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Are
You at Risk for Osteoporosis?
The staff at the Adler Center for
Women’s Health has made a
commitment to educating our patients and the community about health
issues that
concern us all. We would like to raise awareness about a condition,
which has
been somewhat of a silent epidemic.
Osteoporosis is a degenerative bone condition that features loss of normal bone density. This condition leads to abnormally porous bone that is more compressible like a sponge, rather than dense and solid like a brick. Bones are comprised of both protein collagen and calcium. A loss in bone density causes bones to become brittle, and can lead to frequent fractures. It is estimated that one in two women over the age of 50 will have an osteoporosis related fracture. This condition is a threat to 28 million Americans and is currently one of the most under-diagnosed and under-treated disorders in medicine. According to the National Osteoporosis Foundation, women over 60 have a one in four chance of breaking a bone due to osteoporosis. Elderly women (and men) who suffer from severe osteoporosis experience hip,  wrist,
spine and other traumatic fractures from minor falls
that would normally not occur in young adults (or persons who do not
have
osteoporosis). Rehabilitation and reconstruction with a prosthetic hip
can be
painful and difficult to treat. Other serious effects of osteoporosis
include
loss of height (from vertebral compression fractures), restricted
mobility and
kyphosis, a humped back (called a dowager’s hump). Elderly people with
broken bones
may never recover completely or they may continue to have pain and
disability
and even die. It is estimated that osteoporosis accounts for more than 1.5 million fractures each year; 300,000 hip fractures 700,000 vertebral fractures 250,000 wrist fractures 300,000 fractures at other sites Before a woman reaches her mid-30’s, her body gains more bone than it looses. However, with the onset of menopause (and a decrease in the hormone, estrogen) around 50 years of age, the rate of bone loss speeds up. If this bone loss becomes severe, women may develop osteoporosis. Once bone formation (the acquisition of bone mineral density “BMD”) has stopped (around 28 years of age), peak bone mass is maintained by a process called “remodeling". This is a continuous process and involves continuous breakdown and re-formation of bone. Bones are live tissue like all other parts of the body. This live tissue remodels itself to maintain maximal BMD and to repair any damage (small or large fractures). This remodeling, which consists of tearing down small parts of the bones, and then reforming them, is under the control of a number of hormones. The breaking down is termed “resorption” and is performed by large cells within the bones called osteoclasts. The osteoclasts live in the central portion of the bone and continually remove microscopic portions of the bone at the bone edge surface. Nearby, bone-forming cells called osteoblasts fill in the holes. Remodeling is not a perfect give and take of bone mass. The osteoblasts are less efficient at making bone than the osteoclasts are at removing it. This is what accounts for the gradual loss of BMD. Bone density naturally declines with age. By definition 16% of young white women have osteopenia. Young women with osteopenia can still be normal and healthy. Any factor that causes a higher rate of bone remodeling can lead to more rapid bone loss and thus more fragile bones. The amount of strong bones formed during youth minus the amount of bone lost to remodeling over many years equals the level of bone mass as an adult (or degree of osteoporosis). Basic prevention of osteoporosis includes eating a healthy diet, maintaining a sturdy weight, getting regular exercise (weight bearing and strengthening) and not smoking. Women with chronic diseases are at higher risk for the development of osteoporosis. Eating fruits, vegetables, adequate amounts of calcium and Vitamin D are crucial in the prevention of  osteoporosis.
Keeping your bones
healthy throughout life depends on getting adequate amounts of vitamins
and
minerals (phosphorous, magnesium, boron, manganese, copper, zinc,
folate,
Vitamins B12, B6, C and K. Avoiding sodium, alcohol, smoking, caffeine
and
participating in regular weight bearing exercise will also enhance bone
health
and prevent weakened bones in later life. Accelerated bone loss after menopause is a major cause of osteoporosis in women. Your practitioner will factor in your age, your BMD score and other factors such as hip fractures in a close relative, low weight, and smoking. Women with certain medical problems or taking certain medicines may be more at risk. It is important to remember that the risk of getting a fracture is more important than the measurement of Bone Mass Density (BMD). Fracture risk depends on many other factors, especially age. At the same bone density, the risk of fracture doubles every ten years. Other risk factors for fracture include poor general health, unsteady balance, presence of a fracture and low weight. The National Osteoporosis Foundation, The American Medical Association and other major medical associations recommend DEXA (dual energy x-ray absorptometry) scan for diagnosing osteoporosis. It takes about 15 minutes to perform, uses very little radiation (1/10th to 1/100th the amount use on a standard chest x-ray and is quite precise. The bone density is then compared to the average peak bone density of young adults of the same sex and race. Osteoporosis is defined as more than 25% below the average peak bone density of young adults of the same sex and race. Osteopenia (a milder form of osteoporosis) is defined as between 10% and 25% below the average peak bone density of young adults of the same sex and race. Your practitioner will assist you in the decision as to when and by what method Pharmaceutical therapies would be of benefit to aid in the reduction of risk for fractures due to osteoporosis. Some of the therapies include: Estrogen Raloxifene - A new class of medications called SERMs (selective estrogen receptor modulators) SERMs work like estrogen in some tissue, but not in others. SERMS helps prevent bone loss like estrogen does without the potential side effects of estrogen. (trade name: Evista), Bisphosphinates are anti-resorptive agents, which prevent bone breakdown. alendronate (trade name: Fosamax), risedronate (trade name: Actonel)) Both men and women are at risk for osteoporosis as they age. The following are some of the risk factures that increase one’s risk for this condition:
The Adler Center for Women’s Health offers DEXA scan screening for osteoporosis for both men and women. The practitioners will assist clients in assessing their risk for osteoporosis and in a plan to enhance their bone health. For more information about osteoporosis on the web, here are a few sites: www.osteo.org (National Osteoporosis and Related Bone Disease National Resource Center) www.endocrineweb.com www.nof.org (National Osteoporosis Foundation) www.niapublications.org/engagepages/osteo.asp (National Institute on Aging) Would you like to know if you are at risk? Please ask our staff about getting an osteoporosis (DEXA SCAN) test. We can provide this test while you are waiting for your scheduled appointment or after your appointment. You may also schedule an appointment specifically for the test. Home | About Us | Services | Our Staff | Locations | Survey | Resources | Contact http://adlercenter.com | admin@adlercenter.com
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