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Osteoporosis Osteoporosis, which means “porous bones,” is a disease that thins and weakens your bones, making them fragile and more likely to break. It is sometimes called a “silent disease” because it can develop gradually over many years without causing any symptoms. You may be able to reduce or delay bone loss and you can treat osteoporosis, but you may not be able to prevent it. The National Osteoporosis Foundation (NOF) estimates as many as 54 million Americans have osteoporosis and low bone mass. Research shows about half of women and one-quarter of men will break a bone due to osteoporosis. Although men can suffer from osteoporosis, the vast majority of individuals affected by osteoporosis are women. In fact, the annual number of osteoporotic fractures in women is greater than the number of heart attacks, strokes and cases of breast cancercombined. Women are four times more likely to develop osteoporosis than men. Although the disease can strike at any age, women are at greatest risk for osteoporosis after menopause. More than 50 percent of non-Hispanic Caucasian and Asian women age 50 years and older have low bone mass, increasing their risk for osteoporosis. A major reason for this is that women’s bodies produce less estrogenafter menopause, and estrogen plays an important role in helping to prevent bone loss. Although the average age for menopause in the United States is 51, some women experience menopause earlier due to natural causes or following surgery, illness or treatments that destroy the ovaries. For example, a total hysterectomy in which the ovaries and uterus are removed will immediately trigger menopause. When you have not had a menstrual period for more than 12 consecutive months, without another medical reason for the absence of your periods, you are postmenopausal. The good news is that osteoporosis can be prevented and treated and bone health can be maintained. It is never too late to learn how to maintain and keep your bones healthy.

Bone Basics Your bones are complex living tissue. They provide structure and support for your muscles, protect your organs and store 99 percent of the calcium used by the soft tissues of your body for their various functions. Healthy bone is strong and dense with many interconnecting pieces. Bone affected by osteoporosis is porous, fragile and weak. Bone is made mostly of collagen, a protein that provides a soft framework, andhydroxyapatite, a complex of calcium and phosphate, minerals that add strength and harden the framework. This combination of collagen and calcium makes bone strong yet flexible to withstand stress. Bone changes regularly through a process called remodeling, in which the body breaks down old bone and replaces it with new, strong bone. This process continues throughout life, but varies significantly as you age. From birth to age 25 or 30, the body builds more new bone than it breaks down. By age 30, your bones become the strongest they will ever be. This phase of bone development is called peak bone mass. The level of bone mass achieved at the peak is determined largely by genetics, but also by nutrition, exercise and menstrual function. Having healthy, strong bones at younger ages can be a critical factor in protecting against osteoporosis in the future. After about age 30, your body breaks down old bone faster than it builds new bone. This process speeds up dramatically as menopause approaches and for several years after. In the first five to seven years following menopause, you can lose up to 20 percent of bone mass. Bone loss continues at a slower pace throughout the remainder of your life and may accelerate again in your older years, usually after age 70. Rates of bone loss vary among individuals, but even slow rates of loss may be dangerous, especially in women who start with low bone mass prior to menopause. Often, the first symptom of osteoporosis is a broken bone, which is called a fracture. The common sites for these fractures are the hip, spine or wrist.

Diagnosis Osteoporosis develops gradually, usually without symptoms. A broken bone that occurs with minor trauma, such as a slight blow to the wrist, for example, is typically the first symptom. Approximately one in two women and one in four men over age 50 will have an osteoporosis-related fracture in their remaining lifetime. Both hip and spine fractures are associated with an increased risk of death. Spine fractures, also known as vertebrae compression fractures, occur when weakened vertebrae suffer the impact of a strain, bump or fall. They can lead to loss of height, severe and sometimes chronic pain, crowding of internal organs and stooped posture (called kyphosis or “dowager’s hump”). They can also result in prolonged disability and increased mortality. Hip fractures are another common consequence of osteoporosis, accounting for one-quarter of osteoporosis-related breaks. A hip fracture can lead to a downward spiral of declining health, decreased mobility and increased frailty. They almost always require hospitalization and major surgery and may require long-term nursing home care. For some, this injury may cause prolonged or permanent disability or even death. The number of fractures due to osteoporosis is expected to rise to more than three million by 2025, according to the National Osteoporosis Foundation. Your health care professional can make a diagnosis of osteoporosis based on your medical history with an assessment of your risk factors; a physical examination and laboratory tests; and a bone mineral density (BMD) test, a noninvasive test that measures your bone mass. Common risk factors for osteoporosis are:  Small, thin frame (weighing less than 127 pounds)  Personal and/or family history of broken bones or stooped posture in adulthood

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Previous history of osteoporotic fractures of the spine, hip or wrist Low lifetime intake of calcium Excessive thinness Smoking

Excessive alcohol consumption (“Moderate drinking” for women and older people is defined by the National Institute on Alcohol Abuse and Alcoholism as one drink per day—one drink equals: a 12-ounce bottle of beer (5 percent alcohol) , one 5ounce glass of wine (12 percent alcohol), or 1.5 ounces of 80-proof distilled spirits. Moderate drinking is considered safe.) Inactive lifestyle Estrogen deficiency caused by menopause and certain medical conditions such as athletic amenorrhea, anorexia nervosa and treatment with medications that lower estrogen levels  Absence of menstrual periods or irregular menses as a young woman  Long-term use of some anticonvulsants and corticosteroids  Caucasian or Asian ethnic backgrounds, but African-Americans and Hispanic Americans are also at significant risk.  Certain chronic medical conditions including diabetes, hyperthyroidism, hyperparathyroidism, some bowel diseases and rheumatoid arthritis  Depression. People with serious depression have increased rates of bone loss, as do people who take selective serotonin reuptake inhibitor (SSRI) antidepressants. More research is necessary to better understand the associations between depression and SSRIs and bone loss. Use of proton pump inhibitors. The Food and Drug Administration (FDA) requires safety information on the labels of prescription and over-the-counter labels for proton pump inhibitors about a possible increased risk of fractures to the hip, wrist and spine for people using these medications. Proton pump inhibitors are used to treat a variety of gastrointestinal disorders. They are generally prescribed for a two-week course and are not to be used more than six weeks in a year. In observational studies, the risk rises with prolonged use and high doses of proton pump inhibitors. Further study is needed to verify any increased risk of fractures.

Next Steps After discussing your individual concerns about osteoporosis with your health care professional, a series of laboratory tests may be recommended. These tests will help identify or rule out conditions other than menopause that may be causing low bone density. They include:      

Complete blood cell count Blood and urine calcium levels Thyroid function tests Parathyroid hormone levels 25-hydroxyvitamin D test to determine if the body has enough vitamin D Biochemical marker tests, such as CTX and NT

If your medical history or physical findings suggest causes of bone loss other than menopause and age, then additional laboratory tests may be conducted. The U.S. Preventive Services Task Force recommends that women age 65 and older be routinely screened for osteoporosis. It also recommends screening younger women who have a fracture risk equal to or greater than that of a 65year-old white woman. In addition, the National Osteoporosis Foundation and the International Society for Clinical Densitometry recommend DXA screening in postmenopausal women and men 50 to 70 who have risk factors for the disease. For more Information visit us our website:


Osteoporosis, which means “porous bones,” is a disease that thins and weakens your bones, making them fragile and more likely to break. It i...