loss of height and stooping posture.
hip, or vertebral fractures.
When To Call Your Doctor
a doctor with any symptoms of osteoporosis.
have osteoporosis and pain develops after any strain or injury,
call a doctor immediately.
What Is It?
Osteoporosis is characterized by a loss of bone
mass due to an imbalance of bone formation and bone resorption,
a depletion of calcium and phosphorus essential to bone formation,
or both. Affected bones become porous and brittle and susceptible
to fractures. The wrists and hips, and vertebrae in the spine
are the most common fracture sites. The disorder is very common
among people over age 70; it affects women four times more often
than men, owing to hormonal changes that occur with menopause.
What Causes It?
of loss of bone mass is a normal consequence of aging, but a
number of factors hasten osteoporosis: reduced estrogen levels
after menopause; dietary calcium deficiency; physical inactivity;
smoking; excessive alcohol use; and being underweight.
factors may be involved. For example, Caucasian women have a
higher incidence of osteoporosis than others.
may occur as a consequence of an underlying condition, such as
hyperthyroidism, premature menopause (before age 45), chronic
lung diseases, and Cushings disease (excessive production
of corticosteroids by the adrenal glands). It may also arise
from long-term use of corticosteroid drugs or heparin (an anticoagulant).
is highly effective in preventing osteoporosis in postmenopausal
women. Estrogen must be started soon after menopause because
bone loss accelerates rapidly at that time.
A diet rich
in calcium and vitamin D protects against osteoporosis. Older
men and postmenopausal women should get 1,500 milligrams of calcium
daily through diet and calcium supplements.
exercise is important.
and physical examination.
Blood or urine
tests or a bone biopsy to detect or rule out other causes of
X-rays or other
imaging tests, such as CT (computed tomography) scans. Routine
x-rays, however, do not detect osteoporosis until 25 percent
or more bone mass has been lost.
How To Treat It
analgesics are effective for pain.
replacement therapy can slow the progress of osteoporosis in
therapy (with drugs such as alendronate and etidronate) slows
bone resorption and builds bone. Calcium supplements may be advised.
of calcitonin (a hormone that regulates the bodys calcium
usage) can slow bone loss and possibly add bone mass.
The drug raloxifene
(Evista) may be an option for some people.
physical therapy may preserve function.
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