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Osteoporosis

What is it?

Osteoporosis (ah-stee-o-per-o-sis) is a disease where you lose bone tissue. It happens when the body does not make enough new bone. Osteoporosis may also happen when too much old bone is reabsorbed (used up) by the body.

Calcium and phosphorous are minerals needed to make bone. Bone tissue cannot be made if you do not get enough calcium in your diet. Also, the body will take these minerals out of old bone if there is not enough coming into the body in what you eat. This causes bones to get brittle, weak, and fracture (break) very easily. These bone fractures may happen because of a fall. Often doing simple things like lifting something heavy can break a bone in your back. Osteoporosis is a life-long condition but you can keep it from getting worse.

Causes:

The exact cause of osteoporosis is not known. The following may put you at a higher risk of having osteoporosis:

  • Aging. As we age, we lose bone tissue. After age 35, the body builds less new bone to replace old bone.
  • Being female. Women have 8 times a greater chance of having osteoporosis than men.
  • Low estrogen. Estrogen, the female hormone, helps to keep bones strong in women. A woman's body makes much less estrogen after menopause (change of life). Exercising too much and eating disorders, such as anorexia and bulimia, also decrease estrogen.
  • Heredity. Being small and slender, having fair skin, and being Caucasian or Asian increases your risk of having osteoporosis.
  • Life-style. Smoking, caffeine, or drinking too much alcohol for a long time increases your osteoporosis risk. Not exercising regularly or being inactive weakens bones and increases your chance of getting osteoporosis.
  • Medicines. Some medicines, such as steroids, anticonvulsants, and anticoagulants (blood thinners) may cause osteoporosis.
  • Nutrition. Eating poorly and having a low calcium and vitamin D diet can weaken your bones. Excessive protein (over 80 to 100 grams a day) and salt intake may increase osteoporosis risk. Not getting enough protein is also a risk factor for osteoporosis. Eating too much fiber can cause you to absorb less calcium.
  • Other illnesses. Thyroid disease, bone cancer, and other diseases may cause osteoporosis.

Signs and Symptoms:

There are no early signs of osteoporosis. Bone loss happens slowly over many years. Often the first time a caregiver learns that you have osteoporosis is when you break a bone. By this time, the osteoporosis is in the later stages and a lot of bone damage has happened. Following are some of the later signs of osteoporosis.

  • Bone, neck, or low back pain.
  • Broken bones in the back, neck, wrists, or hips.
  • Getting shorter over time.
  • Stooped posture (bent over) or dowagers hump (a very badly rounded upper back).

Wellness Recommendations:

Regular exercise can slow down osteoporosis. Not smoking, drinking little to no alcohol (beer, wine, hard alcohol), decreasing salt, caffeine, and protein can reduce osteoporosis risk.

Lose weight if you weigh too much. This decreases the strain on the joints in your back, hips, knees, ankles, and feet. Talk to your caregiver about a diet to keep your weight under control.

Medical Care:

Several therapies are available to prevent or treat osteoporosis, including:

  • Hormone replacement therapy medicine (estrogen and progesterone).
  • "Biphosphonates" (bone building medicine).
  • Calcitonin (a hormone that regulates calcium).
  • "SERMs" (selective estrogen receptor modulators which have positive effects on bones).

Dietary Measures:

  • Eating more fruit and vegetables may help to decrease your osteoporosis risk.
  • Eating or drinking foods with isoflavones ("phytoestrogens" or plant estrogens ) in them, such as soy, may decrease the risk of osteoporosis.

Herbs and Supplements:

Before taking any herbs or supplements, ask your caregiver if it is OK. Talk to your caregiver about how much you should take. If you are using this medicine without instructions from your caregiver, follow the directions on the label. Do not take more medicine or take it more often than the directions tell you to. The herbs and supplements listed may or may not help treat your condition.

Herbs:

    Supplements:

      Recommended Screening Tests/Exams:

      You may need blood or urine tests, x-rays, CT scan, or bone densitometry. These tests may need to be done again to learn if there has been a change during or after treatment.

      Do's and Don'ts:

      • Avoid falls.
      • Ask you caregiver if any medicines you take can cause dizziness, lightheadedness, or loss of balance.
      • Wear sturdy, low-heeled soft-soled shoes.
      • If you are unsteady on your feet, use a cane or walk with someone else's help.
      • Remove things that could make you trip, such as loose rugs or electrical cords.
      • Keep your home well lit at night.
      • Hold the railing when using stairs.
      • Avoid icy streets and wet or waxed floors.

      Other ways of treating your symptoms:

      Other ways to treat osteoporosis (if you have symptoms or not) are available to you.

      Talk to your caregiver if:

      • You would like medicine to treat osteoporosis.
      • Tests shows that your bone density is not improving or getting worse even though you are using self-help measures.
      • You have questions about what you have read in this document.

      SEEK CARE IMMEDIATELY IF:

      • Sudden, severe pain in your back.
      • You have pain after an injury or fall.

      Care Agreement:

      You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care will be used to treat you. You always have the right to refuse treatment.

      References:

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      2. Burckhardt P: Osteoporosis and nutrition. Ther Umsch 1998; 55(11):712-716.

      3. Caraballo PJ, Heit JA, Atkinson EJ et al: Long-term use of oral anticoagulants and the risk of fracture. Arch Intern Med 1999; 159(15):1750-1766.

      4. Civitelli R, Villareal DT, Agnusdei D et al: Dietary l-lysine and calcium metabolism in humans. Nutrition 1992; 8(6):400-405.

      5. Cornuz J, Feskanich D, Willett WC et al: Smoking, smoking cessation, and risk of hip fracture in women. Am J Med 1999; 106(3):311-314.

      6. Feskanich D, Weber P, Willett WC et al: Vitamin K intake and hip fractures in women: a prospective study. Am J Clin Nutr 1999; 69(1):74-79.

      7. Gennari C, Agnusdei D, Crepaldi G et al: Effect of ipriflavone-a synthetic derivative of natural isoflavones-on bone mass loss in the early years after menopause. J North Am Menopause Soc 1998; 5(1):9-15.

      8. Head KA: Ipriflavone: an important bone-building isoflavone. Altern Med Rev 1999 ; 4(1):10-22.

      9. Krahe C, Friedman R & Gross JL: Risk factors for decreased bone density in premenopausal women. Braz J Med Biol Res 1997; 30(9):1061-1066.

      10. Labrie F, Diamond P, Cusan L et al: Effect of 12-month DHEA replacement therapy on bone, vagina, and endometrium in post-menopausal women. J Clin Endo Crinol Metab 1997; 82(10):3498-3505.

      11. Melhus H, Michaelsson K, Holmberg L et al: Smoking, antioxidant vitamins, and the risk of hip fracture. J Bone 12. Miner Res 1999; 14(1):129-135.

      13. Nordin BE, Need AG, Steurer T et al: Nutrition, osteoporosis, and aging. Ann N Y Acad Sci 1998; 8(3):336-351.

      14. Ohta H, Komukai S, Makita K et al: Effects of 1-year ipriflavone treatment on lumbar bone mineral density and bone metabolic markers in postmenopausal women with low bone mass. Hormone Res 1999; 51(4):178-183.

      15. Shikari M, Kushida K, Yamazaki K et al: Effects of 2 years' treatment of osteoporosis with 1 alpha-hydroxy vitamin D3 on bone mineral density and incidence of fracture: a placebo-controlled, double-blind prospective study. Endocr J 1996; 43(2):211-220.

      16. Spangler JG: Smoking and hormone-related disorders. Prim Care 1999; 26(3):499-511.

      17. Stendig-Lindberg G, Tepper R & Leichter: I Trabecular bone density in a two year controlled trial of peroral magnesium in osteoporosis. Mag Res 1993; 6(2):155-163.

      18. Tucker KL, Hannan MT, Chen H et al: Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women. Am J Clin Nutr 1999; 69(4):727-736.

      19. Ullom-Minnich P: Prevention of osteoporosis and fractures. Am Fam Physician 1999; 60(1):194-202.

      20. Ushiroyama T, Okamura S, Ikeda A et al: Efficacy of ipriflavone and 1-alpha vitamin D therapy for the cessation of vertebral bone loss. Int J Gynecol & Obst 1995; 48(3):283-288.


      Last Updated: 11/4/2014

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