What Is Osteoporosis?
Osteoporosis, which means "porous bone", is a disease characterized by progressive bone thinning. The deterioration of bone tissue can lead to bone fragility and fracture, especially of the:
- hip
- spine
- wrist
Osteoporosis is regarded as a "silent disease" since damage occurs over a period of years without evident symptoms. The disease can remain undiagnosed until so advanced that the weakened bones are easily fractured. Osteoporosis is the cause of 1.5 million fractures each year.
Who Gets Osteoporosis?
Osteoporosis is a major public health concern with more than 25 million Americans affected, 80% of whom are women.
It has been estimated that one out of every two women and one out of five men will experience an osteoporosis-related fracture sometime in their life. By age 75, one third of all men will be affected by osteoporosis. Though osteoporosis is thought of as an old person's disease, it actually can strike at any age.
Risk Factors For Osteoporosis
There are certain risk factors involved which make some people more likely to develop osteoporosis than others:
- advanced age
- being female
- family history of osteoporosis
- thin or small frame
- early menopause, either naturally or surgically
- men having low testosterone levels
- amenorrhea
- anorexia or bulimia
- thyroid disease
- rheumatoid arthritis
- maladies involving blocked intestinal absorption of calcium
- use of corticosteroid medications
- use of anticonvulsant drugs
- diet low in calcium
- lack of exercise
- cigarette smoking
- excessive use of alcohol of caffeine
Detection Of Osteoporosis
Early detection of osteoporosis is very important. There are tests which can detect bone density problems:
- Low level x-ray on a finger or wrist
- Ultrasound of the heel
- CT scan of the spine
- Bone density scan / DEXA (Dual Energy X-Ray Absorption Test)
Standard x-rays do not detect osteoporosis until one-quarter of bone mass is already lost. By then susceptibility to fracture already exists. DEXA is an early detection tool and can detect as little as one percent of bone loss.
DEXA uses a low level of radiation, focuses on the hip and spine which are common sites of fracture, and is considered safe and comfortable for the patient. However, DEXA which has been called the "gold standard" of bone density tests may not be covered by some insurance plans. People at risk for osteoporosis should get one of the less expensive screenings done first. If there is evidence of bone loss the insurance company will likely pay for a DEXA test since it is then indicated.
Treatment Of Osteoporosis
There are now several categories of drugs used to treat osteoporosis:
- estrogens
- parathyroid hormones
- bone formation agents
- bisphosphonates
- selective receptor molecules
Depending on what drug is used you can slow bone loss, promote bone growth, and reduce the risk of fractures. Drugs used for osteoporosis now include:
- Actonel (Risedronate)
- Boniva (Ibandronate)
- Didronel (Etidronate)
- Estrogens (Hormone Therapy)
- Evista (Raloxifene)
- Forteo (Teriparatide)
- Fosamax (Alendronate)
- Miacalcin (Calcitonin)
Other treatments which are frequently used include:
- Calcium and Vitamin D
- Weight-bearing exercise
People taking corticosteroids (steroids) should use the lowest dose possible to minimize the side effects.
Realted Resources - Osteoporosis
Sources: Steroid-Induced Osteoporosis Guidelines Overview, American College of Rheumatology; Fact Sheet on Osteoporosis, American College of Rheumatology; Osteoporosis Tests Getting Quicker, Easier, Salt Lake Tribune 10/15/98
