Osteoporosis
By Lacie and Janay
What is it ?
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Often known as the Silent
thief
Osteoporosis is a disease in
which bones become fragile
and are more likely to break
Characterized by a decrease
in mass resulting in bones
that are more porous and
easily fractured.
These broken bones also
termed fractures usually
happen in the wrist, spine,
and hips
Two types of osteoporosis
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First type is termed type 1 which affect 5-20 %
of women. This is the type associated with
menopause as low estrogen levels cause a
decrease in the amount of calcium absorbed. This
type is characterized by vertebral fractures of the
spine.
Second type is called type two with this type the
process of re-absorption and formation of bone
are no longer coordinated meaning your
osteoblast and osteoclast cells are not balanced
leading to a state where bone breakdown
overcomes bone building. This type happens in
both men and women.
Who This Disease Effects
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It affects both males and females age 35
on. But Effects more women than men as
women have less bone mass compared to
men
Especially seems to effect post
menopausal women
At age 75 both sexes become equally
prone for bone loss
Statistics
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1.4 million Canadians suffer from the disease
1 in 4 women over the age of 50 has osteoporosis. Higher
in women because we have less bone mass and live longer.
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1 in 8 men over the age of 50 has osteoporosis
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It costs about 1.3 million dollars a year to treat this disease
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It is estimated that by 2018 Canada will spend 32.5 billion
dollars a year to treat osteoporotic fractures
Causes
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Caused by decreased osteoblast function
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Change in parathyroid activity
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Menopause is # 1 cause in women due to
the decrease in estrogen levels
Insufficient dietary intake of vitamin C and
D
Symptoms
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Height loss
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Curving spine or stooped posture
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Broken bones or fractures in the wrists
and hips and spine
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Protruding abdomen- this is the most
unrecognized symptom of osteoporosis
as most don’t realize curvature of the
spine cause less abdomen space so
intestines have no where else to go so
lean forward.
Kyphorsis- “ Dowager Hump” caused by
vertebral compression fractures and
factures are disfiguring . This is the
symptom most recognized in patients.
A chest x-ray that shows osteopenia
which is a condition where women’s
bone mass is smaller than usual.
Risk factors
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Race – if you are white or of Southern Asian descent.
Age – Older you get the more you chances of getting osteoporosis
increases.
Family History – greater risk if there is a history of it in your
family
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Frame Size – people who are exceptionally thin and have a small
body
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Sedentary lifestyle
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Low body mass < 19 kg/m2
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Had an eating disorder like anorexia nervosa or bulimia. This
cause high risk of lower bone density on back and hips
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Chronic alcoholism
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Excessive smoking
Risk factors continued
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Never been pregnant
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Had an early menopause
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Abnormal absence of menstrual cycle or periods of amenorrhea
causing low estrogen levels
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Low testosterone in men
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Taking certain medications like corticosteroids and anti
convulsants
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Women who have had surgery to remove an ovary as this
accelerates bone loss
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People who have had an overactive thyroid
How it is detected
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A bone density test should be
done on women who have
reached menopause as bone
mass rapidly decreases each
year.
One type is called a dexa scan
( dual energy x-ray
absorpomentry) which
measures bone density and
assesses your risk of bone
fractures.
A complete survey of dietary
intake, drug history, and
lifestyle can determine your
risks of this condition.
Six steps to bone health and
osteoporosis prevention
age
Amount of calcium
Adult women
pregnant and
lactating
1200-1500mg
Women 25-49
1000mg
50-64 taking
estrogen
1000
50-64 not taking
estrogen
1500mg
Adult men 25-64
1000mg
Adult men over 65
1500mg
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1) get your recommended amounts of
calcium and vitamin D. Recommended
amount for vitamin D is 400-800iu/day
2)Engage in regular weight bearing
exercises like walking, stair climbing,
and swimming at least 3 times a week
to make bone s and muscles stronger.
3) rehabilitation like physiotherapy to
regain mobility and reduce pain.
4) Avoid excessive alcohol and
smoking
5) using medication such as hormone
replacement therapy whenever
applicable
6) talk to your doctor about bone
health and make sure to have a bone
density test.
Prevention continued
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Basic prevention
Model
Treatment
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Calcitionin- naturally occurring hormone that increases
bone mass in the spine and may lessen the pain of
fractures already there.
Raloxifene – It is a selective estrogen receptor modulator
that prevents bone loss and spine fractures.
Alendronate and risedronate - these are biphosphates that
slow down the breakdown of bone and increase bone
density
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Calcium – keeps the bones strong
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Vitamin D – helps you absorb calcium
Consequences
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Decresed quality of life
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Lost work days and disability
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Elderly patients develop pneumonia and blood
clots in legs and veins that can travel to the lungs
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Lowered self esteem
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Disfigurement (ex dowager hump)
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Decreased independence