Osteoporosis is common in people above 50 years. As the name indicates, it is the porous bone disease. There is loss of bony mass making the bone more fragile for fracture. The incidence gradually increasing. US has more than 10 million people with osteoporosis above the age of 50 years.
Risk factors-
. Age– As the age advances, it increases the chances of osteoporosis. With advanced age, bone density gradually decreased over the years leading to osteoporotic fractures.
. Sex– Females have more preponderance than males. Usually post menopausal women are more affected due to hormonal imbalance like estrogen insufficiency.
. Physical inactivity– It increases the chances of osteoporosis due to to waning of bony matrix.
. Smoking and alcohol
. Chronic diseases like chronic kidney disease and hyperthyroidism also increase the chances of osteoporosis.
. Some drugs like heparin, thyroxine, anti-convulsants, glucocorticoids, cyclosporine and anticancer drugs accelerate the process of osteoporosis.
. Malabsorption syndromes resulting decreased level of calcium and micronutrients in healthy bone formation.
Symptoms of Osteoporosis
Initially there is no symptoms. The disease progresses slowly with diminished bony mass. Even minor stress or fall can lead to fractures. The most common sites of fractures are vertebrae, hip , forearm. In severe cases, there may be severe backache resulting in radicular pain due to compression fractures. In hop bone, femoral neck fracture is most common. In fore arm, Colles fracture is very common.
Diagnosis of Osteoporosis
Diagnosis is done by DEXA scan. DEXA means dual energy X ray absorptiometry. It measures the bony density. If the bony density falls below the 2.5 standard deviation that of a normal adult it is diagnosed as having osteoporosis. When the bony density is between 1- 2.5 standard deviation it is termed as osteopenia.
Treatment for Osteoporosis
Foods rich in calcium can counter the process of osteoporosis. The foods rich in calcium are dairy products like milk, cheese, yogurt. One cup of milk meets around 40% RDA of calcium. RDA means the recommended dietary allowance per day. RDA for calcium is around 1000mg per day.
Vitamin D- It helps in absorption of calcium. Sunlight is the best source of vitamin D. Also we get vitamin D from Cod liver oil.
Foods like green vegetables, okra, spinach are rich in magnesium which help in bony matrix formation.
Vitamin C rich foods are equally important as it helps in connective tissue formation in bony matrix. Foods rich in vitamin C are orange, sweet lemon, guava, strawberries, black currants.
Hormone replacement therapy
It is done especially in post menopausal women. As the level of estrogen goes down, it make the bone more brittle or fragile for fractures.
SERM or Selective estrogen receptor modulators like raloxifene are useful in post menopausal women.
Other drugs used in osteoporosis are teriparatide and denosumab. Denosumab is the monoclonal antibody formulation used on osteoporosis.
Weight bearing exercises
It helps in formation of strong bones. Climbing upstairs, leg presses, push ups, dumbbelling help in this regard making strong bones.
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