WHAT IS OSTEOPOROSIS?

Osteoporosis causes our bones to become 1/4i/weak and brittle. They can at times become so brittle that a simple fall or mid-coughing can cause fractures. The common sites of fractures following osteoporosis are related to the hip, wrist, or spine. A fracture of the hip bone carries enormous risk to life.

How does osteoporosis occur?

We must understand that our bones are living tissues. The tissues are constantly being broken down and replaced. Osteoporosis occurs when the new bone formation does not keep pace with the loss of bone. This results in the weakening of our bones.

What are the major risk factors for the development of osteoporosis?

These are either modifiable or nonmodifiable. Advanced age, Asian women, early menopause, slender built and positive family history of hip fragility fractures are nonmodifiable factors.

What are the factors that could be modified to prevent osteoporosis?

Low calcium intake, low vitamin D intake, estrogen deficiency, sedentary lifestyle, cigarette smoking, and excessive alcohol, and excessive coffee intake can contribute to osteoporosis. The use of steroids in any form, including inhalation, can lead to osteoporosis.

What are the complications of osteoporotic fractures?

Vertebral fractures cause loss of height. Forward bent, reduced lung efficiency, and increased death rate are common. Hip fractures are associated with permanent disability and excessive death rates.

How is the diagnosis of osteoporosis made?

Many individuals may not have any symptoms till they have a fall and fragility fracture. However, aches and pains, backache, maybe non-specific symptoms. A simple X-ray of the bone may help you to diagnose osteoporosis. A low Bone Mineral Density can be assessed by various modalities. The DXA scan is most widely used in this regard.

What are the current indications for Bone Mineral Density Measurement?

In women above 65 years and men above 70 years, DXA is generally recommended. Estrogen deficiency with one risk factor for osteoporosis needs a DXA scan. Vertebral deformity, fracture or suspicious X-ray of osteoporosis, hyperparathyroidism, glucocorticoid therapy of more than 5 mg or for more than 3 months requires a DXA scan. For monitoring the treatment of osteoporosis, a DXA scan is necessary. BMD measurement helps the doctor to assess the severity of osteoporosis and plan treatment to prevent fractures.

What measures are required to help and prevent osteoporosis?

About 1000 to 1200 mg of calcium per day for pre-menopausal women and men and 1200 to 1500 mg to post-menopausal women and men above 65 years is necessary. Adequate vitamin D intake, 800 to 1200 units per day, is necessary to prevent osteoporosis. Regular aerobic and resistance exercises, smoking cessation, and limiting alcohol and coffee consumption are important. Excess calcium and vitamin D consumption is unsafe and can cause vascular calcification and kidney stones. Hence, Calcium and vitamin D intake should be under a doctor

What are the other agents commonly used?

Besides adequate intake of Calcium and vitamin D, Bisphosphonates, Tripartite, Denosumab, SERM are other valuable medications to prevent fractures. In steroids, induced osteoporosis, bisphosphonates, and Tripartite are known to reduce fractures. As longevity is improving, the incidence of fractures due to osteoporosis is also on the rise. Proper exercise, nutrition, exposure to sunlight, and avoiding excess alcohol consumption are essential. Smoking should be totally avoided. Adequate intake of vitamin D and calcium is significant. There are other treatment modalities available too. These are recommended in specific circumstances. Remember that a fracture of the hip bone is as dangerous as a major heart attack.

Categories : Health

Dr Jay Deshmukh is Chief Physician and Director, Sunflower Hospital, Nagpur Honorary Physician to Honorable Governor of Maharashtra and PondicherryCentral. Dr Jay Deshmukh is an M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD From Internal Medicine – Bombay and New Delhi.

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