Osteoporosis and Osteopenia
Osteopenia and osteoporosis are increasing in our modern society for a number of reasons. We believe the best offense to having strong healthy bones is a strong defense. This means increased efforts that focus in on nutrition, lifestyle changes, herbs and supplements and exercise.
Osteopenia is the thinning of bone mass. While this decrease in bone mass is not usually considered “severe,” it is considered a very serious risk factor for the development of osteoporosis. Osteopenia is commonly seen in people over age 50 that have lower than average bone density but do not have osteoporosis. The diagnostic difference between osteopenia and osteoporosis is the measure of bone mineral density.
Osteoporosis, the “fragile bone disease,” is characterized by a loss of bone mass caused by a deficiency in calcium, vitamin D, magnesium and other vitamins and minerals. Many of the foods you eat contain these bone-building minerals. If it progresses, osteoporosis can lead to loss of height, stooped posture, humpback, and severe pain. According to the National Osteoporosis Foundation, osteoporosis affects 54 million Americans, mostly women. Millions more Americans are estimated to have osteopenia (low bone mass), putting them at risk for osteoporosis.
- Limit bone elongation in adolescents and prevent bone loss in adults.
- After menopause very small amounts of estrogens, if any, are secreted by the ovaries.
- Low estrogen levels cause diminished bone deposition.
- Low estrogen levels increase the number and activity of osteoclasts.
- Promotes new bone formation and deposition.
- Helps reduce bone loss, and has a role in bone formation.
- Glucocorticoids directly inhibit bone formation by decreasing cell proliferation and the synthesis of DNA, protein and collagen.
- Glucocorticoid-induced bone loss results from lower activity and higher death rate of osteoblasts on the one hand, and from increased bone resorption due to prolonged life span of osteoclasts on the other.
- Glucocorticoids may potentiate the proresorptive actions of parathyroid hormone and Vitamin D on bone, which contribute to net bone resorption.
- Bone loss during or after menopause has been attributed to a drop in estrogen levels. Recent studies show that high FSH is required for hypogonadal bone loss.
- In early menopause, FSH levels show a sevenfold increase over values found in young menstruating women.
- In perimenopause and postmenopause, FSH is correlated with:
- Bone loss and osteoporosis.
- Sleep disturbances.
- Hot flashes and night sweats.
- Enhances bone deposition and remodeling.
- Decreases bone resorption and increases bone formation.
- Type I collagen degradation by-product— a marker for bone resorption.
Diagnosis of Osteoporosis
The best approach to osteoporosis is prevention, especially in patients who are high risk. The diagnosis of osteoporosis relies heavily on bone densitometry (mineralized bone mass) using radioactive or x-ray techniques. However, the diagnostic modalities in use today have limitations in reliability and reproducibility, specifically in fracture prediction capability.
Recent technology has allowed the development of urinary assays for bone resorption markers as a complementary method to bone mineral density in the diagnosis and follow-up of osteoporotic patients.
- Preliminary screening in patients with high risk for osteoporosis.
- Therapeutic monitoring during and after trea™ent for osteoporosis.
- As an adjunct tracking tool in bone and mineralization assessment after initial densitometry is performed.
- Follow-up for monitoring efficacy of hormone replacement therapy in the prevention of osteoporosis in both sexes.
- Hip-fracture risk prediction in the elderly.
- Preliminary screening for estrogen-deficient women at clinical risk for osteoporosis.
- Preliminary screening for individuals receiving or planning to receive long-term glucocorticoid therapy.
- Preliminary screening for metabolic bone diseases.
- Preliminary screening for rheumatoid arthritis and other connective tissue disease.
- Preliminary screening for Paget’s disease.
- Preliminary screening for bone malignancies.
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