Of all the structures in the body, the one least likely to be thought of as living tissue is bone. When we look at the only “solid” tissues we should consider factors such as, food choices, activity level and frequency and severity of weight-loss efforts; use of allopathic medications and/or presence of other systemic diseases; gender, body build, race, age and heredity.
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Salt, already indicated for major roles in hypertension and heart disease, is implicated in yet another major disease. A research study from New Zealand indicates consumption of table salt increases loss of calcium through the kidneys. The study indicated adding a teaspoon of salt to the daily diet of young women increased the calcium loss (enough calcium loss to decrease bone mass 1.5 percent annually).
Race and body build appear to be major risk factors for osteoporosis. The incidence of the disease is much higher in both Caucasian and Oriental women, basically, fair-skinned, thin women. Frequent attempts to lose weight are implicated in bone density loss as well.
Drugs such as L-thyroxine substantially affect calcium loss. Lasix (furosemide), a diuretic; Heparin, a blood thinner; steroids, and some anticonvulsants are also guilty of increasing calcium excretion.
Alcohol, caffeine and a sedentary life-style certainly contribute to the risk of developing osteoporosis; the presence of other illnesses, such as diabetes, lung diseases, rheumatoid arthritis, Cushing’s syndrome and gastrointestinal disorders increase susceptibility to osteoporosis.
Age and heredity complete the list. Age, because the disease doesn’t usually rear its ugly head until late middle age. And, if you have a family history of cardiovascular disease then your chances of getting the disease increases.
The only “solid” tissues in the body, bones are what keep us from being a large, somewhat lumpy puddle, not that distantly removed from our amoeboid cousins. It is only recently that the health and density of bones has reached common awareness, yet, the perception remains that fragile bones only affect elderly and postmenopausal women. While this is basically true, the beginnings of the disease predate the actual diagnosis or pathological event by many years.
OK, so what is it, really?
Osteoporosis literally means porous bones; bones with low mass and density which have lost the minerals which provide the strength and stability vital to supporting body weight.
It is systemic, affecting all the bones of the body quietly, without symptoms, until a cataclysmic event such as hip fracture occurs. A disorder related to aging, osteoporosis is the most common bone disorder afflicting women in affluent Western societies.
And although the curse of weakening bones is shared with men in the same cultures, the numbers of males affected is minuscule until they reach advanced age (and life expectancy for men is considerably shorter than for women). For example, in the US various authors indicate 80 percent or more of those with osteoporosis are women; by the time both genders reach their 90’s, 32 percent of women and 17 percent of men will suffer osteoporosis related hip fractures.
Bone formation requires several minerals, hormones and nutritional factors; both environmental and life-style factors influence the process. Calcium may be the star of the cast, but far from the only actor in the play. Lack of calcium alone, causes soft bone, or osteomalacia. More than one author indicates osteoporosis involves the lack of several minerals as well as the collagen/protein matrix of bone.
Women start out with less bone mass than men, and loss of bone starts earlier. Although some loss may occur earlier, after the age of 35 loss of bone becomes increasingly greater than its manufacture. From roughly age 45 or right around menopause, the rate of bone degeneration accelerates, with five to ten percent of bone mass lost the first five years after menopause. Thereafter, the rate of bone density loss decreases, continuing at a slower rate of about 1 percent per year.
While estrogen has been considered the primary hormone responsible for bone stabilization (and the reason your MD insists you take estrogen replacement), it appears to be progesterone deficiency after menopause which has more effect on bone loss, since progesterone stimulates osteoblasts to build new bones. That would explain why men have little or no problem with the disease until they reach old age; their testosterone levels remain high throughout most of their lives.
The most commonly seen osteoporotic fractures are those of vertebrae, wrist and hip. The elderly lady with the humped back suffers from disintegrating spinal bones, with the result being inability to maintain body posture in the correct position. Wrist fractures accompany near-miss falls, or even attempting to lift something heavy; books, groceries, grandchildren.
Hip fractures, contrary to popular opinion, precede the fall to which they are generally attributed. The fracture occurs and the body falls. Osteoporosis-related fractures appear to be more related to bone density, than to age.
Proven causes of osteoporosis are notably lacking. However, evidence is mounting against several risk factors: Heredity and life-style, because if your mother had the disease, you have a higher risk of developing osteoporosis. But it is not strictly a hereditary disease. Life-style has been proven to be a large factor in the getting osteoporosis. People with similar habits seem to develop the disease.
Diagnosis of this crippling disease is by measuring bone mineral density (BMD) at many sites throughout the body. Usually areas measured for bone density are the spine and hip, since bone loss in these areas causes the greatest disability. Results of radiologic tests, called duel-energy x-ray absorptiometry (DXEA), are then correlated with results from World Health Organization’s database of a healthy young adult population. A normal value is BMD less than one standard deviation (SD) below the mean young adult level. A value more than 2.5 SD below the mean young adult level is diagnostic for osteoporosis. A positive result in the presence of a fracture indicates established disease.
Osteoporosis is often called the "silent disease" because bone loss occurs without symptoms. People may not know that they have osteoporosis until their bones become so weak that a sudden strain, bump, or fall causes a fracture or a vertebra to collapse. Collapsed vertebrae may initially be felt or seen in the form of severe back pain, loss of height, or spinal deformities such as kyphosis (stooped posture).
Certain people are more likely to develop osteoporosis than others. Factors that increase the likelihood of developing osteoporosis are called "risk factors." The following risk factors have been identified:
Women can lose up to 20% of their bone mass in the five to seven years following menopause, making them more susceptible to osteoporosis.
By about age 20, the average woman has acquired 98 % of her skeletal mass. Building strong bones during childhood and adolescence can be the best defense against developing osteoporosis later. There are four steps to prevent osteoporosis. No one step alone is enough to prevent osteoporosis but all four may. They are:
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