by Eileen Renders
Osteoporosis is a big problem for older women. It occurs when the body fails to form sufficient new bone or when too much old bone is reabsorbed by the body, or both. Women are at a much higher risk of osteoporosis than men. The National Center for Biotechnology Information reports that 16 percent of postmenopausal women have osteoporosis of the lumbar spine, increasing their risk of a facture. Indeed, five percent of all 50-year-old women and 25 percent of all 80-year-old women have had at least one vertebral fracture. According to the National Health and Nutrition Examination Survey, an estimated fourteen million American women over the age of 50 are affected by low bone density in their hips, five million more have bone density that measures 2.5 standard deviations or more below the mean at the hip.
Age is an important factor in the relationship between bone density and the absolute risk of fracture. Statistics show that, while 50 in 100,000 Caucasian women may experience a hip fracture at age 50, by age 65, 237 of those 100,000 will experience a fracture. And Caucasian women are two to three times more likely than non-Caucasian women to suffer a fracture. This evidence report describes the effectiveness of various strategies for diagnosing and monitoring postmenopausal women with osteoporosis, as represented by three of six topic areas.
Causes of osteoporosis are as follows: a) Lack of weight-bearing exercise b) Thyroid problems, c) Excessive corticosteroid medication, d) Inadequate calcium and vitamin D ingestion, e) Postmenopausal decrease in estrogen levels, f) Bone cancer, g) Cigarette smoking, h) Eating disorders, and i) Alcoholism.
Pain similar to that of arthritis occurs in the early stages of the disease and becomes sharper pain as the disease progresses. Spontaneous fractures can occur, usually in the spine. These fractures compress the vertebrae and lead to loss of height. Other fractures, especially those that occur in the hips, wrists, or ribs usually are caused from falling down.
Exercise The Mayo Clinic advises that choosing the right form of exercise can help prevent osteoporosis. These include strength training (especially those for the upper back), weight-bearing aerobic activities, flexibility exercises, and stability and balance exercises. Activities such as swimming and cycling have benefits, but, according to the Mayo Clinic, they do not provide the weight-bearing load your bones need to slow down mineral loss.
Nutrition Eating foods rich in calcium and vitamin D, such as dairy, fish and fresh fruit, and vegetables, helps maintain good bone health. Calcium is widely available in many foods as well as in supplements and other forms, such as coral calcium, calcium citrate, or in antacids such as TUMS.
Excessive calcium intake can also contribute to having an overload of blood calcium in the blood, which can cause symptoms and contribute to other health issues. Calcium for some sensitive individuals can cause nausea or even vomiting. Some research has also suggested that too much calcium can contribute to depression, as it is a “calming mineral, and vitamin D taken in excess can lead to toxicity.
Medical Treatments and Guidelines:
In addition to exercise and diet, various drugs, vitamins, and minerals are used to treat osteoporosis. Avoiding smoking and excessive alcohol ingestion are also very important.
Estrogen therapy and Selective Estrogen Receptor Modulators (SERM) Raloxifene is a type of SERM drug produced to provide a particular type of estrogen effect, however it is not to be taken by anyone who has shown an allergy towards SERM, by pregnant women, or by women who are breastfeeding.
Side effects include chest pain, coughing up blood, pain, swelling, redness in the leg (particularly below the knee), blurred vision, severe headache, and chest pain.
Bisphosphonates This class of drug decreases bone loss by increasing bone formation and slowing down bone turnover. A warning: these are not to be taken by anyone allergic to bisphosphonates, those with decreased kidney function, abnormalities of the esophagus, those diagnosed with hypocalcemia or anyone unable to sit or stand upright for 30 minutes after taking bisphosphonates. Caffeine, milk, orange juice, and antacids all reduce the absorption of bisphosphonates. Caution is advised also in use of aspirin or aspirin products such as salsalate, Rowasal, Asacol, mesalamine.
Side effects of bisphosphonates include constipation, diarrhea, gas, stomach bloating, abdominal pain, esophagus ulcers. These ulcers can become severe enough to cause swelling, coughing, and bleeding that can result in hospitalization.
Calcitonins Calcitonins are hormones produced by human C-cells. They can be used as a nasal spray after a fracture to relieve pain. Side effects include increased urinary frequency, elevated blood sugar levels, nausea, vomiting, flushing, and runny nose. Other, more serious side effects are tightness in the chest, light headedness, fainting, trouble breathing, tingling in the mouth or throat, hives, heavy or continuous nose bleeds, and swelling of hands or face. If you experience any of these latter side-effects, call your doctor immediately.
Parathyroid Hormone Derivatives (PTH) PTH works by regulating the amount of Calcium circulating in the blood and also by increasing bone formation. This type of drug is not to be used by individuals with Paget’s disease, and patients with an allergy to this medication are at an increased risk of osteocarcoma, including individuals with Paget’s disease. Side effects include aggravation of existing heart disease, low blood pressure, nausea, vomiting, or tiredness, call your doctor.
Other Drugs being Investigated for Treatment of Osteoporosis Etidronate (Didronel)is another form of bisphosphonate drug approved by the FDA for the treatment of Paget’s disease. Lasofoxifene is a SERM that has been shown to decrease bone loss. It also seems to have favorable effects on levels of blood cholesterol and may prevent the growth of certain breast cancer cells as well, although these claims remain to be proven.
Take care of your bone health and get a bone scan today!
Photo by Emiliano Vittoriosi @emilianovittoriosi (Italy).