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Thursday, 22 March 2001

Osteoporosis- The Silent Disease

Written by  Miriam Lock

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Osteoporosis is also known as porous bone or brittle bone. It generally begins without any symptoms or pain, and is often called the "silent disease". This silent disease is becoming a major public health threat. In the United States alone, ten million people have osteoporosis, eighty percent of them women. Eighteen million more people are at risk for the disease.

People who have osteoporosis do not usually know they have the disease until they experience a fracture. Fractures most often occur in the wrist, hip or spine, but they can happen in any bone of the body.

Bone is a living and growing tissue. It is made mostly of collagen, a protein, and calcium phosphate, a mineral. The collagen provides the bone with a soft framework and the calcium phosphate adds strength to bone and hardens it. This combination makes your bones strong yet flexible.

Women are at a higher risk than men. As you age your risk increases. Other risk factors include; being post-menopausal, being thin or having a small body frame, having an inactive lifestyle, eating a diet low in calcium and having a family history of osteoporosis. Smoking and excessive alcohol consumption also adds to the risk of developing osteoporosis.

Osteoporosis is a gradual thinning and deterioration of the bone tissue. It strikes men as well as women. Because women are affected more often, osteoporosis is often called a "women's disease". It is, however, a significant threat to men as well. It can strike at any age, although it is more common in older people. It affects almost half of all people over the age of seventy-five. Because of osteoporosis, 1.5 million people in the U.S. suffer some form of fracture every year.

The good news is that osteoporosis is preventable and treatable. The best weapon we have against osteoporosis is knowledge and education. The following questions and answers are designed to give you a better understanding of the disease and what can be done to prevent it and treat it.

QWho is most likely to be affected by osteoporosis?

AWomen are at a higher risk than men. As you age your risk increases. Other risk factors include; being post-menopausal, being thin or having a small body frame, having an inactive lifestyle, eating a diet low in calcium and having a family history of osteoporosis. Smoking and excessive alcohol consumption also adds to the risk of developing osteoporosis.



Some medications affect bone density such as corticosteroids and anticonvulsants. A low testerone level may put men at higher risk. When older people become less mobile because of various health problems, osteoporosis can develop from bone disuse.



QHow will osteoporosis affect me?

AMany people who have osteoporosis don't know they have it until they experience a fracture. The pain of a fracture will be severe and once you have fractured, you are at greater risk for additional fractures. The most common fractures are vertebral, hip and forearm fractures. Fractures can greatly limit your ability to move around and function normally, which also puts you at a higher risk for other complications.



QHow can osteoporosis be diagnosed so it can be treated without waiting for a fracture to happen?

AThe best method is to take a bone density test. This is a simple, non-invasive procedure that takes about ten to fifteen minutes. If you are diagnosed with osteoporosis, there are several ways to treat it to prevent a fracture from ever happening.



QHow is osteoporosis treated?

AIn order to prevent fractures, emphasis must be made on proper nutrition, calcium intake and physical activity. Your doctor will prescribe either estrogen-replacement therapy (which is also taken by many women for menopausal symptoms) or a medication specifically designed to strengthen your bones. Men may be prescribed one of the medications that women take, or, if their testerone level is low, testerone-replacement therapy. For some people, certain changes must be made in their home to prevent falls. Even if you have been diagnosed with osteoporosis or osteopenia (borderline low bone density) it is not too late to improve your diet, increase your calcium intake, and to begin an exercise program in order to fortify your bones.



People who have osteoporosis do not usually know they have the disease until they experience a fracture.

QWhat does estrogen-replacement therapy have to do with my bones?

AEstrogen-replacement therapy, or ERT, has important benefits for women after menopause. Besides helping to reduce symptoms of menopause such as hot flashes, it also can play a great role in the prevention of bone loss that occurs in the years following menopause. While many women are prescribed ERT by their gynecologists or family physicians, not all of them fill their prescriptions. There has been controversy about ERT in the media that has caused certain women to be afraid of side effects of the treatment or believe that they do not need it. While your individual health decisions must be made with the guidance of your own doctor, keep in mind that in most cases the benefits of ERT greatly outweigh the drawbacks.



QWhat about diet?

AThe value of a healthy, balanced diet at any age should never be underestimated. As parents, we must strive to introduce our children to a wide variety of fruits, vegetables, dairy products, meat and poultry, and carbohydrates such as cereals, breads and pasta. Healthy eating will affect the strength of their bones as they grow. Calcium in the diet is crucial for their bone health. Calcium is found in milk, cheese, yogurts, ice cream, and also in certain fruits, vegetables and soy products such as tofu. As adults, we must take responsibility for our own health, and choosing a balanced diet is a significant part of self-care. People who eat a balanced diet have a much better chance of not developing osteoporosis.



If you have already developed osteoporosis, no matter how old you are you can still improve your diet. Increasing your calcium intake will also have direct benefits to the health of your bones. Since, when you are older, your body does not absorb calcium from food in the same way as it did when you were young, your doctor may recommend you take a calcium supplement. Be sure to discuss the amount of calcium in your diet with your doctor, so that he can decide what size supplement to prescribe.



QHow will exercise improve the health of my bones?

AJust as with diet, the significance of physical activity is vital. The proper exercise in your youth will have a direct effect on the strength of your bones as an adult. The truth is that both diet and exercise are the keys to good health for every part of your body throughout life. But if you were not particularly active as a child, adolescent or young adult, you can begin exercising TODAY. Even if you have already discovered that you have osteoporosis, an exercise program will help your bones to develop strength so that you are less likely to experience a fracture.



The best exercise for bone health is weight bearing activity such as walking and lifting weights. People of any age can walk for exercise and it is the easiest and cheapest way to get in shape. Aerobic exercise such as swimming, dancing and active sports will also improve the health of your bones, and of your joints as well. (Keep in mind that while your bones are working out, both your heart and your spirit will be gaining strength at the same time.)



Even if you have been diagnosed with osteoporosis or osteopenia (borderline low bone density) it is not too late to improve your diet, increase your calcium intake, and to begin an exercise program in order to fortify your bones.

QWhat is the connection between osteoporosis and osteoarthritis?

AOsteoporosis and osteoarthritis are two totally different medical conditions. Because of the similarity in their names, they are often confused. In osteoporosis there is a loss of bone tissue that causes bones to become fragile. The term arthritis refers to a group of conditions that affect the joints (the places where the bones come together) and the tissues surrounding the joints. Osteoarthritis is the most common form of arthritis. There are some people who have both. The two conditions do share quite a few methods of coping. For example, people with either or both of the conditions benefit greatly from regular exercise.



QAre there any new developments in the treatment of osteoporosis?

ASerious research is being done in the understanding and treatment of osteoporosis. A hormone called PTH, parathyroid hormone, is presently being studied as to how it increases bone mass in the skeleton when taken in combination with estrogen.



Helpful Websites on Osteoporoosis

  • National Institute of Health (NIH) - Osteoporosis and Related Bone Diseases National Resource Center

  • Intelihealth - Condition Center - Osteoporosis

  • National Osteoporosis Foundation a comprehensive, educational site which includes press releases and updates about what's new in the field of osteoporosis and its treatment. The site includes important information for patients about medications.

  • International Osteoporosis Foundation this site brings together 106 osteoporosis societies from sixty countries around the world. In addition to helpful information about osteoporosis itself, the site includes news of the activities of the I.O.F. and press releases about the programs and projects of the I.O.F. member societies. You can visit any of the member societies through this site.

  • American Dietetics Association
Last modified on Tuesday, 19 April 2011 19:37
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Miriam Lock

Miriam Lock is a writer on social and medical issues.

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