Fight Back Against Osteoporosis

 

Fight Back Against Osteoporosis

 

 

 

Osteoporosis (“porous bone”) is a disease that weakens bones, putting them at greater risk for sudden and unexpected fractures. Osteoporosis results in an increased loss of bone mass and strength. The disease often develops without any symptoms or pain, and it is usually not discovered until the weakened bones cause painful fractures. Most of these are fractures of the hip, wrist, and spine.

 

Although osteoporosis occurs in both men and women, women are four times more likely to develop the disease than men. After age 50, one in two white women, and one in four white men, will have an osteoporosis-related fracture in their lifetimes. Another 30 percent have low bone density that puts them at risk of developing osteoporosis (including African-Americans).

Osteoporosis is responsible for more than 2 million fractures each year, and this number continues to grow. There are steps you can take to prevent osteoporosis from ever occurring. Treatments can also slow the rate of bone loss if you do have osteoporosis.

 

 

 

Causes of Osteoporosis

 

Though the exact cause of osteoporosis is unknown, we do understand how the disease develops. Your bones are made of living, growing tissue. The inside of healthy bone looks like a sponge; this area is called trabecular bone. An outer shell of dense bone wraps around the trabecular, or spongy bone. This hard shell is called cortical bone. When osteoporosis occurs, the “holes” in the “sponge” grow larger and more numerous, which weakens the inside of the bone.

In addition to supporting the body and protecting vital organs, bones store calcium and other minerals. When the body needs calcium, it breaks down and rebuilds bone. This process, called “bone remodeling,” supplies the body with needed calcium while keeping the bones strong.

Up until about age 30, a person normally builds more bone than he or she loses. After age 35, bone breakdown occurs faster than bone buildup, which causes a gradual loss of bone mass. A person who has osteoporosis loses bone mass at a greater rate. After menopause, the rate of bone breakdown occurs even more quickly.

 

 

 

Osteoporosis Risk Factors

 

There are many risk factors that increase your chance of developing osteoporosis:

 

  • Gender — Women over the age of 50 or postmenopausal women have the greatest risk of developing osteoporosis. Women undergo rapid bone loss in the first 10 years after entering menopause, because menopause slows the production of estrogen, a hormone that protects against excessive bone loss.

 

  • Age — Your risk for osteoporosis fractures increases as you age.

 

  • Race —Caucasian and Asian women are more likely to develop osteoporosis. However, African-American and Hispanic women are still at risk. In fact, African-American women are more likely than white women to die after a hip fracture.

 

  • Bone structure and body weight — Petite and thin people have a greater risk of developing osteoporosis because they have less bone to lose than people with more body weight and larger frames.

 

  • Family history — If your parents or grandparents have had any signs of osteoporosis, such as a fractured hip after a minor fall, you may have a greater risk of developing the disease.

 

  • Nutrition — You are more likely to develop osteoporosis if your body doesn’t have enough calcium and vitamin D.

 

  • Lifestyle — People who lead sedentary (inactive) lifestyles have a higher risk of osteoporosis.

 

Recommended: Exercise for Better Bones – The Complete Guide by Margaret Martin, PT, CSCS

 

 

  • Medications — Certain medications cause side effects that may damage bone and lead to osteoporosis. These include steroids, treatments for breast cancer, and medications for treating seizures.

 

  • Smoking — Smoking increases the risk of fractures. 

 

Read The Most Effective Stop Smoking Aids.

 

  • Alcohol use — Having one to two drinks a day (or more) increases the risk of osteoporosis.

 

  • Medical conditions — People who have had the following should consider earlier screening for osteoporosis (this is not a complete list):
    • Overactive thyroid, parathyroid, or adrenal glands
    • History of bariatric (weight loss) surgery
    • Hormone treatment for breast or prostate cancer
    • Eating disorders (bulimia, anorexia)
    • Organ transplant
    • Celiac disease
    • Inflammatory bowel disease
    • Missed periods
    • Blood diseases such as multiple myeloma

 

 

Diagnosing Osteoporosis

 

Painless and accurate medical tests can give you information about your bone health before problems begin.

Bone mineral density (BMD) tests, or bone measurements, also known as dual X-ray absorptiometry (DXA) scans, are X-rays that use very small amounts of radiation to determine the bone density of the spine, hip, or wrist.

Your physician can order these tests for you. All women over the age of 65 should have a bone density test. The DXA scan is done earlier for women who have risk factors for osteoporosis.

Men over age 70, or younger men with risk factors, should also consider getting a bone density test.

 

 

Preventing Osteoporosis

 

Your diet and lifestyle are two important risk factors you can control to prevent osteoporosis. Replacing lost estrogen with hormone therapy also provides a strong defense against osteoporosis in postmenopausal women.

 

 

Calcium

 

To maintain strong, healthy bones, you need a diet rich in calcium throughout your life.

One cup of skim or 1 percent fat milk contains 300 milligrams of calcium. Besides dairy products, other good sources of calcium are salmon with bones, sardines, kale, broccoli, calcium-fortified juices and breads, dried figs, and calcium supplements.

It is best to try to get the calcium from food and drink. For those who need supplements, remember that the body can only absorb 500 mg of calcium at a time. You should take your calcium supplements in divided doses, since anything more than 500 mg will not be absorbed.

 

Adults 19-50 years 1,000 mg
Adult men 51-70 years 1,000 mg
Adult women 51-70 years 1,200 mg
Adults 71 years and older 1,200 mg
Pregnant and breastfeeding teens 1.300 mg
Pregnant and breastfeeding adults 1,000 mg

 

 

If you find it difficult to obtain the recommended amounts of calcium through diet alone, your physician may recommend a combination of foods rich in calcium and a low dose calcium supplement as a good strategy for you.

Calcium supplements are tablets, capsules or liquids containing the mineral calcium from a non-food source. Many brands of calcium supplements are available. When making a choice, take the following factors into consideration:

 

Calcium Per Tablet or Dose

The product label should state the amount of elemental calcium in each tablet, e.g., 300 mg of elemental calcium in a 750 mg tablet of calcium carbonate. The amount of elemental calcium is the figure you use to calculate your true daily intake from a supplement.

 

Price

The most expensive preparations are not necessarily better. Costs will vary among brand name products and similar generic supplements. Prices may also vary with the amount of elemental calcium per tablet. Compare brands and prices.

 

Side Effects

For some, calcium supplements may cause stomach upset, constipation or nausea.

Try different brands or forms, e.g., gelatin capsules, chewable calcium or effervescent tablets, to find a suitable product for you. Calcium citrate may be a good alternative to calcium carbonate.

 

Safety

Specific  standards have been established for lead content, quality, and

disintegration; products with DIN (Drug Identification Number) or NPN (Natural

Product Number) numbers have passed these tests. If you have any doubts, ask your pharmacist to recommend a good calcium supplement for you.

 

 

Tablet Size

Some calcium tablets are very large and may be difficult to swallow. If this is a problem for you and you can’t see the tablet through the bottle, ask your pharmacist or sales person about tablet size. You may wish to inquire about chewable or effervescent tablets or calcium in a gelatine capsule form. In addition, calcium tablets that also contain vitamin D tend to be larger in size. If size matters to you, take your calcium and vitamin D separately rather than in a combined form.

 

Taking Your Calcium Supplements

 

To maximize the absorption of calcium:

 

  • Take calcium carbonate with food or immediately after eating. It is absorbed more effectively when there is food in the stomach. Calcium citrate, calcium lactate and calcium gluconate are well absorbed at any time.
  • Take calcium with plenty of water.
  • Take no more than 500-600 mg of elemental calcium at one time. In fact, it is best to take smaller doses more frequently rather than large doses once a day.
  • Antacids are an acceptable source of calcium. The calcium in these products is calcium carbonate and should be taken at mealtime for better absorption.

 

Double-Check Your Calcium Supplement Dose

Only take a calcium supplement if your doctor has advised you to do so. Unless you are very confident that you are taking the correct dose, show your bottle of calcium to your doctor or pharmacist to be sure that you are not taking too much calcium, which may be harmful. If you change the brand of calcium supplement you are taking, you may need to show the new bottle to your doctor or pharmacist again, to make sure that your dose of calcium has not changed.

 

 

Vitamin D

 

Vitamin D is also important because it enables the body to absorb calcium. The recommended daily allowances of vitamin D are listed below. Vitamin D can also be obtained from sunlight exposure a few times a week or by drinking fortified milk.

 

Recommended daily allowances:

 

  Vitamin D Calcium
Infants 0-6 Months 400 mg 1,000 mg
Infants 6-12 months 400 mg 1,500 mg
1-3 years old 600 mg 2,500 mg
4-8 years old 600 mg 3,000 mg
9-70 years old 800 mg 4,000 mg
Over 70 years old 800 mg 4,000 mg
14-50 years old pregnant/lactating 600 mg 4,000 mg

 

There are very few food sources of vitamin D. In fact, it is impossible for adults to get sufficient vitamin D from diet alone, no matter how good their nutrition. Therefore, you should have a routine of vitamin D supplementation all year round.

 

Healthy adults between19-50 years of age, including pregnant or breast feeding women, require 400 – 1,000 IU daily. Those over 50 or those younger adults at high risk (with osteoporosis, multiple fractures, or conditions affecting vitamin D absorption) should receive 800 – 2,000 IU daily. These amounts are safe.  Taking more than 2,000 IU of vitamin D daily should be done only under medical supervision.

 

The best way to ensure that you are getting sufficient vitamin D is by taking a supplement. The type of vitamin D you should purchase is vitamin D3 (also called cholecalciferol). This is the most common type of vitamin D found in supplements.

 

Vitamin D by itself comes in 400 and 1000 IU tablets. Most multivitamins contain some vitamin D but the amounts vary quite a bit, so be sure to read the small print on the label carefully. Some calcium supplements also contain vitamin D3 and again the amounts vary. If you are unclear how much vitamin D your supplements contain, please check with your pharmacist.

 

There is something special about Vitamin D that does not apply to most other vitamins or supplements.  Vitamin D is fat soluble. This means vitamin D can be “made up.” If you miss your vitamin D today, for example, you can take double the amount tomorrow. If you miss your vitamin D for a whole week, you can take all the vitamin D that you missed altogether at the end of the week. However, you shouldn’t do this on a regular basis  without consulting with your physician and this can only be done with vitamin D. It cannot be done with other medications or supplements.

 

Ask your doctor for more detailed handouts to learn about getting the right amount of calcium and vitamin D. In some cases, your doctor might recommend higher doses of vitamin D.

 

 

 

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Lifestyle — Maintaining a healthy lifestyle can reduce the degree of bone loss. Begin a regular exercise program, and don’t use too much alcohol and tobacco. Exercises that make your muscles work against gravity (such as walking, jogging, aerobics, and weightlifting) are best for strengthening bones.

 

 

Treating Osteoporosis

 

Women whose bone density test shows T-scores of -2.5 or lower should begin therapy to reduce their risk of fracture. Many women need treatment if they have osteopenia, which is bone weakness that is not as severe as osteoporosis.

Your doctor might use the World Health Organization fracture risk assessment tool, or FRAX, to see if you qualify for treatment based on your risk factors and bone density results. . People who have had a typical osteoporosis fracture, such as that of the wrist, spine, or hip, should also be treated (sometimes even if the bone density results are normal).

 

Medications:

  • Estrogen therapy
  • Bisphosphonates: Fosamax® (aledronate sodium), Actonel®, Atelvia® (risedronate), Boniva® (ibandronate), Reclast® (zoledronic acid)
  • Selective estrogen receptor modulators: Evista® (raloxifene)
  • Parathyroid hormone: Forteo® (teriparatide)
  • Biologic therapy: Prolia® (denosumab)

 

 

 

Recommenced Sources:

 

 

 

 

Part whistle-blower book, part bone health bible, Dr. Lani’s No-Nonsense Bone Health Guide is the first consumer book to expose the shocking difficulty of getting an accurate bone density reading and the serious risks of long-term use of osteoporosis medications, which are often prescribed based on inaccurate readings.

In addition to this vital information about bone density testing, Dr. Lani Simpson cuts through the confusion and inaccuracies surrounding osteoporosis and explains what readers can do now to build and maintain healthy bones for life. Dr. Simpson shares her well-rounded, whole-body approach to bone health, including discussions of digestive health, diet, supplements, exercise, and how aging affects the bones. Readers learn surprising facts about what foods and medicines might hurt bone health and which ones will help build strong bones.

Also included is a thorough discussion of calcium supplementation and how to do it right. Dr. Lani’s No-Nonsense Bone Health Guide is the key to long, healthy, fracture-free golden years.

 

 

 

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Be Aware of Bone Diseases in the Elderly

Be Aware of Bone Diseases in the Elderly

 

 

 

 

Bone diseases in the elderly can be very serious and can cause pain, fractures or even bone cancer in patients. As we age, our bone density decreases which can cause bone disease or fractures to occur.

 

 

 

Osteoporosis and Paget’s disease are the two most commonly seen bone diseases in the elderly, but there are others to look for as well. Here are some tips on what to look for and how to possibly prevent these diseases.

 

 

Rheumatoid Arthritis

 

https://ghr.nlm.nih.gov/art/large/joint-with-rheumatoid-arthritis.jpeg

 

Rheumatoid arthritis is a joint disease and is caused by inflammation of the joints. Symptoms of rheumatoid arthritis include painful, swollen or deformed joints and painful and stiff movements.

Rheumatoid arthritis is usually developed before age 45 but it can be chronic and can cause problems for the elderly population as well. Keeping the body healthy is the best way to manage and prevent rheumatoid arthritis because the swelling is usually caused by an infection in the body. Seniors can modify their daily activities and take medication to help reduce pain.

 

 

Paget’s Disease

 

 

Paget’s disease is the second most common bone disease found in the elderly and it affects the formation of bones in the body. Normal bones are constantly remodeling, but people with Paget’s disease have an abnormal remodeling process.

People with Paget’s disease experience an excessive amount of bone removal followed by even more excessive bone formation which results in larger bones being formed. Paget’s disease can cause the new bones to be softer or deformed which can result in pain and fractures. Very rarely, patients will experience a malignant transformation of the bone which will result in a bone tumor.

Most people that suffer from Paget’s disease can easily manage their disease at home with anti-inflammatory drugs. Those that suffer from a serious case of Paget’s disease can have surgery to help treat their disease. Seniors who experience changes in bowel or bladder functioning should seek immediate care as this can be a result of spinal cord and nerve root damage caused by the abnormal bone reformation.

 

 

Osteoarthritis

 

 

Osteoarthritis is another common problem found in the elderly although it affects the joints instead of the bones. Osteoarthritis occurs when the cartilage at the ends of the bones wears down and causes the bones to have a hard time moving smoothly. Osteoarthritis can cause movements to be very stiff and painful because the cartilage is not there to protect the bones. Researchers believe that nearly all seniors over age 75 have osteoarthritis in at least one joint, so seniors should make sure that their bones are in good health.

 

 

Osteoporosis

 

Osteoporosis is the most common bone disease found in seniors and is caused by the thinning of the bones. Osteoporosis is called a “silent disease” because most seniors are unaware that they have osteoporosis until they fracture a bone. Osteoporosis can be prevented by making sure that your loved one gets enough calcium and vitamin D and exercises on a regular basis.

 

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Many elderly women experience sudden back pain from a compression fracture caused by osteoporosis, so this is a good warning sign to watch out for. Many seniors also appear to be losing height as their bones thin, so family caregivers should monitor closely their loved one’s height if they are at risk for osteoporosis.  If your loved one starts to experience the symptoms listed above, they should visit their doctor to discuss treatment options.

 

 

Exercise Tips for Seniors With Osteoporosis

Exercise is important for people with osteoporosis as it can help improve bone density in addition to strengthening the muscles. Osteoporosis can cause the bones to become brittle and lose density which makes them more likely to break, so it is important for people with osteoporosis to do everything they can to strengthen their bones. When exercising it is important for seniors to make sure that they are being safe so that they will not get injured. In this article we would like to offer some exercise safety tips for people with osteoporosis.

 

The first thing that people with osteoporosis should do is consult their doctor before beginning any exercise programs. Many doctors recommend a bone density test for those with osteoporosis which can be used to determine which exercises will be the most beneficial. A bone density test should ideally be done before starting any exercise programs because doctors can advise their patients which exercises are safe for them based on fracture risk, age, medical history, medications and physical condition. Beginning an exercise program before consulting a doctor can often lead to injuries from falls such as fractures or broken bones.

 

People with osteoporosis should also ask their doctor if it is safe for them to engage in high impact exercise. High impact exercises can often be dangerous for those with osteoporosis because the physical activity from high impact exercises puts excess pressure and strain on the body in areas such as the spine, hips and legs. Some examples of high impact exercises are running, jumping and jogging. Those with osteoporosis do not necessarily have to avoid these exercises at all cost but it is best to consult a doctor before engaging in any high impact activity. Slower movements are usually best for those with osteoporosis so seniors should try walking or using an elliptical machine at the gym. Those that are at risk for vertebral fractures should also avoid exercises that put too much stress on the spine. Many exercises that might seem safe because they are low impact can put excess stress on the spine and cause vertebral fractures. Some examples are golf, tennis, yoga, rowing and sit-ups because all of these activities require bending or twisting the spine. Regular activity is not usually harmful to the spine but adding extra stress beyond what a normal daily routine would require can potentially be harmful.

 

Another important safety tip to keep in mind is that seniors should pay attention to their body. Seniors that experience soreness for several days after exercising should ease up on their routine and work on building up to a more strenuous work out. Overworking the body can be very dangerous and can potentially cause injuries so seniors should make sure that they avoid overexerting themselves. Seniors who experience unusual pain or discomfort should visit their doctor to make sure that they have not injured themselves in any way.

 

People with osteoporosis should also consider visiting a physical therapist. Physical therapists can help by developing safe exercise plans for seniors and showing them how to properly do each exercise activity. Over time seniors can work with their physical therapists to increase the difficulty of their exercise routine. It is important that those with osteoporosis do not overexert themselves and seniors with a physical therapist helping them will be better equipped in knowing when they are ready to change their routine. Many physical therapists also have experience working with patients with osteoporosis so those that are newly diagnosed can definitely benefit from having extra assistance as they begin an exercise program. Family caregivers can help by talking to their loved one’s doctor to get recommendations for a good physical therapist and can also go with their loved one to meet the physical therapist so that they will be comfortable. Many people with osteoporosis benefit from weight training and physical therapists can act as a spotter for patients so that they will not drop their weights and get hurt. Family caregivers can also help their loved ones with this at home in between trips to the physical therapist.

 

Following these tips is a good way for people with osteoporosis to avoid injuring themselves. Family caregivers can help their loved ones with their exercise routine by exercising with them to keep them motivated and to help monitor their routine to prevent injury. It is important for those with osteoporosis to understand the specific limitations of their body so that they do not injure themselves while exercising. Those with further questions or concerns should always contact their doctor as it is always best to be cautious and safe.

 

 

Preventive Measures

 

Seniors who experience any fractures or breaks should visit their doctor to be tested for bone disease. Treating or monitoring bone disease in the elderly can greatly decrease their risk for pain and fractures. Decrease in bone density in seniors can cause many seniors to have brittle bones even if they do not have any type of bone disease, so it is important to keep an eye on your loved ones even if they are not diagnosed with a bone disease.

Seniors should make sure that they are doing all that they can to keep their bones strong, such as getting enough calcium and vitamin D and exercising regularly because that is the best way for them to prevent bone disease. When exercising, it is important for seniors to make sure that they are choosing activities that are safe for them and will not cause them to fall or get hurt as this can also result in breaks or fractures. Many seniors suffer from broken bones as a result of falling, so family caregivers should make sure that their loved ones have an adequate assistance if they have trouble walking. Seniors with osteoporosis or Paget’s disease might want to consider getting a walker or cane to steady their walking to keep themselves from getting hurt.

 

 

 

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