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Osteoporosis
What is Osteoporosis?
Primary osteoporosis is
an age-related disorder characterized by decreased bone mass and
by increased susceptibility to fractures in the absence of other
recognizable causes of bone loss.
How can I tell
if I am at risk for Osteoporosis?
An ordinary x-ray
of your bones will not reveal any abnormality until you have lost
over 25% of your bone mass. At that point you are already at
significant risk for severe, life-threatening fractures. Putting
bone mass back on, after it is lost, is difficult, requiring
long-term use of expensive, poorly tolerated medicines.
Fortunately, preventing
bone loss is relatively easy for most women, as long as you
know if you are at risk. Fortunately, quick and inexpensive test
are available for determining your bone mineral density (BMD).
Who Is at Risk for Developing Osteoporosis?
Women are at
higher risk than men in that they have less bone mass and, for
several years following natural or induced menopause, the rate of
bone mass decline is accelerated. Early menopause is one of the
strongest predictors for the development of osteoporosis. Women
who are underweight also have osteoporosis more often than
overweight women. Cigarette smoking may be an additional predictor
of risk. Calcium deficiency has been implicated in the
pathogenesis of this disease.
Immobilization and
prolonged bed rest produce rapid bone loss, while exercise
involving weight bearing has been shown both to reduce bone loss
and to increase bone mass.
What Are the Possible Causes of Osteoporosis?
Osteoporosis is
histologically, biochemically, and kinetically heterogeneous;
rapid bone turnover or reduced rates of bone formation have been
documented in patients with primary osteoporosis. Multiple
etiologies would not be surprising, considering the complex
factors regulating normal bone metabolism. Among the many possible
etiologies of primary osteoporosis, current data point to two
probable causes: deficiency of estrogen and deficiency of calcium.
Rapid bone loss often accompanies menopause, and premature
osteoporosis follows bilateral oophorectomy. Estrogen replacement
prevents bone loss in both conditions. The following observations
support a causal relationship between calcium deficiency and
osteoporosis: Calcium deficiency in experimental animals causes
osteoporosis; a low calcium intake is common among the elderly and
calcium supplementation reduces bone loss.
How can Osteoporosis be prevented and treated?
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Hormone Replacement
Therapy:
HRT
replaces the estrogen that
your body no longer produces, thereby slowing down and even
stopping the loss of bone mass.
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Calcium Intake:
Include more
calcium-rich foods, such as milk and yogurt, in your diet, or
consider taking a daily calcium supplement. Peri and
postmenopausal women taking estrogen need 1200 mg of calcium per
day, and postmenopausal women not on estrogen require about 1500
mg per day (the average menopausal women only gets about 750 mg
per day).
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Vitamin D:
Vitamin D is activated by the liver and kidneys to boost calcium
absorption. Women age 51-70 require 400 units of vitamin D per
day, and women over the age of 70 need 600 units.
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Exercise:
Exercise can't stop bone loss, but the activity, especially
walking, can slow down the pace of osteoporosis. In addition,
exercise keeps muscles toned and strong, making falls less
damaging. Just 30 minutes of brisk walking several days a week
is all you need to increase strength and overall fitness.
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