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SPOTLIGHT
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Taking steps to prevent bone loss

Published on -4/26/2013, 9:45 AM

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During the month of May, we have much to celebrate and be thankful for -- Memorial Day, Mother's Day (make sure you don't forget this one), Armed Forces Day and Cinco de Mayo to name only a few. The month of May is also recognized as National Osteoporosis Awareness Month.

Osteoporosis is a disease process characterized by low bone density or mass. Osteoporosis is a progressive disease, meaning bone loss will continue to occur without proper intervention. The disease process results in thin bone and a resulting risk of fracture, most commonly within the hip, spine and wrist.

For the people who suffer from osteoporosis these fractures can be life-altering experiences. In 2009, there were 279,000 hip fracture hospital discharges with an average length of stay of 6.3 days. (National Hospital Discharge Survey 2009) Activities of daily living can be severely limited for many who sustain one or more of these fractures. Osteoporosis can affect men but is more prevalent in the female population.

In America alone, 2 percent of men 50 years and older are afflicted with osteoporosis of the hip. The population size in this group is approximately 800,000. The percent of women aged 50 years or older who have osteoporosis of the hip is 10 percent. The number of women aged 50 years or older with osteoporosis of the hip is 4.5 million.

There are many factors that increase the probability of osteoporosis: post-menopausal women, older adults, diet low in calcium and physically inactive people are only a few. Considering these risk factors, there a number of interventions that can help prevent osteoporosis.

As with most disease processes, proper diet is key for long-term success. Calcium is required for healthy bones and teeth and also is used in the body for many critical functions including the heart, kidney, muscle and nerves. Calcium cannot be synthesized by the body so outside resources are needed for absorption.

Foods that tend to be high in calcium are dairy products, green leafy vegetables and "calcium-fortified" foods. Orange juice is one of the products sometimes labeled "calcium fortified." The makers of such products will add calcium during production. It is recommended a person aged 50 or older consume approximately 1,200mg every day. Vitamin D also is needed to aid in bone development; it assists with calcium absorption, as well. This is why the majority of calcium supplements also have Vitamin D within their product. Sometimes people might suffer from Vitamin D deficiency, which can cause deleterious effects with bone synthesis and structure. A vitamin D level can be checked by a simple blood test. Your physician might consider getting a vitamin D level if he or she is concerned with such a disease process.

Weight-bearing exercise is a great way to prevent osteoporosis. Investing 15 to 30 minutes of mild exercise daily can help protect current bone structure as well as help increase bone mass. Getting out and exercising has numerous benefits; improving bone mass is only one. Be sure to speak with your physician or health care provider before starting an exercise program.

There are many different medications that can aid a person with osteoporosis. One of the categories of such medications is the bisphosphonates. This class of medications is the most popular and is frequently used as the first-line choice for medical providers. These medications help with osteoporosis by decreasing bone resorption and turnover rate. There are numerous medications within this class.

Another class of medications used frequently is the parathyroid hormone antagonists. The most commonly used medication in this class is calcitonin. This medication inhibits bone resorption and helps with calcium regulation within the body. Calcitonin is found naturally in the human body. Calcitonin (also known as thyrocalcitonin) is a hormone that is produced in humans primarily by the parafollicular cells (also known as C-cells) of the thyroid.

Hormone replacement therapy is another option for postmenopausal women. After menopause, bones lose mass and density more rapidly than before menopause. Postmenopausal women are more likely to experience broken bones, such as hip fractures and compression fractures of the spinal bones due to persistent bone loss. Women who have osteoporosis frequently lose height because of bone loss. Long-term hormone replacement therapy reduces a woman's risk of developing osteoporosis, especially among women who have increased risk factors for osteoporosis. However, hormone replacement therapy is not without potential side-effects or risks. Hormone replacement may increase the risk of health problems for some women, including blood clots, stroke and breast cancer. Be sure to speak with your physician regarding hormone replacement therapy and potential side effects.

These medications have benefits as well as potential risks. Be sure to speak with your physician regarding these and any other medications you are currently taking.

Surveillance exams are necessary not only for the initial diagnosis of osteoporosis but also to map its progression. One of the more popular choices is the DEXA scan (dual-energy X-ray absorptiometry). Two X-ray beams with different energy levels are aimed at the patient's bones. When soft tissue absorption is subtracted out, the BMD can be determined from the absorption of each beam by the bone. The lumbar spine and hip are the most common areas investigated during a DEXA scan. Dual-energy X-ray absorptiometry is the most widely used surveillance exam. Many factors are considered when to order an initial DEXA scan as well as continued surveillance scans. Be sure to discuss surveillance options with your physician during your next visit.

May provides us with ample opportunities to get out and enjoy the Kansas Spring weather. Multiple celebrations are in store during this month including Osteoporosis Awareness. During the month of May take some time to discuss the topic of osteoporosis with your physician or health care provider. If you, a friend, or family members have been diagnosed with osteoporosis consider the above interventions. To the reader, I wish a very enjoyable month of May and continued good health.

As with all medical conditions, always feel free to contact your physician or health care provider with any questions or concerns.

Dr. Charles Weintz is the author of "Healthy Headlines." He is a family physician at Stanton County Family Practice.

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