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Yefim Boars
Yefim Boars

Osteoporosis


About 200 million people are estimated to have osteoporosis throughout the world. In the U.S., the figure is about 54 million people. Although osteoporosis occurs in both men and women, women are four times more likely to develop the disease than men. There are currently about two million men in the U.S. who have osteoporosis and some 12 million more who are at risk of developing the condition.




osteoporosis



After age 50, one in two women and one in four men will have an osteoporosis-related fracture in their lifetimes. Another 30% have low bone density that puts them at risk of developing osteoporosis. This condition is called osteopenia.


Osteoporosis is responsible for more than two million fractures each year, and this number continues to grow. There are steps you can take to prevent osteoporosis from ever occurring. Treatments can also slow the rate of bone loss if you do have osteoporosis.


Researchers understand how osteoporosis develops even without knowing the exact cause of why it develops. Your bones are made of living, growing tissue. The inside of healthy bone looks like a sponge. This area is called trabecular bone. An outer shell of dense bone wraps around the spongy bone. This hard shell is called cortical bone.


When osteoporosis occurs, the "holes" in the "sponge" grow larger and more numerous, which weakens the inside of the bone. Bones support the body and protect vital organs. Bones also store calcium and other minerals. When the body needs calcium, it breaks down and rebuilds bone. This process, called bone remodeling, supplies the body with needed calcium while keeping the bones strong.


Up until about age 30, you normally build more bone than you lose. After age 35, bone breakdown occurs faster than bone buildup, which causes a gradual loss of bone mass. If you have osteoporosis, you lose bone mass at a greater rate. After menopause, the rate of bone breakdown occurs even more quickly.


Age and osteoporosis affect men also. You might be surprised to know that men over the age of 50 are more likely to have an osteoporosis-induced bone break than to get prostate cancer. About 80,000 men per year are expected to break a hip, and men are more likely than women to die in the year after a hip fracture.


Your risk of developing osteoporosis is also linked to ethnicity. Caucasian and Asian women are more likely to develop osteoporosis. However, African-American and Hispanic women are still at risk. In fact, African-American women are more likely than white women to die after a hip fracture.


Another factor is bone structure and body weight. Petite and thin people have a greater risk of developing osteoporosis because they have less bone to lose than people with more body weight and larger frames.


Family history also plays a part in osteoporosis risk. If your parents or grandparents have had any signs of osteoporosis, such as a fractured hip after a minor fall, you may have a greater risk of developing the disease.


Finally, some medical conditions and medications increase your risk. If you have or had any of the following conditions, some of which are related to irregular hormone levels, you and your healthcare provider might consider earlier screening for osteoporosis.


Some medications cause side effects that may damage bone and lead to osteoporosis. These include steroids, treatments for breast cancer, and medications for treating seizures. You should speak with your healthcare provider or pharmacist about the effect of your medications on bones.


Your healthcare provider can order a test to give you information about your bone health before problems begin. Bone mineral density (BMD) tests are also known as dual-energy X-ray absorptiometry (DEXA or DXA) scans. These X-rays use very small amounts of radiation to determine how solid the bones of the spine, hip or wrist are. Regular X-rays will only show osteoporosis when the disease is very far along.


All women over the age of 65 should have a bone density test. The DEXA scan may be done earlier for women who have risk factors for osteoporosis. Men over age 70, or younger men with risk factors, should also consider getting a bone density test.


Treatments for established osteoporosis may include exercise, vitamin and mineral supplements, and medications. Exercise and supplementation are often suggested to help you prevent osteoporosis. Weight-bearing, resistance and balance exercises are all important.


Raloxifene acts like estrogen with the bones. The drug is available in tablet form and is taken every day. In addition to treating osteoporosis, raloxifene might be used to reduce the risk of breast cancer in some women. For osteoporosis, raloxifene is generally used for five years.


Bisphosphonate osteoporosis treatments are considered antiresorptive drugs. They stop the body from re-absorbing bone tissue. There are several formulations with various dosing schemes (monthly, daily, weekly and even yearly) and different brands:


Women whose bone density test shows T-scores of -2.5 or lower, such as -3.3 or -3.8, should begin therapy to reduce their risk of fracture. Many women need treatment if they have osteopenia, which is bone weakness that is not as severe as osteoporosis. Your doctor might use the World Health Organization fracture risk assessment tool, or FRAX, to see if you qualify for treatment based on your risk factors and bone density results. People who have had a typical osteoporosis fracture, such as that of the wrist, spine or hip, should also be treated (sometimes even if the bone density results are normal).


There are other supplements that have been touted as useful for osteoporosis. One of these is strontium, which has never been approved in the U.S. for osteoporosis. A prescription version of strontium ranelate had been available in the E.U., but it was taken off the market due to serious side effects.


Your diet and lifestyle are two important risk factors you can control to prevent osteoporosis. Replacing lost estrogen with hormone therapy also provides a strong defense against osteoporosis in postmenopausal women.


If you have osteoporosis, you should continue with the lifestyle measures mentioned earlier in terms of eating well, getting enough exercise, avoiding excessive caffeine and alcohol consumption, and not smoking. Make sure that you follow the suggestions of your healthcare provider. You should do all that you can to prevent falls inside and outside of your home. You might want to start with a medical evaluation, which could lead to your healthcare provider providing assistive devices.


If you have risk factors and are concerned about osteoporosis, ask your healthcare provider about being screened, even if you are not as old as 65 (for women) or 70 (for men). Osteoporosis can be serious. Fractures can alter or threaten your life. A significant number of people have osteoporosis and have hip fractures die within one year of the fracture. Always call your healthcare provider if you fall, if you are worried about bone breaks, or if you have back pain that is severe that comes on suddenly.


How likely you are to develop osteoporosis depends partly on how much bone mass you attained in your youth. Peak bone mass is partly inherited and varies also by ethnic group. The higher your peak bone mass, the more bone you have "in the bank" and the less likely you are to develop osteoporosis as you age.


Bone fractures, particularly in the spine or hip, are the most serious complications of osteoporosis. Hip fractures often are caused by a fall and can result in disability and even an increased risk of death within the first year after the injury.


In serious cases of osteoporosis, a simple motion such as a cough or minor bump can result in a broken bone, also called a fracture. People with osteoporosis also have a harder time recovering from broken bones, which can sometimes cause pain that does not go away. Broken hip and spine bones are especially serious, as these injuries can cause older adults to lose their mobility and independence.


While people of all races and ethnic groups can develop osteoporosis, certain groups are more likely to develop the disease. Osteoporosis affects about one in five women over age 50, but only one in 20 men. Among women, those of White and Asian descent are more likely to develop osteoporosis. Other risk factors for osteoporosis include:


The risk of developing osteoporosis increases as people grow older. At the time of menopause, women may lose bone mass quickly for several years. After that, the loss slows down but continues. In men, the loss of bone mass is slower. By age 65 or 70, men and women lose bone mass at the same rate.


If you are a woman over age 65, the U.S. Preventive Services Task Force recommends that you get tested for osteoporosis. Women younger than 65 who are at greater risk should also get tested. The task force does not recommend regular screening for men. Men lose bone density more slowly than women but should still be aware of the possibility of developing osteoporosis. Older men who break a bone easily or who are at risk for osteoporosis should talk with their doctor about testing and treatment.


Treating osteoporosis means slowing or stopping the bone loss to prevent breaks. If your test results show that you have osteoporosis or bone density below a certain level and you have other risk factors for fractures, your doctor may recommend lifestyle changes and medications to lower your chances of breaking a bone.


The same healthy lifestyle choices that help prevent osteoporosis can be used to treat it. These include exercising regularly and eating a healthy diet. However, lifestyle changes may not be enough if you have lost a lot of bone density. There are also several medications to consider. Some can slow your bone loss and others can help rebuild bone.


You can also help reduce the risk of breaking a bone by preventing falls. For individuals with weakened bones, falling is more likely to cause a fracture. Additionally, broken bones in people with osteoporosis may not heal properly and could cause persistent pain, leading to a loss of mobility and independence. 041b061a72


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