Osteoporosis By Lacie and Janay

What is it ? 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 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 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 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. 1 in 8 men over the age of 50 has osteoporosis It costs about 1.3 million dollars a year to treat this disease It is estimated that by 2018 Canada will spend 32.5 billion dollars a year to treat osteoporotic fractures

Causes Caused by decreased osteoblast function Change in parathyroid activity Menopause is # 1 cause in women due to the decrease in estrogen levels Insufficient dietary intake of vitamin C and D

Symptoms Height loss Curving spine or stooped posture Broken bones or fractures in the wrists and hips and spine 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 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 Frame Size – people who are exceptionally thin and have a small body Sedentary lifestyle Low body mass < 19 kg/m2 Had an eating disorder like anorexia nervosa or bulimia. This cause high risk of lower bone density on back and hips Chronic alcoholism Excessive smoking

Risk factors continued Never been pregnant Had an early menopause Abnormal absence of menstrual cycle or periods of amenorrhea causing low estrogen levels Low testosterone in men Taking certain medications like corticosteroids and anti convulsants Women who have had surgery to remove an ovary as this accelerates bone loss People who have had an overactive thyroid

How it is detected 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 Adult men over 65 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 Basic prevention Model

Treatment 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 Calcium – keeps the bones strong Vitamin D – helps you absorb calcium

Consequences Decresed quality of life Lost work days and disability Elderly patients develop pneumonia and blood clots in legs and veins that can travel to the lungs Lowered self esteem Disfigurement (ex dowager hump) Decreased independence