Monday, January 11, 2010

Health Care and Osteoporosis

Ever wonder why the older people get, the shorter they appear as they age? A major contributor to the height question is from a debilitating disease that can be treated and prevented called Osteoporosis, commonly found in more women than men. And, according to the National Osteoporosis Foundation (NOF), this ailment is a disease in which bones become fragile and more likely to break. If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks. These broken bones, also known as fractures, occur typically in the hip, spine, and wrist; any bone can be affected, but of special concern are fractures of the hip and spine. A hip fracture almost always requires hospitalization and major surgery. It can impair a person's ability to walk unassisted and may cause prolonged or permanent disability or even death. Spinal or vertebral fractures also have serious consequences, including loss of height, severe back pain, and deformity.

The NOF provides some very simple guidelines to help prevent osteoporosis:
--EAT RIGHT:Get your daily recommended amounts of Calcium and Vitamin D.
--EXERCISE: Engage in regular weight-bearing and muscle strengthening exercise.
--MAINTAIN A HEALTHY LIFESTYLE: Avoid smoking and excessive alcohol consumption.
--TALK TO YOUR HEALTHCARE PROVIDER: Talk to your healthcare provider about bone health.
--GET TESTED:Have a bone density test and take medication when appropriate.

Osteoporosis, according to the Mayo Clinic, which means "porous bones," causes bones to become weak and brittle — so brittle that a fall or even mild stresses like bending over or coughing can cause a fracture. In many cases, bones weaken when you have low levels of calcium and other minerals in your bones. It's never too late — or too early — to do something about osteoporosis. You can take steps to keep bones strong and healthy throughout life. Because osteoporosis rarely causes signs or symptoms until it's advanced, the National Osteoporosis Foundation recommends a bone density test if you are:
--A woman older than age 65 or a man older than age 70, regardless of risk factors.
--A postmenopausal woman with at least one risk factor for osteoporosis.
--A man between age 50 and 70 who has at least one osteoporosis risk factor.
--Older than age 50 with a history of a broken bone.
--Take medications, such as prednisone, aromatase inhibitors or anti-seizure drugs, that are associated with osteoporosis.
--A postmenopausal woman who has recently stopped taking hormone therapy.
--A woman who experienced early menopause.

According to the National Institutes of Health (NIH), there are risk factors. Those include the following:
--Getting older.
--Being small and thin.
--Having a family history of osteoporosis.
--Taking certain medicines.
--Being a white or Asian woman.
--Having osteopenia, which is low bone mass.

According to eMedicineHealth.com, osteoporosis is often considered to be a condition that frail elderly women develop. However, the damage from osteoporosis begins much earlier in life. Because peak bone density is reached at approximately 25 years of age, it is important to build strong bones by that age, so that the bones will remain strong later in life. Adequate calcium intake is an essential part of building strong bones. In the United States, nearly 10 million people already have osteoporosis. Another 18 million people have low bone mass that places them at an increased risk for developing osteoporosis. As our population ages, these numbers will increase. About 80% of those with osteoporosis are women. Of people older than 50 years of age, one in two women and one in eight men are predicted to have an osteoporosis-related fracture in their lifetime. According to the World Health Organization, the prevalence of osteoporosis among U.S. white women past menopause is estimated to be 14% in those 50-59 years of age, 22% in those 60-69 years of age, 39% in those 70-79 years of age, and 70% in those 80 years of age and older. Significant risk has been reported in people of all ethnic backgrounds. White and Asian racial groups, however, are at greatest risk.

According to FamilyDoctor.org, treatment for osteoporosis starts with changes to your diet. You want to take in more calcium. Your doctor will suggest ways to get more calcium through food, drink and possibly a calcium supplement. He or she may also suggest you take a vitamin D supplement, which helps your body process calcium. Your doctor will want you to increase your physical activity, especially weight-bearing exercise. This helps increase bone density. Examples of weight-bearing exercise include walking, jogging and climbing steps. There are medicines available to treat osteoporosis. They include the following:
--Biophosphonates: These medicines help reduce the risk of breaks and fractures, as well as increase bone density in the hips and spine. They can be taken in orally (in pill form) of intravenously (with an injection). Side effects include nausea, abdominal pain and irritation of the esophagus (the tube that connects the mouth to the stomach). People who cannot take biophosphonates include people who have kidney disease, low levels of calcium in their blood and women who are pregnant or nursing.
--Calcitron: This is a hormone that helps slow the breakdown of bone. It is available as an injection or nasal spray. Side effects include irritation of the lining of the nose and headache (with use of the nasal spray) and diarrhea, abdominal pain, nausea and vomiting (with use of the injection).Raloxifene. This medicine is used to prevent and treat osteoporosis in women by increasing bone density. It is not a hormone, but it mimics some of the effects of estrogen. Side effects may include hot flashes and a risk of blood clots.
--Teriparatide: This medicine is a synthetic form of parathyroid hormone and helps new bone to grow. It comes in an injectable form, and is injected once a day in the thigh or abdomen. It can be used in both women and men for the treatment of osteoporosis. Common side effects may include nausea, abdominal pain, headache, muscle weakness, fatigue and loss of appetite.
--Alendronate and Risedronate: These medicines are used to help prevent and treat osteoporosis. They help reduce the risk of fractures by decreasing the rate of bone loss. They are taken orally in pill form. Their most common side effect is an upset stomach.
--Ibandronate: This medicine helps to slow bone loss and increases bone density. It is available both as a pill or as an injection. If you take the pill, you have 2 options: a daily pill or a monthly pill (the pill you take each month has a greater dose of ibandronate than the pill you take daily). If you take the injection, your doctor or nurse will give you a shot every 3 months. Some of the possible side effects include lower back or side pain, shortness of breath, tightness in the chest, and bloody or cloudy urine.

It is hard to grow new bone after it is lost, so prevention is important according to the American Congress of Obstetricians and Gynecologists (ACOG). Slowing bone loss helps build strong bones. To prevent osteoporosis, focus on building and keeping as much bone as you can. This can be done by doing weight-bearing exercises and choosing foods with enough calcium and Vitamin D. After menopause, your doctor may suggest medication to protect against bone loss if your bones show signs of early osteoporosis. Bone loss can increase if your diet is low in calcium. Calcium slows the rate of bone loss. If the amount of calcium in the bloodstream is too low, it will be taken from the bones to supply the rest of the body. Good sources of calcium are dairy products, such as milk and yogurt. Other sources are leafy green vegetables, nuts, seafood, and juices and cereals that are fortified with calcium. A well-balanced diet is very healthy for bones. Most women do not consume enough calcium in their diets. In fact, many women get only one half of the daily amount of calcium they need. You may need to take calcium supplements. Ask your pharmacist to suggest one that is right for you. Calcium cannot be absorbed without vitamin D; milk that is fortified with vitamin D, including lactose-free milk, is one of the best sources. And, another is sunlight. Being in the sun for just 15 minutes a day helps your skin produce vitamin D and activates vitamin D in your body. You also can use vitamin D supplements.

To increase your chances of staying healthy, you have an important goal—to prevent bone loss, according to ACOG. Exercise every day, even if you walk only a few blocks, and get enough calcium. Talk with your doctor about methods to prevent, diagnose, and treat osteoporosis.

Until next time. Let me know what you think.

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