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You should be aware that among the lesser-known risk factors
for osteoporosis are a variety of other medical conditions that are known to
compromise bone mass. In some cases, these conditions -- and/or the medications
used to treat them - are the cause of osteoporosis. In others, they contribute
to or complicate osteoporosis that developed on its own. Sometimes it's
difficult to determine which of these is the case. Osteoporosis that occurs as a
result of another medical condition or long-term drug therapy is known as
"Secondary" osteoporosis.
Other medical conditions that may increase your risk of developing secondary osteoporosis include thyroid disorders, endometriosis, kidney or liver disease, early menopause due to surgery and Type I diabetes. If you are affected by any of these conditions or circumstances, it is especially important to be attentive to maintaining your bone health. That means talking to your doctor about bone-density testing and asking to have the lowest effective dose of bone-depleting medications prescribed. Also, make sure to get plenty of calcium and Vitamin D on a daily basis through diet and supplementation - and, as possible, engage in regular weight-bearing exercise to help maintain bone strength. What is Osteoporosis? Literally "porous bones," osteoporosis sets in later in life when bones begin to lose density. As the bones weaken, the chance of fractures increases. Hips, wrists, and vertebrae in the spine are especially vulnerable. While hips, wrist, and other fractures occur due to a fall or
other impact, vertebrae commonly break during routine activities such as bending
or lifting, and can lead to severe back pain. Or, they may crumble painlessly,
with loss of several inches in height or a deformed, outwardly curved spine
(dowager's hump) as the first visible sign of damage. As fragility increases,
self esteem, confidence, and independence can shrink along with height. Bones may not seem like dynamic, changing tissues, but they are. The body adds new bone tissue until about age 30, at the same time tearing down bone tissue in a natural process. It is the balance of these opposite processes that determines bone density. Throughout childhood, the balance tips towards the positive side as the body steadily accumulates bone, using calcium in the diet as the building block. By their 30's, a person has as much bone as they ever will. In scientific terms, they have achieved "peak bone mass." After 30, bone is re-absorbed by the body at about the same rate it is created, and usually there's no net gain or loss. Later in adulthood, the process that breaks down bone tissue dominates. In a sense, the body starts making withdrawals from its "bone bank." Now osteoporosis becomes a potential problem, especially in women during the first years of menopause, when bone loss speeds up. Two important ways to limit the severity of osteoporosis are
by attaining optimal peak bone mass in the first two to three decades of life,
and minimizing the rate at which bone is lost in later years. Our bodies must maintain a constant level of calcium to
function. Unfortunately, we excrete calcium normally every day. When we don't
replace it daily, our body steals calcium from our bones, weakening them
overtime-- a process that can contribute to the development of osteoporosis. Because the patterns of reforming and resorting bone often vary from patient to patient, experts believe a number of different factors account for this problem. Important hormones, such as estrogen, parathyroid, and vitamin D, and blood factors that affect cell growth are involved with this process. Changes in levels of any of these factors could play a role in the development of osteoporosis. Osteoporosis Risk Factors
What Is Osteoporosis? The Bones The skeleton has a dual function. It provides structural support for muscles and organs and also serves as a depot for the body's calcium and other essential minerals, such as phosphorus and magnesium. The skeleton holds 99% of the body's calcium; the one-percent remaining calcium is freed to circulate in the blood and is essential for crucial bodily functions, ranging from muscle contraction to nerve function to blood clotting. Like the body's other organs, bone tissue is constantly being broken down and reformed again. 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. The breakdown, or resorption, of the skeleton is done by cells known as osteoclasts, which are formed from certain types of blood cells. These cells dig holes into the bone, releasing the small amounts of calcium into the bloodstream that are necessary for other vital functions. Cells called osteoblasts, which are produced by bone cells, then rebuild the skeleton -- first, by filling in the holes with collagen and, then, by laying down crystals of calcium and phosphorus. Each year, approximately 10% to 30% of the adult skeleton is remodeled in this way. The osteoclast/osteoblast balance is controlled by a complex mix of hormones and chemical factors. Osteoporosis Osteoporosis is a disease of the skeleton in which the amount of calcium present in the bones slowly decreases to the point where the bones become brittle and prone to fracture. In other words, the bone loses density. Osteoporosis is diagnosed when bone density has decreased to the point where fractures will happen with mild stress, its so-called fracture threshold. There are two primary kinds of osteoporosis: type I and type II. Type I, or high turnover, osteoporosis occurs in some women between the ages of 50 and 75 because of the sudden postmenopausal decrease in estrogen levels, which results in a rapid depletion of calcium from the skeleton. It is associated with fractures that occur when the vertebrae compress together causing a collapse of the spine and fractures of the hip, wrist, or forearm caused by falls or minor accidents. Type II, or low turnover, osteoporosis (also known as age*related or senile osteoporosis) results when the process of resorption and formation of bone are no longer coordinated, and bone breakdown overcomes bone building. This occurs with age in everyone to some degree. Type II osteoporosis affects both men and women and is primarily associated with leg and spinal fractures. In older women, both type I and type II osteoporosis may occur. The determining factor for the actual existence of either type I or type II osteoporosis is the amount of calcium left in the skeleton. Someone who has exceptionally dense bones to begin with will probably never lose enough calcium to reach the point where osteoporosis occurs, whereas a person who has low bone density could easily develop osteoporosis despite losing only a relatively small amount of calcium. What Causes Osteoporosis? Until a person is around 40, the process of breaking down and building up bone by osteoclasts and osteoblasts is a nearly perfectly coupled system, with one phase stimulating the other. As a person ages, however, this system breaks down and the two processes become out of sync. The reasons for this are not clear. Some individuals have a very high turnover rate of bone; some have a very gradual turnover, but the breakdown of bone eventually overtakes the build-up. Some Lifestyle Factors May Compromise Bone Health The lifestyle choices that you make may have an adverse effect on the condition of your bones. That's what experts on bone health have learned from a variety of recent research studies. Here are some factors that have been associated with bone loss:
If any of these contributing factors apply to you, making changes in your daily living patterns may be very beneficial to your bone health. Eliminating or reducing your use of tobacco and intake of alcohol... lessening or learning to better manage your stress... using only nutritionally-sound weight-loss methods and becoming more physically active will all be helpful in maximizing your overall health and the health of your bones. And, as always, it is important to continue to emphasize adequate daily intake of calcium through diet and supplementation. Bone-Depleting Drugs A major but often overlooked cause of osteoporosis is a group
of prescription medications that, when used on a long-term basis, may decrease
bone mass and bone strength. These drugs are usually necessary treatment for a
serious or chronic health condition, and may be the only way to manage that
condition. In many cases they are life saving or vital for maintaining quality
of life. But in the process of treating one condition, these drugs may cause
another one: osteoporosis. The use of bone-depleting drugs is quite prevalent. According to Dr. Lawrence Raisz, head of the Division of Endocrinology and Metabolism at the University of Connecticut Health Center, there are hundreds of thousands of people who are taking ther. Drugs called "corticosteroids" that are used to
treat conditions like arthritis, asthma, liver disease, Iupus, Crohn's disease,
multiple sclerosis and glaucoma are, by far, the number one category of bone
depleters. Corticosteroids are also used following organ transplantation,
and in conjunction with chemotherapy to treat some types of cancer. |
