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Osteoporosis
Defined
Osteoporosis is a bone disease that occurs when the body loses too much bone, makes too little bone, or both. As a result, bones become weak and may break from a fall or, in serious cases, from sneezing or minor bumps.
Osteoporosis means “porous bone.” Viewed under a microscope, healthy bone looks like a honeycomb. When osteoporosis occurs, the holes and spaces in the honeycomb are much larger than in healthy bone. Osteoporotic bones have lost density or mass and contain abnormal tissue structure. As bones become less dense, they weaken and are more likely to break. If you’re 50 or older and have broken a bone, ask your doctor or healthcare provider about a bone density test.
Osteoporosis is Common
About 54 million Americans have osteoporosis and low bone mass, placing them at increased risk for osteoporosis. Studies suggest that approximately one in two women and up to one in four men age 50 and older will break a bone due to osteoporosis.
Osteoporosis is Serious
Breaking a bone is a serious complication of osteoporosis, especially with older patients. Osteoporotic bone breaks are most likely to occur in the hip, spine or wrist, but other bones can break too. In addition to causing permanent pain, osteoporosis causes some patients to lose height. When osteoporosis affects vertebrae, or the bones of the spine, it often leads to a stooped or hunched posture.
Osteoporosis may limit mobility, which often leads to feelings of isolation or depression. Additionally, twenty percent of seniors who break a hip die within one year from either complications related to the broken bone itself or the surgery to repair it. Many patients require long-term nursing home care.
Osteoporosis is Costly
Osteoporosis is responsible for two million broken bones and $19 billion in related costs every year. By 2025, experts predict that osteoporosis will be responsible for approximately three million fractures and $25.3 billion in costs annually.
Osteoporosis Can Sneak up on You
Osteoporosis is often called a silent disease because one can’t feel bones weakening. Breaking a bone is often the first sign of osteoporosis or a patient may notice that he or she is getting shorter or their upper back is curving forward. If you are experiencing height loss or your spine is curving, be sure to consult your doctor or healthcare professional immediately.
Diseases, Conditions and Medical Procedures That May Cause Bone Loss
There are many health problems and a few medical procedures that increase the likelihood of osteoporosis. If you have any of the following diseases or conditions, talk to your doctor or health care provider about what you can do to keep your bones healthy.
Autoimmune Disorders
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Rheumatoid arthritis (RA)
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Lupus
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Multiple sclerosis
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Ankylosing spondylitis
Digestive and Gastrointestinal Disorders
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Celiac disease
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Inflammatory bowel disease (IBD)
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Weight loss surgery
Medical Procedures
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Gastrectomy
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Gastrointestinal bypass procedures
Cancer
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Breast cancer
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Prostate cancer
Hematologic/Blood Disorders
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Leukemia and lymphoma
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Multiple myeloma
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Sickle cell disease
Neurological/Nervous System Disorders
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Stroke
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Parkinson’s disease
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multiple sclerosis (MS)
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Spinal cord injuries
Blood and bone marrow disorders
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Thalassemia
Mental Illness
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Depression
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Eating disorders
Endocrine/Hormonal Disorders
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Diabetes
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Hyperparathyroidism
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Hyperthyroidism
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Cushing’s syndrome
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Thyrotoxicosis
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Irregular periods
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Premature menopause
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Low levels of testosterone and estrogen in men
Other Diseases and Conditions
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AIDS/HIV
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Chronic obstructive pulmonary disease (COPD), including emphysema
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Female athlete triad (includes loss of menstrual periods, an eating disorder and excessive exercise)
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Chronic kidney disease
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Liver disease, including biliary cirrhosis
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Organ transplants
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Polio and post-polio syndrome
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Poor diet, including malnutrition
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Scoliosis
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Weight loss
Pregnancy and Lactation Associated Osteoporosis (PLO)
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Temporary decreases in bone density are a normal part of pregnancy and lactation—but fractures during this time are extremely rare.
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Fractures of the spine associated with severe back pain are most commonly described, but PLO can also be associated with hip fractures or other types of fracture.
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In the most common scenario, PLO is discovered after a pregnant or breastfeeding woman develops severe back pain, and imaging reveals multiple vertebral fractures.
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Some women with PLO have a pre-pregnancy diagnosis of osteoporosis, but most women with PLO have not been previously diagnosed with osteoporosis, and never had a bone assessment prior to the onset of symptoms.
Diagnosis
To diagnose osteoporosis and assess your risk of fracture and determine your need for treatment, your doctor will most likely order a bone density scan.
This exam is used to measure bone mineral density (BMD). It is most commonly performed using dual-energy x-ray absorptiometry (DXA or DEXA) or bone densitometry. The amount of x-rays absorbed by tissues and bone is measured by the DXA machine and correlates with bone mineral density.
The DXA machine converts bone density information to your T score and Z score. The T score measures the amount of bone you have in comparison to a normal population of younger people and is used to estimate your risk of developing a fracture and need for drug therapy. Your Z score measures the amount of bone you have in comparison to those in your age group. This number can help indicate whether there is a need for further medical tests.
The following procedures can be performed to determine bone fractures due to osteoporosis:
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Bone x-ray: Bone x-ray produces images of bones within the body, including the hand, wrist, arm, elbow, shoulder, foot, ankle, leg (shin), knee, thigh, hip, pelvis or spine. It aids in the diagnosis of fractured bones, which are sometimes a result of osteoporosis.
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CT scan of the spine: CT scanning of the spine is performed to assess for alignment and fractures. It can be used to measure bone density and determine whether vertebral fractures are likely to occur.
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MRI of the spine: Magnetic resonance imaging of the spine is performed to evaluate vertebral fractures for evidence of underlying disease, such as cancer, and to assess if the fracture is old or new. New fractures usually demonstrate a better response to treatment by vertebroplasty and kyphoplasty.
Treatment
Although you can’t completely reverse osteoporosis, there are ways to manage it. Some of those methods are things you can do every day through diet and exercise. Your doctor may also recommend that you take medicine.
Osteoporosis Treatment Approaches
Once you know you have osteoporosis, you have many options for treating the condition and strengthening your bones to prevent fractures.
Types of Osteoporosis Treatments
Along with a healthy diet and exercise, you can treat osteoporosis with medicines that help your bones to stay as strong as possible.
Some people say the supplement strontium improves bone health, but it’s important to consider its benefits and risks before you take it.
Selective Estrogen Receptor Modulators (SERMs)
Selective elective estrogen receptor modulators, or SERMS, are a class of estrogen-boosting drugs used to treat osteoporosis in postmenopausal women.
Forteo (teriparatide) is the only FDA-approved osteoporosis medication that builds bone.
Myth: No Treatment Helps Active Osteoporosis
Even if you already have osteoporosis, many medicines can help prevent bone loss and rebuild bone. They also may lower your chances for bone fractures.
Recently diagnosed with osteoporosis? You may want to ask your doctor these 10 questions.
Monitoring Osteoporosis Treatment
Is your osteoporosis therapy working? Are you having any side effects? Learn about monitoring osteoporosis therapy.
https://www.webmd.com/osteoporosis/guide/osteoporosis_treatment_care
Drugs
Current research & peer reviewed journals
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5335887/
https://www.hindawi.com/journals/jos/
https://www.omicsonline.org/osteoporosis-peer-review-journals.php
https://www.longdom.org/osteoporosis-and-physical-activity.html
Support Groups
https://www.nof.org/patients/patient-support/nof-support-groups/
https://www.inspire.com/groups/national-osteoporosis-foundation/
Patient /Family Stories
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