up things. Pick things up by bending your knees and keeping your back straight.
o Wear flat, sturdy, non-skid shoes.
o If you use throw rugs, make sure they have non-skid backs.
o Use a cane or walker if necessary.
o See that halls, stairways and entrances are well lit. Use night lights in hallways, bathrooms, etc.
* Proper posture.
* Medication therapy - two medicines have been approved by the Food & Drug Administration (FDA) to treat osteoporosis. They are estrogen replacement therapy and calcitonin.
* Surgery (such as hip replacement), if necessary.