Osteoporosis

Osteoporosis and its Classification

Osteoporosis is a condition characterized by increased porosity of the bones which can eventually lead to fractures. Osteoporosis is derived from the Greek word “ostoun,” which means bone, and poros meaning pore. It is characterized by a decrease in bone mineral density (BMD) and is most prevalent among women aged 35 and above. Osteoporosis is classified as primary type 1, primary type 2 and secondary osteoporosis.

Women suffering from this condition after their menopausal period belong to the primary type 1, which is also known as postmenopausal osteoporosis. Males and females who are above 75 years old would have the second classification, which is primary type 2 or senile osteoporosis. The last classification, secondary osteoporosis, may affect both males and females and may occur at any age. This usually results as a secondary effect resulting from a previous condition like a disease or excessive use of certain medications.

Who are at risk?

Risk factors for osteoporosis can be classified into nonmodifiable or uncontrollable risk factors and the modifiable or controllable risk factors.

Nonmodifiable factors would include the sexual orientation of an individual, menopause, the age, family history, ethnicity and those having a small stature.

• Osteoporosis can affect both men and women. The latter, however, is more susceptible to developing osteoporosis especially after their menopausal stage. This is associated with the decreased levels of estrogen among women after menopause. Men, on the other hand, would have a decrease in their testosterone levels but the effect is usually not as profound as that of women.
• Those who have family history of osteoporosis are also at an increased risk of 25 to 80% because of the genetic makeup of their bone mineral density.
• Ethnicity and people with small statures are also at risk, examples of which are Asian women.

Modifiable factors would encompass alcoholism, tobacco smoking, calcium and vitamin D intake, malnutrition and exposure to heavy metals. In addition, certain disease condition increases the likelihood for osteoporosis. These would include immobilization, endocrine disorders like Cushing’s syndrome, malnutrition, renal insufficiency and those who are suffering from scoliosis. Women, who are pregnant or under lactation, are also at an increased risk. These factors can still be changed or adjusted.

• Alcoholism, for instance, could be avoided as excessive alcohol intake increases the risks for bone fractures.
• Smoking increases the breakdown of estrogen as well as predisposes a woman to an earlier menopause.
• Decreased vitamin D and calcium intake is also a risk factor as these vitamins and minerals are necessary for bone strengthening.
• Nutrition is also vital to ensure proper bone development and maintenance.
• Exposure to heavy metals like cadmium and lead has also been linked to osteoporosis and osteomalacia, which is the softening of the bone.
• Some disease and disorders have been associated with the development of osteoporosis. Immobilization, for example, could lead to osteoporosis especially if prolonged.  People with endocrine disorders like Cushing’s syndrome, hyperparathyroidism and hyoparathyroidism, thyrotoxicosis, diabetes mellitus type 1 and 2 as well as adrenal insufficiency are at greatest risk as well because of the role of regulation the endocrine organs play in the levels of calcium and phosphorus in the body.

Signs and Symptoms

• Osteoporosis is actually a silent killer as it may not present with any symptoms for decades.
• Pain and fracture are usually the first indication that a person may be suffering from osteoporosis. Fractures are usually caused by trauma or falls that a patient may be even unaware of.
• The “dowager-hump” is probably the most profound symptom that is visible especially among older women. This is brought about by the chronic and repeated spinal fracture, causing the vertebrae to collapse and form a curved shape. The dowager hump also causes the chronic lower back pain experienced by the elderly.

Osteoporosis Diagnosis

Doctors would usually begin by having a look at the medical history of the patient. Risk factors may need to be identified so as to identify the underlying cause of osteoporosis. Mainly, osteoporosis can be diagnosed through radiography and by measuring the bone mineral density. Blood tests would also be included to measure calcium, vitamin D, phosphorus, testosterone levels as well as thyroid and kidney functions.

Bone mineral density tests would usually utilize the use of a specific radiographic examination. This is known as a dual x-ray absorptiometry scan (DXA). This is used diagnose osteoporosis by determining the bone density in the in specific areas. The test is usually precise and quite convenient to be done. Radiation exposure is also very minimal.

Treatment for Osteoporosis

• Osteoporosis is best treated by a physician. Self-medication and self-treatment would not be able to resolve the condition other than prolong the appropriate treatment required in treating the condition.
• Once signs and symptoms are noted or risk factors are identified, it would be best to have a physical examination done by a physician so that osteoporosis may be treated at the earliest possible time and prevent further consequences.

• Treatment for osteoporosis would focus on slowing down the progress of the condition, improving bone density, controlling pain and preventing fractures and other complications. Treatment would include modification of diet and lifestyle, referral to a bone specialist as well as physical and occupational therapists and certain medications.

• Estrogen replacement therapy remains to be the best option for women after menopause as it helps in slowing down bone loss. However, this is best done under the supervision of a physician as there are still conflicts surrounding estrogen intake among women after their menopause. Increased levels of estrogen have also been associated to coronary heart disease, stroke and thromboembolism. It is therefore important to have the proper dosing for estrogen replacement therapy.

Ways to Prevent Osteoporosis

The best approach against osteoporosis is to avoid it at the earliest possible time. This can be done by building strong bones through eating a well-balanced diet rich in calcium and vitamin D, regular exercise as well as avoidance of alcohol and smoking. Certain vitamins and mineral supplements can also help in the prevention of osteoporosis.

References:

http://www.medicinenet.com/osteoporosis/article.htm

http://www.nlm.nih.gov/medlineplus/osteoporosis.html

http://www.emedicinehealth.com/osteoporosis/article_em.htm