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Osteoporosis

 

General Info
In Greek, Osteo means “bone” and porosis mean “a porous condition”. 
In osteoporosis the bone mass in the body becomes reduced or porous like and the skeletal system of your body is deeply affected and brings about a lot of changes to your system. 
 
Osteoporosis is often known as "the silent thief" because bone loss occurs without symptoms and the progressive loss and thinning of bone tissue happens over many years. This disease affects millions of people throughout the world. Women are four times more likely than men to develop the disease.
 
Bones are living, growing tissue in the body. It is made mostly of collagen, a protein that provides a soft framework, and calcium phosphate, a mineral that adds strength and hardens the framework. This combination of collagen and calcium makes bone strong yet flexible to withstand stress. More than 99% of the body's calcium is contained in the bones and teeth. The remaining 1% is found in the blood.
 
Risk factors for developing osteoporosis
 
 Women, of Asian race having thin and small body frames, and a family
   history of osteoporosis are at increased risk of developing osteoporosis.
 Excess consumption of alcohol reduces bone formation and interferes with
   the body's ability to absorb calcium.
Excessive smoking can lead to prous bones.
Lack of exercise, and a diet low in calcium.
Poor nutrition and poor health condition.
Malabsorption (nutrients are not properly absorbed from the gastrointestinal
   system) from conditions such as Celiac disease and Sprue.
Low estrogen levels such as occur in menopause or with early surgical
   removal of both ovaries.
Another cause of low estrogen level is chemotherapy, such as for breast
   cancer.
Amenorrhea (loss of the menstrual period) in young women also causes low
   estrogen and osteoporosis.
Chronic alcoholism. Alcoholism is one of the highest risk factors for
   osteoporosis in men.
 
Causes
 

Chronic diseases such as rheumatoid arthritis and chronic hepatitis C, an infection of the liver. Immobility, such as after a stroke, or from any condition that interferes with walking. Hyperparathyroidism, a disease wherein there is excessive parathyroid hormone production by the parathyroid gland (a small gland located near the thyroid gland). Normally, the parathyroid hormone maintains blood calcium levels is by removing calcium from the bone. In untreated hyperparathyroidism, excessive parathyroid hormone causes too much calcium to be removed from the bone and this can lead to osteoporosis. Too much thyroid hormone can also cause bone loss. This condition can occur when your thyroid is overactive (hyperthyroidism) or when you take excessive thyroid hormone medication to treat an underactive thyroid (hypothyroidism). Vitamin D deficiency. Vitamin D helps the body absorb calcium. When vitamin D is lacking, the body cannot absorb adequate amounts of calcium to prevent osteoporosis. Certain medications can cause osteoporosis. These include heparin (a blood thinner), anti-seizure medications phenytoin (Dilantin) and phenobarbital, and long term use of corticosteroids (such as Prednisone).

How does it occur?
Calcium and phosphate are two minerals that are essential for normal bone formation. Throughout youth, the body uses these minerals to produce bones. If calcium intake is not sufficient, or if the body does not absorb enough calcium from the diet, bone production and bone tissues may suffer. Calcium and phosphate may be reabsorbed back into the body from the bones, in which case the bone tissue becomes weaker. This results in brittle, fragile bones that can be easily broken. Usually, the loss occurs gradually over an extended period of time (years) and most of the time, a person will sustain a fracture before becoming aware that the disease is present. By the time this occurs, the disease is in its advanced stages and damage is profound.  
 
Symptoms
 

No noticeable symptoms are found in the beginning. The presence of the disease is recognized after a fracture in the early stages. Symptoms occurring late in the disease can range from:

Fractures of vertebrae, wrists, or hips after a fall can show the progressive
   loss of bone.
Pain in the neck or back.
Loss of height over the years and a stooped posture are the other results of
   this condition.
 
Diagnosis
 
X-ray of the bones show thinning of the cortex section of the bone.
A Whole Body Bone Densitometry Scanning can detect bone density loss. The scan works like a miniature x-ray (with minimal radiation exposure). The bone density of the hip, spine, forearm or the 'whole body' can be checked to diagnose osteoporosis before a debilitating, life-threatening fracture occurs.
Blood levels of Ca++ and phosphate are usually normal. Hormone levels of the thyroid and parathyroid maybe elevated in some cases. 
 
Treatment
 

The goal of osteoporosis treatment is the prevention of bone fractures by stopping bone loss and by increasing bone density and strength.
 
Progression of the disease can sometimes be slowed or stopped with treatment. Some people become severely disabled as a result of weakened bones. Hip fractures, which are frequently sustained by people with osteoporosis, leave victims unable to walk independently. Estrogen Replacement Therapy is suggested for those with the hormone deficiency. Change in lifestyle is advised to those who are likely to get affected with this disease and those who are already affected. Walking and jogging must be made a routine in your schedule.

Important
Exercise that risks of falling should be avoided.
A diet that includes an adequate amount of calcium, vitamin-D and protein should be maintained.
Though this will not completely stop bone loss, it will however, help to maintain the balance and supply the materials the body requires for bone formation.
Prevention
Maintaining a healthy diet which includes a sufficient amount of calcium, phosphorous, and vitamin-D is very important. Vitamin-D aids in the absorption of Calcium.
Regular exercise can reduce the likelihood of bone fractures.
Routine screening has to be done to detect early deterioration of bone mass in post menopausal women.
Post-menopausal women, especially those who have reduced bone density should take estrogen replacement therapy.  
Early detection would allow early intervention and could prevent fractures and complications associated with osteoporosis.  
 
More Info
 

Calcium and phosphate are two minerals that are essential for normal bone formation. Throughout youth, the body uses these minerals to produce bones. If calcium intake is not sufficient, or if the body does not absorb enough calcium from the diet, bone production and bone tissues may suffer. Calcium and phosphate may be reabsorbed back into the body from the bones, in which case the bone tissue becomes weaker. This results in brittle, fragile bones that can be easily broken. Usually, the loss occurs gradually over an extended period of time (years) and most of the time, a person will sustain a  fracture before becoming aware that the disease is present. By the time this occurs, the disease is in its advanced stages and damage can be profound.  
 
FAQ
 

If I have a fracture which doctor should I consult?
 
 See an orthopaedic doctor.
 
How do I know I have a fracture?
 
There will be severe pain and swelling at the site of fracture. An x-ray will help in confirming the fracture.
 
What can I do to prevent Osteoporosis?

Maintaining a healthy diet which includes a sufficient amount of calcium, phosphorous, and vitamin-D is very important, along with regular exercise can reduce the likelihood of bone fractures.
 
Will estrogen replacement therapy help to prevent osteoporosis?
 
For patients with hormone deficiency, estrogen replacement therapy is given to reduce the bone loss.

 
Glossary
 
Cushings Syndrome - This is caused due to the abnormal levels of corticosteroids in the body. Weight gain and obesity are the common symptoms associated with it.
Hyperthyroidism - This disease is accused by the excess of thyroid hormones in the body.
Hyperparathyroidism -  Production of excess parathyroid hormones and low calcium level in the blood.

 
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