Osteoporosis is a progressive systemic disease.
It is characterized by decreased bone mass and bone tissue resulting in bone fragility and increased susceptibility to fractures.
More than 40 million American women and 14 million men are at higher risk of developing osteoporosis.
60 million American people will develop osteoporosis in the year 2020.
The estimated cost of osteoporosis in the US is 17 billion per year.
Bone fracture is the primary cause of morbidity and mortality in patients with osteoporosis.
The most common fractures are vertebrae, distal radius, and femur.
Types of osteoporosis
1. Type1/ postmenopausal osteoporosis; women’s; it mainly occurs in postmenopausal women between 51 to 75 years age group. Decreased estrogen secretion causes it, and it leads to increased bone loss. The most common fractures are vertebrae and distal radius.
2. Senile osteoporosis; occurs both in men and women older than the 75 years age group population. The most common fractures are the hip, pelvis, vertebrae.
3. Secondary osteoporosis; occurs in both men and women of any age group. It is most commonly caused by certain drugs (corticosteroids, chemotherapy) and diseases (thyrotoxicosis, Cushing syndrome, etc.).
Risk factors for Osteoporosis
1. Gender; women are more likely to develop O.P than men.
2. Age; older peoples are more susceptible to O.P than adults.
3. Races; white Asians at higher risk for developing O.P than the black peoples
4. Family history
5. Body frame size
6. Sex hormones; decreased secretion of LH/FSH will decrease osteoblast formation, increasing bone loss.
7. Thyroid hormones; too much elevation of T3&T4 will increase the bone loss
8. Low calcium intake
9. GI surgery
10. Low food intake
11. Drugs; corticosteroids, lithium, chemotherapy, heparin, anti-convalescents.
12. Diseases; Cushing syndrome, thyrotoxicosis, thpe2 diabetes, thalassemia, rheumatoid arthritis.
Patient counseling points for Osteoporosis
1. Quite smoking otherwise it increases the bone loss and fractures
2. Avoid excessive intake of alcohol and caffeine (it decrease bone formation)
3. Prevent falls
4. Maintain a healthy body weight; Being overweight and underweight can increase the risk of bone fractures, so; keep your body weight in a healthy range that is good for your health.
5. Calcium; about 99% of calcium is present in our bone teeth only, and it is responsible for strengthening the bone. The Recommended calcium is approximately 1.2 gms daily.
It is mainly present in the egg, milk, cheese, ice cream, calcium-fortified juices and cereals, salmon, pork, broccoli. Excessive supplementary calcium ((pills, syrups, capsules) calcium gluconate, citrate, carbonate, and lactate) intake may harm your heart and vascular system. But calcium in dietary form is not a problem.
6. Vitamin-D; vitamin D is helpful in the absorption of calcium in the gut, kidney, and bones. Without vitamin D, you can’t get all of its benefits, and its deficiency may also lead to bone loss and decreases BMD.
The recommended vitamin-D is about 400 to 600 IU/ day. Dietary vitamin D is mainly present in egg yolk, fatty fish (tuna and salmon), fortified juices, cereals, egg, cod liver oil, beef liver.
7. Avoid bone killer food items; sugar snacks, high sodium foods, soft drinks, caffeine, and alcohol.
8. Weight-bearing exercise: It is necessary for maintaining bone health. Such as regular exercise like walking, jogging, running, skipping, cycling, etc.
9. BMD testing; if you’re in the postmenopausal phase every 1-2 years, you must check your bone density.