Osteoporosis

Presented by dr. Faisal Muttaqien

12 February 08

Questions • What is osteoporosis ? • What are the symptoms of osteoporosis ? • What are risk factors for developing and causes of osteoporosis ? • How is osteoporosis treated ?

DEFINITION

WHAT IS OSTEOPOROSIS ? • Osteoporosis is a disease in which bones become fragile and more likely to break (fracture). “Osteo” is Latin for “bone” “Porosis” means “porous or full of holes” “Osteoporosis” means “bones that are full of holes”

Osteoporosis leads to literally abnormally porous bone that is more compressible like a sponge.

In osteoporosis the bone mineral density (BMD) is reduced and bone microarchitecture is disrupted

Illustation of porous bone

Healthy Bone

Osteoporotic Bone

In osteoporosis, the bone microarchitecture is disrupted

• Like other organs in the body, bone tissue is constantly being broken down and reformed again. Resorption-removes old bone Formation-replaces old bone with new bone

• This turnover is necessary for growth, for repair of minor damage that occurs from everyday stress, and for the maintenance of a properly functioning body.

From birth through adolescence, new bone is built faster than old bone is removed In mid-life, depending on lifestyle and other factors, bone removal can achieve a balance with bone formation As part of the aging process (after age 35), bones begin to break down faster than they are formed.

In women, bone loss accelerates after menopause, when ovaries stop producing estrogen - the hormone that protects against bone loss.

CHANGES IN BONE MASS

After menopause, bone removal accelerates due to a decrease in estrogen

SYMPTOMS WHAT ARE THE SYMPTOMS OF OSTEOPOROSIS ?

WHAT ARE THE SYMPTOMS OF OSTEOPOROSIS ? • “Silent Disease” - You may not know you have the disease until a bone fractures • Then the symptoms are related to the location of the fractures. The spine, hips, and wrists are common areas of bone fractures. • The fractures can occur as a result of minor trauma.

Fracture of Spine • Dowager hump • Low back pain • Lose of height

Normal Posture

Dowager’s Hump

Fracture of Spine

Fracture of Hip

RISK FACTORS WHAT ARE RISK FACTORS FOR DEVELOPING AND CAUSES OF OSTEOPOROSIS ?

RISK FACTORS - CAN’T CONTROL Gender: Females are usually diagnosed with osteoporosis at four times the rate of males. Bone mass in males is approximately 15-20% higher than females Small Boned & Thin: may result in smaller bones with a lower bone density

RISK FACTORS - CAN’T CONTROL Race/Ethnicity: Women, especially Caucasian and Asian women with thin frames are at greater risk African American women have a higher peak bone mass (10%) than Caucasian women, but other factors such as nutrition, exercise, certain diseases, and medications may increase their risk of osteoporosis

RISK FACTORS - CAN’T CONTROL Heredity: your family history may put you genetically at risk or may be a result of family members sharing the same environment, exercise, and nutritional habits Menopause or several months without periods: bone loss begins to exceed bone formation, due to a decrease of estrogen

RISK FACTORS - CAN’T CONTROL

Age: In your 40’s you start to lose bone faster than you build new bone. The accumulated loss of bone puts an older person at higher risk

RISK FACTORS – CAN CONTROL

Diet low in Calcium

Diet low in Vitamin D

RISK FACTORS – CAN CONTROL Caffeine: RecommendationNo more than 2-3 cups of caffeine beverages per day Cola, coffee and chocolate all contain caffeine

RISK FACTORS – CAN CONTROL Alcohol: consuming more than one alcoholic drink per day is associated with risk of low bone mass Eating Disorders: anorexia nervosa can lead to malnutrition and bone loss

RISK FACTORS – CAN CONTROL Smoking: causes lower bone density Immobility: extreme lack of exercise can lead to bone loss

OTHER RISK FACTORS Prolonged use of steroids - cause increased bone breakdown and decreased bone replacement

Prolonged hyperthyroidism – can cause increased risk of bone loss

TREATMENT How is Osteoporosis treated ?

TREATMENT • 1) Life style changes • 2) Medications

Treatment – Life Style Changes • Exercise regularly • Quit smoking • Minimize alcohol intake • Minimize caffeine intake • Consume a balanced diet with adequate calcium and vitamin D

Exercise

VITAMIN D

CALCIUM

VITAMIN

•Vitamin D is necessary for calcium to be absorbed

Treatment - Medications • Medications that stop bone loss • Medications that increase bone formation • Hormon therapy (Menopausal hormon therapy)

CONCLUSION • Osteoporosis is a disease in which bones become fragile and more likely to break (fracture). • Osteoporosis is called “Silent Disease” You may not know you have the disease until a bone fractures. The symtomps can be stooped posture (hump), low back pain and lose of height.

CONCLUSION • The risk factor of developing osteoporosis are : - Female gender - Small bone and thin - Race / ethnicity - Family history of osteoporosis - Menopause - Old age - Diet low in calsium and vitamin D

CONCLUSION - Alcohol abuse - Cigarette smoking - Excessive caffeine intake - Immobility - Hyperthyroidism - Certain medications – prolonged use of steroids

CONCLUSION • Treatment of osteoporosis are : 1) Life style changes : - Exercise regularly - Quit smoking - Minimize alcohol and caffeine intake - Balanced diet with adequate calcium and vitamin D 2) Medications - Medications that stop bone loss - Medications that increase bone formation - Hormon theraphy (menopausal hormon therapy)

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