Transcript Osteoporosis: Keeping the Bone Thief at Bay

Osteoporosis: Keeping the
Bone Thief at Bay
AHMAD ALGUHANI
MOSA A. ALHAFI
Osteoporosis: Keeping the Bone Thief at Bay
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Osteoporosis is common: all too
common. It is estimated that 25%-30% of
all women will break or fracture a bone
because of osteoporosis, and by the age
of 75, 50% of women have osteoporosis.
Unfortunately there are no early warning
signs, a broken bone or osteoporotic
fracture is usually the first indication
The bone thief doesn't arrive over night.
When you are younger, your bone
constantly replenishes itself. As you age
this process slows down. Between ages
35-40, you begin to lose bone mass.
After menopause, when your body is no
longer making estrogen, bone loss
accelerates. Over time, bones may
become brittle, and too weak to withstand
normal stress by this time you already
have osteoporosis.
Osteoporosis does not need to be a
consequence of aging, however. It is
largely a preventable disease.
So how you keep the bone thief at bay?
Many people mistakenly believe that the answer is to increase
calcium intake, yet the amount of calcium in your diet does not
correlate with the amount of calcium that your body retains.
Research has shown that keeping healthy bones depends more
on preventing calcium loss than on increasing calcium
intake, in fact, eating too much calcium in the absence of other
nutrients may actually lead to osteoporosis. Other substances
are needed to prevent calcium loss, such as boron,
phosphorous and vitamin D. There are also other tactics you
can use to protect calcium levels. Reducing meat protein,
which causes calcium to leach away in urine, is just one. There
are many other easy adjustments to make right now, so the bone
thief won't sneak upon you later.
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Exercise and Osteoporosis
Weight bearing exercise (that you do on feet, that works the
bones and muscles against gravity) and muscle contraction
combined have been shown to effectively increase bone density
in the spine. It is recommended that an individual perform 20 to
30 minutes of aerobic exercise 3 to 4 times weekly to increase
bone mass.
Diet and Osteoporosis
Adequate calcium intake is critical in keeping bones strong, and it
is estimated that approximately 70% of people do not regularly
ingest adequate amounts of calcium or vitamin D. Vitamin D is
also critical, to ensure absorption and retention of calcium
in the bones.
The recommended amounts of calcium and vitamin D for adults
are as follows:
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For pre-menopausal women 25-50 years old and post-menopausal
women on estrogen replacement therapy, 1,000 milligrams of calcium
per day with 400 i.u. of Vitamin D. 1,500 milligrams of calcium per day
is recommended for pregnant or lactating women.
For postmenopausal women less than age 65 not on estrogen
replacement therapy, 1,500 milligrams of calcium per day is
recommended along with 400-800 i.u. of Vitamin D.
For men ages 25-65, 1,000 milligrams of calcium per day is
recommended.
For all people (women and men) over age 65, 1,500 milligrams of
calcium per day is sufficient.
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Foods that contain calcium include: dairy products (e.g.,
milk, yoghurt, and cheese), dark green vegetables (e.g.
spinach), grains, beans and some fish. Calcium
supplements are also available. Vitamin D comes from
sunshine, fatty fish, liver, and fortified foods like milk,
orange juice and cereals. Vitamin D supplements are
also available.
Minimize protein and sodium intake. Diets that are high
in protein and/or sodium increase the loss of calcium
through the urine and contribute to decreased calcium
availability.
Amounts above 2000 milligrams of calcium per day can
be harmful to the kidneys and cause kidney stones.
However, when calcium is taken in the recommended
dose there is no increase in kidney stone formation.
People with pre-existing kidney disease should consult
their physician
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Estrogen is probably the most widely known and discussed of all
hormones. The term "estrogen" actually refers to any of a group of
chemically similar hormones; estrogenic hormones are sometimes
mistakenly referred to as exclusively female hormones when in fact
both men and women produce them. However, the role estrogen plays
in men not entirely clear.
The term "estrogen" includes a group of chemically similar hormones:
estrone, estradiol (the most abundant) and estriol. Overall, estrogen is
produced in the ovaries, adrenal glands and fat tissues. More
specifically, the estradiol and estrone forms are produced in the ovaries,
while estriol is produced by the placenta during pregnancy.
In women, estrogen circulates in the bloodstream and binds to estrogen
receptors on cells in targeted tissues, affecting not only the breast and
uterus, but also the brain, bone, liver, heart and other tissues.
Estrogen controls growth of the uterine lining during the first part of the
menstrual cycle, and regulates various other metabolic processes,
including bone growth and cholesterol levels.
Oral contraceptives containing estrogen may also relieve menstrual
cramps and some perimenopausal symptoms, and regulate menstrual
cycles in women
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Other Roles of Estrogen
Bone
Estrogen produced by the ovaries helps prevent bone loss and works
together with calcium and other hormones and minerals to build bones.
Osteoporosis occurs when bones become too weak and brittle to
support normal activities.
Your body constantly builds and remodels bone through a process
called resorption and deposition. Up until around age 30, your body
makes more new bone than it breaks down. But once estrogen levels
start to decline, this process also slows.
Thus, after menopause your body breaks down more bone than it
rebuilds. In the years immediately after menopause, women may lose
as much as 20 percent of their bone mass. Although the rate of bone
loss eventually levels out after menopause, keeping bone structures
strong and healthy to prevent osteoporosis becomes more of a
challenge
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The American Society for Nutritional Sciences
The American Society for Clinical Nutrition
"The bone-building imbalance that occurs in osteoporosis results in fragile
bones with an increased susceptibility to fracture, which can lead to death in the
elderly," added Dr. Baumgartner. "That's why knowing what protective effect a
factor such as fat might have in elderly women not taking estrogen can be so
important. Also, we believe that lean women with low body fat are more likely to
benefit from estrogen replacement therapy."
INTRODUCTION
Prior to menopause androgens, mostly testosterone, are produced by the
ovaries and adrenal glands. Androgens are important for maintaining bone
density and sex drive. After menopause the ovaries stop making androgens, the
adrenals continue, but the total amount produced by the body is greatly
diminished. Androgens are available combined with estrogen, for replacement
therapy. The only combination drugs is ESTRATEST®,. This is prescribed as
second line therapy. For women who have not achieved good relief from hot
flashes, or who are complaining of loss of sex drive, on estrogen.
BONE MINERAL DENSITY ( BMD )
After menopause bones loose significant amounts of calcium. In 25% of women
this bone loss can result in osteoporosis with the resultant high risk of broken
bones. Taking estrogen stops the loss of any more calcium but does not replace
the calcium already lost. Taking calcium supplements and vitamin D will not
replace the lost calcium either. There is now evidence that taking a estrogenandrogen combination can promote new bone formation.