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    Osteoporosis (porous bones)

    Clinical News & Knowledge:

    Osteoporosis (porous bones) affects about eight million women and two million men and causes more than 1.5 million fractures yearly in the U.S. But osteoporosis can be prevented and treated. Learn about its causes, risk factors, treatments, and prevention. Use this guide to build stronger bones and cut fracture risk.

    What Is Osteoporosis? What You Need to Know
    What is osteoporosis anyway? Is osteoporosis a normal sign of aging? Does osteoporosis only affect women? Here's the truth: What you don't know about osteoporosis may hurt you.

    What is osteoporosis?
    Osteoporosis is a common disease that weakens bones. As it does, your risk of sudden and unexpected fractures goes up. Osteopenia is the forerunner of osteoporosis. It is a silent but destructive condition that robs bones during a woman's -- even a young woman's -- most productive time.

    No matter what your age or sex, osteoporosis and osteopenia can affect you. Your bones might seem sturdy now. You may be very active and doing the things you want to do. But osteoporosis and osteopenia are quiet, accomplished thieves. In fact, there are usually no visible signs. You may notice a loss of height or a Dowager's hump over time. But chances are good the first sign that you have one of these conditions will be a painful fracture.

    What is osteoporosis bone loss?
    The bone loss with osteoporosis occurs over many years and is severe. It's so severe that the normal stress on bones from sitting, standing, coughing, or even hugging a loved one can result in painful fractures and immobility. Then, after the first fracture, you are at risk for more fractures. These future fractures may cause you to live with daily chronic pain. They can cause you disability. They may rob you of your independence.

    That's why it's important to learn all you can about osteoporosis and osteopenia. Then you can take immediate steps to keep your bones strong. That way you can prevent bone loss and painful fractures.

    What are osteoporosis symptoms?
    Osteoporosis often progresses without symptoms or pain. Losing height may be noticeable. Or a Dowager's hump may develop with age. Usually, though, a doctor diagnoses osteoporosis after a painful fracture occurs.
    That fracture is usually in the back or hips. Painful fractures are debilitating and disfiguring. They can result in loss of mobility and independence.
    In WebMD's Osteoporosis Guide, you can read all about the latest medical recommendations and complementary treatments for preventing bone loss. You can read how to prevent osteopenia and osteoporosis and how to reduce your risk of painful fractures. In addition, you can read how osteoporosis medications, along with diet, exercise, and other lifestyle choices, can slow the rate of bone loss and help you prevent fractures.

    What is osteopenia?
    With osteopenia, there are no warning signs until you fracture a bone. Osteopenia is the forerunner of osteoporosis. If it isn't diagnosed and isn't treated, osteopenia can lead directly to osteoporosis. With osteoporosis, your bones become thin, weaker, and fracture easily.
    The good news is if you are diagnosed with osteoporosis, you can get treatments. Those osteoporosis treatments can slow bone loss, increase the amount of bone you have, and lower your chances of fractures. But there's no reason to wait until you can't reverse how weak your bones have become. Detecting osteopenia with a bone density test is easy. From there, making a plan to prevent disfiguring and painful fractures is simple.

    Why is there so much concern about osteopenia?
    If you're wondering why osteopenia has become such a topic of concern for younger and middle-aged women, consider this. Years ago, people didn't think it was important to treat hypertension (high blood pressure). They didn't think it was important because there were no obvious consequences. We now know, though, that treating high blood pressure in the present lowers the risk of stroke years later.

    Again, thirty years ago, blood cholesterol levels that were not over 300 were not considered abnormally high. Now we know that treating cholesterol when the levels are at 200 can prevent heart attacks years later.
    Research has shown that the connection between bone loss and fractures is stronger than the connection between high blood pressure and stroke. It's also stronger than the connection between high blood cholesterol and heart attack. You can stop osteopenia and prevent a fracture. But you have to take action early in life. Treating osteopenia before a broken bone happens is as effective as treating high blood pressure before a stroke or high cholesterol before a heart attack.

    What is an osteoporosis fracture?
    A fracture is a break in a bone. If you have osteoporosis, your bones become thin, lose structure, and become fragile. You could lift a bag of groceries and suffer a fracture or a collapsed vertebra in your back. Or you might stoop down to tie your shoe and feel a sudden, severe pain from a fracture.
    While the pain from the fracture may subside, you may develop continued chronic pain. As spinal bones collapse, deformities in your spine, such as a dowager's hump, and other areas will become obvious to both you and people around you. You may feel stiff most of the time and have trouble being active.
    There are ways to prevent and treat osteoporosis. So no one has to suffer with fractures and chronic pain. Learn more about preventing fractures in this guide. Then you can stay active all your life.

    What is the cause of osteoporosis?
    We don't know a lot about what causes osteoporosis. We do know how osteoporosis develops throughout a person's life. Bones are complex, living tissue. Your body constantly breaks down old bone and rebuilds new bone. This bone-building process is called "remodeling."

    As you are growing up, your body builds more bone than it removes. During childhood, your bones become larger and stronger. Peak bone mass occurs when you have the maximum amount of bone mass you will ever have. For most people, this usually happens during the third decade of life. Then, at a certain age, the bone remodeling process changes. New bone gets laid down at a slower rate. This slowdown results in a decrease in the total amount of bone you have.

    If this loss of bone reaches a certain point, you have osteopenia. When bone loss becomes more severe, you have osteoporosis. Both men and women with osteopenia or osteoporosis are at a higher risk of fractures.
    In the early stages of osteoporosis, there may be no signs or symptoms. As the breakdown and removal of bone continues at a faster pace than bone building, the degree of bone loss may be detectable on a bone mineral density (BMD) test or bone density scan.

    What is my risk for osteoporosis?
    It's smart to know the risk factors for osteoporosis. By changing those risk factors you can control, you can reduce your chance of osteoporosis.

    Key risk factors for fractures include the following.

    Family history: Osteoporosis seems to run in families. If your mother had hip fracture or spinal collapse fracture, chances are you are at risk for osteoporosis. That means you are at risk of reduced bone mass and fractures.
    Sex: Women are four times more likely than men to get osteoporosis. But men also suffer from osteoporosis.

    Age: The risk of osteoporosis increases with age. Women over the age of 50 have the greatest risk of developing osteoporosis. Anyone of any age can have osteoporosis. But the older you are, the more risk you have of fractures and osteoporosis.

    Bone structure and body weight. Petite and thin women have a greater risk of developing osteoporosis. Weight loss after age 50 in women also seems to increase the risk of hip fractures. Weight gain decreases the risk. Small-boned, thin men have a greater risk of osteoporosis than men with larger frames and more body weight.

    History of fractures: Having one fracture increases the chance of more fractures.

    Smoking : Smoking increases the risk of fractures. Studies show that cigarette smokers (past or current smokers) have lower bone densities and higher fracture risks. Women who smoke have lower levels of estrogen -- a key component for having healthy bones -- compared to nonsmokers. They also frequently go through menopause earlier.

    Medications: Some medications may increase your risk of osteoporosis. These include long-term use of steroids (prednisone), thyroid medication, anticonvulsants, antacids, and other medications.

    How is osteoporosis related to menopause?
    At menopause, there's a dramatic decline in the female hormone, estrogen. This decline in estrogen slows the bone remodeling process and causes an accelerated rate of bone loss. This more rapid loss of bone continues for about 10 years after menopause. The rate of bone loss eventually returns to premenopausal levels. But bone formation does not. This causes postmenopausal women to have a much greater chance of having a fracture.
    In addition, having an early menopause (before age 40) also increases the chance of osteoporosis and fractures. Having prolonged periods of time when hormone levels are low and/or absent, such as can happen with excess exercise, causes loss of bone mass and osteoporosis.

    How do I know if I have osteoporosis?
    First, check your risk factors. Then, ask your doctor about a bone mineral density (BMD) test or bone scan. A bone mineral density test can provide information about your bone health before problems begin. Bone mineral density tests use very small amounts of radiation to determine the strength of your bones.

    For in depth information, see WebMD's Osteoporosis Self-Test: Check Your Risk.

    How is osteoporosis treated?
    Many osteoporosis treatments and osteoporosis medications are successful in stopping bone loss and reducing your risks of fractures. Some osteoporosis treatments include dietary and lifestyle choices. Other treatments include osteoporosis medications. These medications can slow bone loss or build new bone.

    Osteoporosis treatment can include:
    estrogen replacement therapy
    osteoporosis medications such as Actonel, Boniva, Calcimar, Evista, Fosamax, Reclast, Fortical, Miacalcin
    injectable Forteo or PTH to build bone
    calcium and vitamin D dietary supplements
    weight-bearing exercises (which force your muscles to work against gravity)
    smoking cessation

    How can I prevent osteoporosis?
    There are several proven ways to prevent osteoporosis and fractures.
    Exercise. Establish a regular exercise program. Exercise makes bones and muscles stronger and helps prevent bone loss. It also helps you stay active and mobile. Weight-bearing exercises are best for preventing osteoporosis.

    They should be done at least three to four times a week.
    Walking, jogging, playing tennis or racket sports, and dancing are all good weight-bearing exercises. In addition, strength and balance exercises help build stronger muscles and may help you avoid falls. This will decrease your chances of breaking a bone.

    Increase calcium in your diet. Getting enough calcium throughout your life helps to keep bones strong. Experts recommend 1,000 milligrams each day for premenopausal women and 1,500 milligrams a day for postmenopausal women.

    Excellent sources of calcium include:
    milk and dairy products (low-fat versions are recommended)
    canned fish with bones, such as salmon and sardines
    dark green leafy vegetables, such as kale, collards, and broccoli
    calcium-fortified orange juice
    breads made with calcium-fortified flour
    You can get the recommended amounts of calcium by having four servings of calcium-rich foods each day. Good choices might include:
    yogurt made with low-fat milk or whole milk
    a selected serving of cheese, tofu, or milk
    a selected serving of fish or broccoli
    calcium-fortified juices, breads, and cereals
    calcium-fortified dairy products

    Supplement your diet. If you do not get enough dietary calcium, ask your doctor about calcium supplements. Take a 300-milligram calcium supplement to replace each serving of calcium-rich foods you miss each day. Calcium carbonate and calcium citrate are good forms of calcium supplements.
    Get plenty of vitamin D. Vitamin D is necessary for the body to absorb calcium. While being out in the sun 20 minutes each day helps your body get vitamin D, more research is showing that people may get too little of this vitamin, particularly in the wintertime. You can also get vitamin D from:
    fatty fish like salmon
    milk fortified with vitamin D

    The Daily Value of vitamin D is 400 International Units (IU). Daily Values (DVs) are established by the National Academy of Sciences and National Research Council as the amount necessary to prevent deficiencies. Still, these levels may not be enough to prevent chronic diseases such as osteoporosis and fractures.

    Older adults should get at least 800 International Units (IU) daily of vitamin D. Although multivitamins are a convenient and inexpensive way to get vitamin D, many multivitamins contain only 400 IU. Read the label on your multivitamin to see what's available in your supplement.

    Symptoms & Types
    Osteoporosis often starts silently and may not be found until a bone fractures. But sometimes, symptoms appear. Learn about the types and symptoms of osteoporosis.

    Osteoporosis can be a silent disease, but many patients suffer symptoms such as pain and height loss. Read a brief description of osteoporosis symptoms.
    Compression Fractures of the Back
    Sudden, severe back pain, especially in older women, often signifies a spinal compression fracture -- a sign of weak bones. So get that back pain checked out.
    Warning Signs
    Many people have thinned bones and don’t know it. Osteopenia is mildly thin bones that are heading towards osteoporosis. Learn more about how osteopenia is detected and treated.

    Juvenile Osteoporosis
    Osteoporosis rarely affects children. But when it does, it’s usually due to a medical condition or medication. It’s a significant problem because it occurs during the child’s prime bone-building years.Those rare cases are called juvenile osteoporosis. Read about it in this brief article.
    Related Web Site: Premenopausal Osteoporosis
    Osteoporosis usually strikes after menopause. But some diseases and drugs -- noted one by one in this guide’s “Risk Factors” section -- may lead to earlier osteoporosis. *This link will take you to another site.

    Osteoporosis Pain
    Bone fractures caused by osteoporosis can be very painful, and sometimes the pain and disability lasts for months. Physical activity helps contribute to bone health. Read article on handling chronic pain.

    Hip fractures can make it a lot harder to walk, get around, and lead an independent life. People with these fractures may not recover for months and often cannot care for themselves. Learn more about the dangers of weak bones and how to prevent them.

    Diagnosis & Tests

    How can you know if you have osteoporosis -- before your bones break? There are several ways to measure bone density. Learn about these osteoporosis tests. *
    Peak Bone Mass
    Did you know that up to 90% of peak bone mass is reached by age 18 for women and age 20 for men? After your mid-30s you begin to slowly lose bone. Read more about peak bone mass.

    What is Bone Mineral Density?
    Almost 80% of bone density is determined by heredity, and 20% by lifestyle. Bone mineral density tests (BMD) shows how dense bones are and whether you have osteoporosis. This information helps determine which prevention or treatment steps are needed. Learn more.

    DEXA Scan (Dual X-ray Absorptometry)
    The most common osteoporosis test is dual X-ray absorptometry -- also called DXA or DEXA. It measures people’s spine, hip, or total body bone density to help gauge fracture risk. Read more.
    Beyond DEXA: Other Bone Mineral Density Tests
    Various methods can check bone density, including ultrasound and quantitative computed tomography (QCT).* Bone density scores and cost may vary by testing method.* Learn about these tests.

    Who Should Get Bone Density Testing?
    Bone density normally drops with age. When should you get a bone density test? Read guidelines from the National Osteoporosis Foundation.
    Know Your Osteoporosis Blood Test Markers
    Whether you're being screened or treated for osteoporosis, your doctor may order a blood or urine test to see the metabolism of bone. This provides clues to the progression of your disease.

    Treatment & Care

    Osteoporosis treatments include the “basic CDE’s” -- calcium(C), vitamin D (D), weight-bearing exercise (E), prevention of Falls (F), and bone-friendly medicines.* *

    Osteoporosis Treatments
    Osteoporosis treatments come in several forms. Many should be started during childhood; others include prescription drugs to treat osteoporosis. Get an overview.
    Osteoporosis Exercise
    Weight-bearing exercise is often an option for osteoporosis patients, and it might even help your bones, as this article explains. Check with your doctor before starting a new fitness program.
    Learn about some of the medications used to treat and prevent osteoporosis here.

    Fosamax and Jaw Problems: Osteonecrosis
    Fosamax may be linked to “jaw death” (osteonecrosis of the jaw) --a condition of chronic pain and facial disfigurement. Read about the other symptoms and be sure to report them to your doctor

    More details:


    Fosamax Jaw Death

    Last edited by trimurtulu; 11-24-2008 at 11:17 PM.

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