Have you ever heard of the disease “Osteoporosis” and wondered what it is and if you may be at risk? Well, you will learn throughout this paper how important it is to be informed about osteoporosis. This medical condition is when your bones become brittle and fragile with thinning and reduction in bone mass, due to depletion of calcium and bone protein (MedicineNet). Bone is living tissue that is constantly becoming broken down and replaced. When you have osteoporosis, bone brittleness can lead to fractures if you fall, bend over or even cough(mayo clinic).
This paper will talk about the diagnosis, prevention and treatment/cures of osteoporosis in adults. You may be asking yourself, well who is at risk and what is causing this disease? Everyone is at risk from children to adults, males and females. Osteoporosis is most often seen in females. There is an estimated 200 million women worldwide that are affected by osteoporosis(International Osteoporosis Foundation). Juvenile osteoporosis affects previously healthy children between the ages of 8 to 14. While 1 in 8 men over the age of 50 are affected by osteoporosis in North America(International Osteoporosis Foundation).
In the past osteoporosis was considered a disease in adults with specific diseases such as hyperparathyroidism, rickets and osteomalacia that cause progressive bone loss and fragility(National Osteoporosis Foundation). There are two types of osteoporosis in children, Secondary Osteoporosis which is caused by an underlying medical condition. It is most commonly caused by diseases like: Osteogenesis imperfecta, Diabetes, Hyperthyroidism, Kidney Disease and Malabsorption syndrome(National institutes of health). It can also be caused from medications like Corticosteroids and Anticonvulsants.
The other type is Idiopathic Osteoporosis which is when a cause is unknown. The symptoms for children can be pain in lower back, hips and feet often accompanied by difficulty walking and spinal deformities(Better Health). Osteoporosis can also be carried through genetics. Of these two types of osteoporosis, Idiopathic is the most rare form of this disease. How is Osteoporosis diagnosed? This disease is most commonly diagnosed through a Dexa Scan or Bone Density test which is similar to an x-ray but it tells you the density of your bones. This test will take a picture of your spine, hip and wrist.
Although most are diagnosed this way, there are several other ways to be diagnosed. The SXA (single energy x-ray absorptiometry) which measures your heel and wrist. The DPA (Dual photon absorptiometry) that measures the spine, hip or total body. The SPA (single photon absorptiometry) that measures your wrist. The QCT (Quantitative computer tomography) that measures the spine or hip. The PQCT (peripheral QCT) that measures the forearm. And lastly, the QUS (quantitative ultrasound) that uses sound waves to measure the heel or finger. You then get a T-score back which if it comes back as -2. r less it then indicates you have Osteoporosis (News in Health).
A T-Score of -1 and above is what a normal scan should show up as. There are stages that your T-score can be at before fully diagnosed with osteoporosis. The first stage before you get osteoporosis is osteopenia. About 18 million americans have osteopenia, which is a T-score between -1 and -2. 5(International Osteoporosis foundation). Doctors normally recommend a Bone Density Test for adults after a break or fracture in a bone and children to young adults once you have 3 fractures from three different areas of your body.
What can be done to prevent osteoporosis? Taking Vitamin D and Calcium supplements are thought to be a good idea to increase bone mass. Men and Women between the ages of 18 to 50 need 1,000 milligrams of calcium a day(Mayo clinic). This number then increases to 1,200 when women turn 50 and men turn 70. Some good sources of calcium are low fat dairy products, dark leafy green vegetables, soy products and canned salmon or sardines. The importance of Vitamin D is to absorb calcium. Eating Vitamin K and magnesium rich foods daily will also be a great help to strengthening your bones.
However, according to European Society of Endocrinology there is no evidence to support the need of supplements unless you have a deficiency in either of these, then it would be appropriate to take a supplement for that. A good prevention would be to exercise daily with weight bearing exercises to increase bone density in the spine and femur. The pulling and tugging on the bones by your muscles helps to stimulate bone making cells(Patient). How is Osteoporosis so called “Cured”? Well to start out, there is no known cure for this disease. There are treatments for this however.
The typical drugs that are prescribed are Bisphosphonates. The types of this drug include: alendronate, ibandronate, risedronate and zoledronic. Alendronate is an oral medication typically taken once a week and is also known as Fosamax. Ibandronate is offered as an oral tablet monthly or as an intravenous injection four times a year and is also known as Boniva. Risedronate is available in daily, weekly, bimonthly or monthly doses and is known as Actonel. Lastly, Zoledronic acid is given intravenously every one or two years and is known as Reclast. These drugs do come with several side effects though.
These side effects are acid reflux, nausea and stomach pain(healthline). Bisphosphonates are not a suggested long term treatment for children as it has damaging side effects to their organs. Although these are the main drugs used, there are a few hormone therapies that can be used but aren’t on the top of the list for treatment options. First is Raloxifene (Evista) which is a SERM treatment that is available in a daily oral tablet. SERM or Selective Estrogen Receptor Modulator re-creates the bone preserving effect of estrogen. Synthetic thyrocalcitonin is a treatment available by nasal or injection.
Thyrocalcitonin is the hormone made by the thyroid gland to regulate calcium levels. This treatment is usually only used to treat spinal osteoporosis for those who can’t take bisphosphonates(Healthline). Teriparatide is the last drug treatment option which is given as a daily injection. This treatment is very expensive and usually reserved for those with severe osteoporosis. This treatment is for your Parathyroid Hormone that controls your calcium and phosphate levels. These hormone treatments are usually for women post menopause and come with some significant side effects.
These side effects consist of increased risk of breast cancer, blood clots and heart disease(UMM). Is there any other treatment options for osteoporosis? As stated above to prevent osteoporosis some vitamins are used. These can also be used as treatments for osteoporosis to avoid the drug treatments. These vitamins and herbs that will be discussed can be harmful for you if you consume more than the desired amount. The first of which is calcium, this is around 800 to 1,200 mg/day for children and 1,200 to 1,500 mg/day for adults 50+. This calcium helps the body build bone. This calcium can and should be mainly consumed in a daily diet.
Good sources of this are in dark greens, almonds, salmon, tofu and low fat dairy. If you can not however get enough from these types of food in your daily diet, there are supplements that are available. Calcium Citrate which is the most easily absorbed but costs more. Calcium Carbonate which is least expensive and must be taken with meals. This type of supplement may also cause gas or constipation. The last supplement for calcium is calcium phosphate which is easily absorbed but doesn’t cause stomach upsets. This supplement is more expensive than calcium carbonate though.
The next vitamin that works right along with calcium is vitamin D. Your body will not absorb enough calcium without this. Adults under 50 should be getting anywhere from 400 to 800 IU/day and 51 to 70 should be getting up to 2,000 IU/day. Vitamin K is the next mineral you need. It is recommended that you get 150 to 500 mcg/day, your body does make this in your intestine though. You may need to take supplements if you are not making enough. Vitamin K helps bind calcium into the bone. You do need to be careful taking supplements of this though because it may interact with other medications you are on.
Soy isoflavones are phytoestrogens, plant chemicals that have some of the same effects are estrogen. Since estrogen helps protect against osteoporosis, researchers theorize that isoflavones may have similar effects. The best source of this is thorough soy milk, soybeans and tofu. The positive of this is that it does not have the same negative effects that supplemental estrogen does. Ipriflavone is a synthetic isoflavone that may help prevent and treat osteoporosis. Most studies suggest that combining ipriflavone and calcium will slow bone loss and prevent fractures in the vertebrate in postmenopausal women.
It is suggested to take 600 mg/day when choosing this treatment. Omega 3 fatty acids is another route that you can take for natural treatment. Essential fatty acids appear to increase the amount of calcium your body absorbs and decrease the amount that is lost in urine, improve bone strength, and enhance bone growth. It is suggested that you take 4 g/day, a good source of this would be cold water fish, like salmon. Supplements for this exist in fish oil. Carotenoids have been shown to protect bone mineral density in older men and women. Zinc will help with stimulating bone formation.
Vitamin C wouldn’t be bad to take either as it may limit bone loss in early years of menopause. Melatonin is the last natural treatment for osteoporosis as it is involved in bone growth. Since melatonin drops as you age it is possible that it contributes to osteoporosis. More studies need to be done to tell if this will truly make an impact though. With that being said, there are also herbs that could help treat osteoporosis that have not yet been extensively studied. They are believed to have similar effects that estrogen does. Black Cohosh contains estrogen like substances that helps protect against bone loss.
It is mainly used to relieve menopausal symptoms but its effectiveness has mixed studies. Red clover is another herb that is believed to be good in protecting bone loss. Isoflavones that are extracted from this herb may slow bone loss in women but it is unclear as to weather the whole herb is effective. Lastly, these three herbs may help treat osteoporosis but lack a lot of evidence. Horsetail that contains silicon which is believed to strengthen bones. Kelp which is rich in minerals so it may be complementary to treat osteoporosis. And Oat straw which boosts hormone levels to stimulate cell growth.
In conclusion, osteoporosis is a very serious disease that can have a major impact in your life. Bone loss and deterioration of bone structure can be minimized and osteoporosis prevented through daily weight bearing physical activity with good, balanced nutrition and supplements. If you do end up with this disease you have several paths you can take to treat it. Medical doctors have a variety of drugs with known side effects while functional/alternative doctors offer a variety of natural vitamins, herbs and supplements. You are not on your own with this disease.