Osteoporosis
Causes
Osteoporosis is the most common type of bone disease.
Researchers estimate that 1 in 5 U.S. women over 50 have osteoporosis. Nearly half of all women over 50 will have a broken hip, wrist or vertebra (bones of the spine).
Osteoporosis occurs when the body is unable to form enough new bone, when too much old bone is reabsorbed by the body or both.
Calcium and phosphorus are two minerals essential for normal bone formation. Throughout youth, your body uses these minerals to produce bones. If you do not get enough calcium or if the body does not absorb enough calcium from the diet, can affect bone formation and bone tissues.
As you age, calcium and phosphate may be reabsorbed back into the body from the bones, which makes the bone tissue weaker. This can lead to brittle bones that are more prone to fractures, even without an injury.
Usually, the loss occurs gradually over a period of years and, often, the person will suffer a fracture before becoming aware of the presence of the disease. When this happens, the disease is in its advanced stages and damage is severe.
Osteoporosis
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Osteoporosis
The main causes of osteoporosis are a drop in estrogen levels in women at the time of the menopausiamenopausia and decreased testosterone in men. Women over age 50 and men over 70 have a higher risk of osteoporosis.
Other causes include:
* Being confined to a bed
* Chronic rheumatoid arthritis reumatoideaArtritis, chronic kidney disease, eating disorders
* Take corticosteroids (prednisone, methylprednisolone) every day for more than three months or take some anti-
* HiperparatiroidismoHiperparatiroidismo
White women, especially those with a family history of osteoporosis, have a higher than average risk of developing the disease. Other risk factors include:
* Absence of menstrual periods (amenorreaamenorrea) long
* Take a large amount of alcohol
* Family history of osteoporosis
* Background Hormone therapy for breast cancer or prostate cancer
* Low body weight
* Smoking
* Too little calcium in the diet
Symptoms
Symptoms
There are no symptoms in the early stages of the disease.
The symptoms that occur in advanced disease are:
* Pain or tenderness or bone tenderness óseaDolor
* FracturasFracturas with little or no trauma
* Loss of height (up to 6 inches) over time
* Low back pain due to fractures of the bones of the spine
* CuelloDolor neck pain due to fractures of the bones of the spine
* Stooped posture or cifosiscifosis, also called “dowager’s hump”
Exams and Tests
Exams and Tests
The examination of bone mineral density (specifically a densitometry or dual energy radioabsorciometría, DEXA, for its acronym in English) measures how much bone you have. The doctor uses this test to predict risk of bone fracture is one in the future. For information on when to have the test, see óseaexamen density test bone density.
On rare occasions, you can use a special type of CT scan vertebraltomografía column of the spine may show loss of bone mineral density, Quantitative computed tomography (CBT).
In severe cases, a radiograph of the spine or caderaradiografía of the spine or hip may show fracture or vertebral collapse. However, plain radiographs of the bones are not very accurate in predicting whether someone is likely to have osteoporosis or not.
You may need other blood and urine tests if your osteoporosis is thought to be due to a medical condition, rather than simply the usual bone loss seen with older age.
Treatment
Treatment
The goals of treatment for osteoporosis are:
* Control pain with the disease
* Slow down or stop bone loss process
* Prevent bone fractures with medicines that strengthen bone
* Minimize the risk of falls that might cause fractures
There are several different treatments for osteoporosis, including change in lifestyle and a variety of medications.
Medications are used to strengthen bones when:
* Has been diagnosed with osteoporosis by a bone density study
* Has been diagnosed with osteopenia (thin bones, but not osteoporosis) through a bone density test, if there has been a bone fracture
Bisphosphonates:
Bisphosphonates main drugs used to both prevent and treat osteoporosis in postmenopausal women.
* The bisphosphonates taken by mouth include alendronate (Fosamax), ibandronate (Boniva) and risedronate (Actonel). Most are taken by mouth, usually once a week or once a month.
* Bisphosphonates administered intravenously are taken less frequently.
CALCITONIN
It comes in nasal spray or injection. It is a drug that slows the rate of bone loss and relieves bone pain. The main side effects of calcitonin are nasal irritation from the spray and nausea from the injectable form.
Calcitonin appears to be less effective than bisphosphonates.
Hormone
Estrogen therapy hormonoterapiahormonoterapia or almost not used to prevent osteoporosis and are not approved to treat a woman who has already been diagnosed with the condition.
Sometimes, if estrogen has helped a woman and she can not take other options to prevent or treat osteoporosis, the doctor may recommend that you continue using hormone therapy. If you are considering taking hormone therapy to prevent osteoporosis, discuss the risks with your doctor.
Parathyroid Hormone
Teriparatide (Forteo) is approved for the treatment of postmenopausal women with severe osteoporosis and are considered at high risk of fractures. The drug is administered via daily subcutaneous injections and the same woman might apply at home.
Raloxifene
Raloxifene (Evista) is used for the prevention and treatment of osteoporosis. It’s like a drug for breast cancer tamoxifen. Raloxifene can reduce the risk of spine fractures by almost 50%, however, does not seem to prevent other fractures, including hip. You may have protective effects against heart disease and breast cancer, although further studies are needed to confirm.
The most serious side effect of raloxifene is a small risk of blood clots in the veins of the legs (deep vein thrombosis) or lungs (pulmonary embolism).
EXERCISE
Regular exercise can reduce the likelihood of bone fractures in people with osteoporosis. Some of the recommended exercises include:
* Weight-bearing exercises such as walking, jogging, tennis, dancing
* Resistance exercises free weights, weight machines, rubber bands for stretching
* Balance Exercises: tai chi, yoga
* Riding a bike
* Using rowing machines
Avoid any exercise that presents a risk of falling or high-impact exercise that can cause fractures.
DIET
Eat at least 1,200 milligrams of calcium daily and 800 to 1,000 international units of vitamin D. This vitamin helps your body absorb calcium. Your doctor may recommend a supplement to provide calcium and vitamin D is needed.
Eat a diet that provides adequate amounts of calcium, vitamin D and proteínaproteína Dvitamina. Although this will not completely stop bone loss, it will guarantee that the supply of materials the body uses to form and maintain bones.
Foods rich in calcium include:
* Cheese
* Ice Cream
* Leafy green vegetables such as spinach and kale
* Low-fat milk
* Salmon
* Sardines (with bones)
* Tofu
* Yogurt
Unhealthy habits SUSPENSION
Stop smoking, if they do. Also limit alcohol consumption. Excessive alcohol can cause damage to bones, as well as put you at risk for falls and broken bones.
FALL PREVENTION
It is critical to prevent falls. Avoid sedating medications and remove household hazards to reduce the risk of fractures. Make sure your vision is good. Other ways to prevent falling include:
* Avoid walking alone on days when snow falls
* Using bars in the bathroom when needed
* Wear shoes that fit well
CONTROL
The response to treatment can be monitored with serial measurements of bone mineral density every two years.
Women taking estrogen should have mammograms, pelvic exams and Pap smears.
RELATED SURGERIES
There are no surgeries to treat osteoporosis such, but can use a procedure called vertebroplasty to treat any small fractures in the spine due to osteoporosis. This procedure may also help prevent weak vertebra from becoming fractured by strengthening the bones in the spine.
The procedure involves injecting a paste that hardens quickly in areas that are fractured or weak. A similar procedure, called kyphoplasty, uses balloons to widen the spaces that need the glue (The balloons are removed during the procedure.)
Prognosis
Prognosis
Medications to treat osteoporosis may help prevent fractures, but vertebral collapse that has already occurred can not be neutralized.
Some people with osteoporosis become severely disabled as a result of weakened bones. Hip fractures leave about half of patients unable to walk independently. This is one of the main reasons why people are admitted to nursing homes.
Although osteoporosis is debilitating, it does not affect life expectancy.
Possible complications
Possible complications
* Crushing vertebral
* Disability caused by severely weakened bones
* Hip and wrist
* Loss of ability to walk due to hip fractures
Call your health care provider
Call your health care provider
Call your doctor if you have symptoms of osteoporosis or to be screened for this disease.
Prevention
Prevention
Calcium is essential for the formation and maintenance of healthy bones. Vitamin D is also needed because it helps your body absorb calcium. The Eating a healthy, well-balanced diet can help you get these and other important nutrients throughout life.
Other tips for prevention:
* Avoid excessive alcohol consumption
* Do not smoke
* Exercise regularly
There are many drugs approved for the prevention of osteoporosis.
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