about the osteoporosis

3.  Osteoporosis means "porous bones," causes
bones to become weak and brittle – so brittle
that even mild stresses like bending over,
lifting a vacuum cleaner or coughing can
cause a fracture.
 In most cases, bones weaken when low levels
of calcium, phosphorus and other minerals in
the bones and results as low bone density.
 A common result of osteoporosis is fractures
of the spine, hip or wrist.
 Although it's often thought of as a women's
disease, osteoporosis also affects many men.

4. SYMPTOMS
 Back pain, which can be severe if fractured or
collapsed vertebra
 Loss of height over time, with an
accompanying stooped posture
 Fracture of the vertebrae, wrists, hips or other
bones

5. Normal bone has the appearance of a honeycomb
matrix (left). Under a microscope, osteoporotic
bone (right) looks more porous.

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

7. The process of bone remodeling
 Scientists have yet to learn all the reasons why
this occurs, but the process involves how bone
is made. Bone is continuously changing —
new bone is made and old bone is broken
down — a process called remodeling, or bone
turnover.
 A full cycle of bone remodeling takes about 2-
3 months.
 In young – the body makes new bone faster
than it breaks down old bone, and the bone
mass increases.

8.  Reaches the peak bone mass in mid-30s.
 After that, bone remodeling continues, but
loses slightly more than gain.
 At menopause, when estrogen levels drop,
bone loss increases dramatically.
 Many factors contribute to bone loss, the
leading cause in women is decreased estrogen
production during menopause.

9.  Risk of developing osteoporosis depends on
how much bone mass attained between ages
25 and 35 (peak bone mass) and how rapidly
loses it later. The higher peak bone mass, the
more bones "in the bank" and less likely to
develop osteoporosis as ages.
 Not getting enough vitamin D and calcium in
the diet may lead to a lower peak bone mass
and accelerated bone loss later.

10. What keeps bones healthy
 Regular exercise
 Adequate amounts of calcium
 Adequate amounts of vitamin D, which is very
essential for absorbing calcium

12. RISK FACTORS
 Sex – Fractures from osteoporosis are about
twice more in women than in men. Risk in
women at menopause (45 yrs) that accelerates
bone loss. Risk in men is greater than age 75.
 Age. The older, the higher risk of
osteoporosis. Bones become weaker as ages.
 Race. Greatest risk – white or of Southeast
Asian descent. Black and Hispanic men and
women have a lower, but still significant, risk.

13.  Family history. Osteoporosis runs in families.
Parent or sibling with osteoporosis puts at
greater risk, especially if having a family
history of fractures.
 Frame size. Men and women who are
exceptionally thin or have small body frames
tend to have higher risk because they may
have less bone mass to draw from as they age.
 Lifetime exposure to estrogen. The greater a
woman's lifetime exposure to estrogen, the
lower her risk of osteoporosis.

14.  Eating disorders. Women and men with
anorexia nervosa or bulimia are at higher risk
of lower bone density in their lower backs and
hips.
 Corticosteroid medications. Long-term use
like prednisone, cortisone, prednisolone and
dexamethasone, is damaging to bone.
Common treatments for chronic conditions –
asthma, rheumatoid arthritis and psoriasis.
 Thyroid hormone. Too much thyroid
hormone can cause bone loss.

15.  Other medications. Long-term use of the
blood-thinning medication heparin, the cancer
treatment drug methotrexate, some anti-
seizure medications, diuretics and aluminum-
containing antacids also can cause bone loss.
 Breast cancer. Postmenopausal women who
have had breast cancer are at increased risk of
osteoporosis, especially if they were treated
with chemotherapy or aromatase inhibitors
such as anastrozole and letrozole, which
suppress estrogen.

16.  Low calcium intake. A lifelong lack of
calcium plays a major role in the development
of osteoporosis.
 Medical conditions and procedures that
decrease calcium absorption. Stomach
surgery (gastrectomy) can affect the body's
ability to absorb calcium.
 Sedentary lifestyle. Bone health begins in
childhood. Children who are physically active
and consume adequate amounts of calcium-
containing foods have the greatest bone
density. Exercise throughout life is important,
but can increase bone density at any age.

17.  Excess soda consumption. The link between
osteoporosis and caffeinated sodas isn't clear, but
caffeine may interfere with calcium absorption
and its diuretic effect may increase mineral loss.
In addition, the phosphoric acid in soda may
contribute to bone loss by changing the acid
balance in the blood.
 Chronic alcoholism. For men, alcoholism is one
of the leading risk factors for osteoporosis.
Excess consumption of alcohol reduces bone
formation and interferes with the body's ability to
absorb calcium.
 Depression. People who experience serious
depression have increased rates of bone loss.

19. TESTS AND DIAGNOSIS
 Osteopenia refers to mild bone loss that isn't
severe enough to be called osteoporosis, but
that increases the risk of osteoporosis.
 The best screening test is dual energy X-ray
absorptiometry (DEXA) – measures the
density of bones in the spine, hip and wrist
and it's used to accurately follow changes in
these bones over time.
 Ultrasound
 Quantitative CT scanning
Dual energy X-ray absorptiometry

20. Test should ….
 Older than age 65, regardless of risk factors.
 Postmenopausal and have at least one risk
factor for osteoporosis, including having
fractured a bone.
 Having vertebral abnormality.
 Use medications, such as prednisone, that can
cause osteoporosis.
 Type 1 diabetes, liver disease, kidney disease,
thyroid disease or a family history of
osteoporosis.
 Experienced early menopause.

21. COMPLICATIONS
 Fractures are the most frequent and serious
complication of osteoporosis.
 Often occurs in spine or hips – bones that
directly support your weight.
 Hip fractures and wrist fractures from falls are
common.
 Compression fractures can cause severe pain
and require a long recovery. If many such
fractures, can lose several inches of height as
the posture becomes stooped.

22. TREATMENTS AND DRUGS
 Hormone therapy (HT)
 Prescription medications – Bisphosphonates,
Raloxifene (Evista) / selective estrogen
receptor modulators (SERMs), Calcitonin,
Teriparatide (Forteo), Tamoxifen.
 Emerging therapies – New physical therapy
program combines the use of a device called a
spinal weighted kypho-orthosis (WKO), a
harness with a light weight attached and
specific back extension exercises. The WKO
is worn daily for 30 minutes in the morning
and afternoon.

23. ESTROGEN AND BONE PROTECTION
Estrogen is essential for
healthy bone, and that when
the production of estrogen is
reduced, as occurs normally
in postmenopausal women
and pathogenically after
exposure to radiation or
chemotherapeutic drugs,
bones become brittle and
break easily. However, the
mechanisms involved aren't
clearly understood.

24. The new study observed that one way estradiol
helps to maintain bone density is by stopping the
activation of an enzyme known as caspase-3.
Also called the executioner caspase, caspase-3 is
the central player in initiating the process of
apoptosis, or programmed cell death of
osteoblasts, the bone cells that aid in the growth
and development of new bone and teeth.

25. PREVENTION
 Do exercise such as walking, running,
skipping rope, jogging regularly.
 Add soy in diet – plant estrogens found in soy
helps to maintain bone density and reduce the
risk of fractures.
 Avoid smoking, it can reduce the levels of
estrogen and increase bones Loss.
 Avoid excessive alcohol.
 Avoid caffeine, which is very harmful.
 Consider hormone therapy.

27. LIFESTYLE AND HOME REMEDIES
 Maintain good posture – Good posture which
involves keeping the head held high, chin in,
shoulders back, upper back flat and lower
spine arched – helps to avoid stress on the
spine. When sit or drive, place a rolled towel
in the small of the back. Don't lean over while
reading or doing handwork. When lifting,
bend at the knees, not the waist, and lift with
the legs, keeping the upper back straight.
 Prevent falls.
 Manage pain. Don't ignore chronic pain.

29. ESTIMATED DAILY CALCIUM INTAKES
RECOMMENDED DAILY INTAKE OF VITAMIN D

30. Milk equivalents containing 300 mg of calcium per serving