Osteoporosis

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What is it

Meaning porous bones in Latin, osteoporosis is a thinning of the bones, which makes them fragile and brittle so that they fracture easily.

Bone tissue constantly “remodels” itself lays down calcium and then releases and replaces it but for most of adult life there is an equilibrium calcium is laid down and released without apparent change in bone density. However, at about age 35 for women and slightly later for men, bone density begins to decrease.

Bone loss does not mean that the bone is diseased or abnormal. It just means there’s less of it: when new bone forms, it’s less dense. The body continues to remove calcium from the bone storehouse, but in older people some of this calcium is not replaced.

Although osteoporosis can affect men, it’s about eight times more common in women. For both men and women, the chief risk factor is age: the disease usually becomes detectable in people in their 60s, 70s, and beyond. About 1.3 million older Americans suffer fractures each year owing to osteoporosis. It can also result in a reduction in height because of the solidity of the vertebrae, and it causes the curved position well-known as dowager’s hump. It’s a major cause of disability among older women.

There is no cure for osteoporosis and no way to prevent it in very advanced age. But it can be delayed and it can be treated. Like hypertension, osteoporosis has been called a silent dis- ease. You may not be aware of it until you fall and fracture a bone. Thus, prevention is the best line of defense.

Symptoms

  • Lower-back pain.
  • A gradual loss of height; a stooping posture.
  • Sometimes no obvious symptoms until a bone breaks, typically the hip, arm, or wrist.

What causes it

Gender may be the most important factor in bone maintenance. The sex hormones (testosterone in men, estrogen in women) are a major influence on calcium uptake by bone tissue and thus skeletal strength. Other hormones aid in the release of calcium and the breakdown of bone mass. In this respect women are at a disadvantage. They begin life with less bone mass, on average, than men. Then at menopause, usually around the age of 50, a woman’s supply of the hormone estrogen decreases, and her bone loss becomes more rapid than a man’s. That’s why after age 65, so many women suffer from osteoporosis.

Nutritional factors the intake of calcium and vitamin D, as well as other nutrients whose function in bone building is not fully understood also play an important role in formation and loss of bone mass.

Another factor is physical activity: a lack of it can hasten the onset of osteoporosis. Bones respond to mechanical stress by becoming denser and stronger. Without the stress that comes primarily from weight-bearing activity, in which your legs support your body, and from strength-building activity (such as weight lifting), your bones will eventually grow weaker. (Conversely, if you walk a lot, for example, your leg bones will respond by increasing their mass.)

Another influence on bone is genetics. Asian and white women tend to be small-boned, which makes them susceptible to osteoporosis. African and many African-American women tend to have more bone mass throughout life (which is a protective genetic trait), though that does not mean they never develop osteoporosis.

What if you do nothing

If you have osteoporosis and choose not to do anything to stop the loss of bone, the condition will worsen and can have serious implications for your health.

Home remedies

There is no cure for osteoporosis nor are there any remedies, but you can take steps to slow down and even reverse some of the bone loss. These include exercise and dietary measures as well as medication. You should discuss available options with your doctor.

Prevention

Unfortunately, many women think they don’t have to start worrying about osteoporosis until menopause. This a myth. Recent research shows that certain lifelong habits are the best preventive for osteoporosis. You can’t do much about small frame size or hereditary factors that put you at risk but that’s all the more reason to take preventive steps.

The best time to begin a program of prevention is in childhood; you should then continue it throughout your life. In your 20s and early 30s, bone density is on the increase. The more bone you build early in life, the better you will be able to withstand bone loss later in life. Even if you’ve waited until your 40s, 50s, or 60s, there is still plenty of reason to follow a preventive program.

Make weight-bearing exercise part of your daily life

That means walking, running, cycling, dancing, or weight lifting or activities such as housework or mowing the grass. Swimming and yoga are not weight-bearing exercises and thus don’t build bones, though they have other benefits. Exercise should be part of your life at all stages, but it’s particularly important as you grow older.

Consume enough calcium

Besides building strong bones and maintaining bone density and strength, calcium also plays a role in regulating your heart beat and other vital functions. The daily recommended dietary allowance, or RDA, is 800 milligrams, except for adolescents and young adults (ages 1 1 to 24) and pregnant or lactating females, who are recommended to consume 1,200 milligrams daily; some specialists suggest that postmenopausal women consume at least 1,500 milligrams. Similar upsurges in calcium consumption for men may be significant as well.

Many dark green leafy vegetables are rich in calcium. But the best source of calcium for most Americans, who usually don’t eat much kale, beet greens, or fish bones, remains low-fat or non-fat dairy products. The vitamin D added to milk and the lactose naturally in milk and dairy products are thought to aid in the absorption of calcium.

If you smoke, stop

Do so not only for the strength of your bones but for your general health and well-being.

Drink lightly or moderately

Light to moderate drinking is defined as an average of no more than two drinks a day. A drink is defined as 5 ounces of wine, 12 ounces of beer, or 1.5 ounces of 80-proof liquor (all contain about half an ounce of pure alcohol).

If you are menopausal, think about  hormone replacement therapy (HRT)

This contains of low-dose estrogen and progesterone treatments which can indisputably slow bone loss and avoid breakages as well as decrease hot flashes and other common menopausal difficulties. The added progesterone also reduces the risk of endometrial cancer. HRT probably protects against heart disease, though the evidence remains controversial. (It’s estrogen, not the combination of estrogen with progesterone, that’s known to be protective.) HRT, if used to prevent osteoporosis, should be started at menopause when bone loss greatly accelerates for maximum effect. But it can still have a beneficial effect even if started years later.

Only you, in consultation with your doctor, can decide whether HRT is appropriate for your health. Some women do very well without HRT, which has its downside, too. It may increase the risk of breast cancer, though the evidence isn’t yet clear. Women who have had breast cancer should not undergo HRT. Those with migraine headaches, diabetes, and other disorders are sometimes advised against it. AU women should be informed about HRT and at menopause should discuss the pros and cons with their physicians.

In particular, if you have one or more risk factors for osteoporosis, you should consider HRT But whether you opt for it or not, you should modify the risk factors that you can modify: begin an exercise program if you’re sedentary, increase your calcium intake, don’t smoke, and limit your alcohol intake.

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