Definition of osteoporosis: Condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones.

Literally leads to abnormally porous bone that is compressible like a sponge. This disorder of the skeleton weakens the bone and results in frequent fractures (breaks) in the bones.

Symptoms of osteoporosis: Bone pain / tenderness Fractures with minimal trauma (stress fracture) or no trauma Loss of height over time (as much as 6 inches) Low back pain due to fractures of the spinal bones. Neck pain due to fractures of the spinal bones Stooped posture or kyphosis ( Dowagers hump )

Risk factors / causes of osteoporosis: Diet low in minerals (Calcium & phosphate) Absence of menstrual period for long periods of time Excessive alcohol consumption Family history of osteoporosis History of hormone treatment for prostate cancer / breast cancer Low body weight / thin and small body frame (anorexia nervosa) Being confined to a bed / immorbility (stroke) Chronic inflammation (chronic rheumatoid arthritis & chronic kidney disease Poor nutrition / eating disorders Vitamin D deficiency Hyperparathyroidism and hyperthyroidism Female gender Caucasian / Asian race Personal history of fracture Cigarette smoking Lack of exercise Mal-absorption Low estrogen level in women (menopause/ early surgical removal of both ovaries) Low testosterone levels in men (hypogonadism) Chemotherapy(cause early menopause) Amenorrhea (loss of menstrual period) Poor general health Certain medications (anti-seizure medications and long-term use of oral corticosteroids (prednisone)

Osteoporosis
Statistics / facts: In U.S., 44 million people have low bone density (10 million have osteoporosis; 34 million have osteopenia). Osteopenia- condition of bone that is slightly less dense than normal bone but not to the degree of bone in osteoporosis. This amounts to 55% of the U.S. population aged 50 years and older. 1 in 2 Caucasian women will fracture a bone due to osteoporosis in her lifetime. In U.S., direct health-care costs from osteoporosis fractures amount to 1 billion dollars, without even taking into account the indirect costs, such as lost days at work and productivity. Approximately 20% of those who experience a hip fracture will die in the year following the fracture. One per three of hip-fracture patients regain their pre-fracture level of function. With the ageing of America, the number of people with osteoporosis-related fractures will increase exponentially.

ii) Calcitonin i) Bisphosphonates Primary drugs used to prevent & treat osteoporosis in postmenopausal women. Taken by mouth once a week or once a month. Example: alendronate, ibandronate, risedronate. It is taken through a vein or intravenously. These drugs are taken less often. a) b) Slows the rate of bone loss Relieves bone pain Comes as a nasal spray or injection. Less effective than bisphosphonates The main side effects: Nasal irritation (spray form) Nausea (injectable form)

iv) Raloxifene
Prevention & treatment of osteoporosis Similar to breast cancer drug, tamoxifen Reduce the risk of spinal fractures by 50%. Does not appear to prevent other fractures especially at the hip. May have protective effects against heart disease & breast cancer Most serious side effect : a) Very small risk of blood clots in

iii) Hormone Replacement Therapy (HRT) or oestrogen Known as oestrogens Rarely used anymore to prevent osteoporosis Are not approved to treat woman diagnosed with the condition If oestrogen has helped a woman, she cannot take other options for preventing/ treating osteoporosis. Discuss the risks with doctor. 1) Medications

leg veins (deep venous thrombosis) b) lungs (pulmonary embolus)

Preventions of osteoporosis
2) Exercise

Reduce the likelihood of bone fractures in people with osteoporosis. Recommended exercise: a) Weight-bearing exercises- walking, jogging, dancing, playing tennis b) Resistance exercises- free weights, weight machines, stretch bands c) Balance exercises- tai chi & yoga d) Riding a stationary bicycle e) Using rowing machines

3) Diet Intake at least 1,200 milligrams calcium per day. Intake 800-1000 international units of vitamin D3 (helps the body to absorb calcium) Doctor recommends supplement. Proper amount of calcium, Vitamin D & protein. Will not completely stop bone loss Guarantee sufficient supply of materials needed by the body.

4) Stop unhealthy habits Quit smoking Avoid drinking excess alcohol It damage bones, risk for falling & breaking a bone.

Preventions of osteoporosis

5) Prevent falls

6) Monitoring Monitored with a series of bone mineral density measurements. taken every 1-2 years woman taking estrogen should do: a) routine mammograms b) pelvic exams c) pap smears

Avoid sedating medications Remove household hazards (reduce the risk of fractures) Have good vision (look where u go) Avoid walking alone on icy days Using bars in bathtub Wearing well-fitting shoes

7) Related surgeries Injecting a fast-hardening glue into areas which are fractured or weak. Similar procedure- kyphoplasty. Uses balloons to widen spaces that need the glue. Balloons are removed during the procedure.