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even mild stresses like bending over, lifting a vacuum cleaner or coughing can cause a fracture. In most cases, bones weaken when you have low levels of calcium, phosphorus and other minerals in your bones. A common result of osteoporosis is fractures — most of them in the spine, hip or wrist. Although it's often thought of as a women's disease, osteoporosis also affects many men. And aside from people who have osteoporosis, many more have low bone density. It's never too late — or too early — to do something about osteoporosis. take steps to keep bones strong and healthy throughout life. • Symptom In the early stages of bone loss, you usually have no pain or other symptoms. !ut once bones have been weakened by osteoporosis, you may have osteoporosis symptoms that include"
!ack pain, which can be severe if you have a fractured or collapsed vertebra #oss of height over time, with an accompanying stooped posture $racture of the vertebrae, wrists, hips or other bones Causes %he strength of your bones depends on their si&e and density' bone density depends in part on the amount of calcium, phosphorus and other minerals bones contain. (hen your bones contain fewer minerals than normal, they're less strong and eventually lose their internal supporting structure. The process of bone remodeling )cientists have yet to learn all the reasons why this occurs, but the process involves how bone is made. !one is continuously changing — new bone is made and old bone is broken down — a process called remodeling, or bone turnover. A full cycle of bone remodeling takes about two to three months. (hen you're young, your body makes new bone faster than it breaks down old bone, and your bone mass increases. ou reach your peak bone mass in your mid*+,s. After that, bone remodeling continues, but you lose slightly more than you gain. At menopause, when estrogen levels drop, bone loss in women increases
What keeps bones healthy %hree factors that you can influence are essential for keeping your bones healthy throughout your life" • • • 3egular e4ercise Ade5uate amounts of calcium Ade5uate amounts of vitamin 2. especially if you also have a family history of fractures. having a parent or sibling with osteoporosis puts you at greater risk. small*framed women are particularly at risk.dramatically. $or that reason. but still significant. /peak bone mass0 and how rapidly you lose it later. Frame si"e 6en and women who are e4ceptionally thin or have small body frames tend to have higher risk because they may have less bone mass to draw from as they age. the higher your risk of osteoporosis. risk. %he higher your peak bone mass. !lack and 8ispanic men and women have a lower. Race ou're at greatest risk of osteoporosis if you're white or of )outheast Asian descent. . our bones become weaker as you age. the leading cause in women is decreased estrogen production during menopause. Although many factors contribute to bone loss. 6en who have low levels of the male hormone testosterone also are at increased risk. %hat's because women start out with lower bone mass and tend to live longer. the more bone you have "in the bank" and the less likely you are to develop osteoporosis as you age. on. which is essential for absorbing calcium Risk Factor A number of factors can increase the likelihood that you'll develop osteoporosis. Family history Osteoporosis runs in families. and +. %hey also e4perience a sudden drop in estrogen at menopause that accelerates bone loss. !ge %he older you get. including" • • • • • • • Your sex $ractures from osteoporosis are about twice as common in women as they are in men. but researchers do know that tobacco use contributes to weak bones. %he risk of osteoporosis in men is greatest from age 7. 1ot getting enough vitamin 2 and calcium in your diet may lead to a lower peak bone mass and accelerated bone loss later. )lender. Tobacco use %he e4act role tobacco plays in osteoporosis isn't clearly understood. our risk of developing osteoporosis depends on how much bone mass you attained between ages -.
)o can conditions such as =rohn's disease. Corticosteroid medications #ong*term use of corticosteroid medications. some anti*sei&ure medications. Any weight*bearing e4ercise is beneficial.• • • • • • • • • • #ifetime exposure to estrogen %he greater a woman's lifetime e4posure to estrogen. $ating disorders (omen and men with anore4ia nervosa or bulimia are at higher risk of lower bone density in their lower backs and hips. %hese medications are common treatments for chronic conditions. :4ercise throughout life is important. which suppress estrogen. %his can occur either because your thyroid is overactive /hyperthyroidism0 or because you take e4cess amounts of thyroid hormone medication to treat an underactive thyroid /hypothyroidism0. cortisone. +edical conditions and procedures that decrease calcium absorption )tomach surgery /gastrectomy0 can affect your body's ability to absorb calcium. especially if they were treated with chemotherapy or aromatase inhibitors such as anastro&ole and letro&ole. the cancer treatment drug methotre4ate. 6ore research is needed to fully understand the association between ))3I use and low bone density. the lower her risk of osteoporosis. #o* calcium intake A lifelong lack of calcium plays a ma<or role in the development of osteoporosis. such as asthma.ostmenopausal women who have had breast cancer are at increased risk of osteoporosis.. such as from infre5uent menstrual periods or menopause before age 9. Sedentary lifestyle !one health begins in childhood. these results don't necessarily mean that ))3Is cause bone loss or osteoporosis. Thyroid hormone %oo much thyroid hormone also can cause bone loss.. Selecti%e serotonin reuptake inhibitors &SSR's( 3esearch published in -. . $or e4ample. but <umping and hopping seem particularly helpful for creating healthy bones. you have a lower risk if you have a late menopause or you began menstruating at an earlier than average age. rheumatoid arthritis and psoriasis. =hildren who are physically active and consume ade5uate amounts of calcium*containing foods have the greatest bone density. but you can increase your bone density at any age. such as prednisone. diuretics and aluminum*containing antacids also can cause bone loss. :vidence does not currently indicate that you should stop using ))3Is because of concerns about bone loss. which may reduce the risk of fractures. 8owever. anore4ia nervosa and =ushing's disease — a rare disorder in which your adrenal glands produce e4cessive corticosteroid hormones. #ow calcium intake contributes to poor bone density. If you need to take a steroid medication for long periods. )reast cancer . Other medications #ong*term use of the blood*thinning medication heparin. your doctor should monitor your bone density and recommend other drugs to help prevent bone loss. is damaging to bone. prednisolone and de4amethasone. celiac disease. %his isn't true for women treated with tamo4ifen. !ut your risk of osteoporosis is increased if your lifetime e4posure to estrogen has been deficient. vitamin 2 deficiency. early bone loss and an increased risk of fractures.7 showed lower bone mineral density among both men and women currently using ))3Is compared with study participants not taking these antidepressants.
2octors can detect osteopenia or early signs of osteoporosis using a variety of devices to measure bone density. regardless of risk factors. If you do drink caffeinated soda. including having fractured a bone. alcoholism is one of the leading risk factors for osteoporosis. . then discuss your prevention strategy with your doctor. If you're a woman.• • • • $xcess soda consumption %he link between osteoporosis and caffeinated sodas isn't clear.eople who e4perience serious depression have When to seek medical ad%ice :arly detection is important in osteoporosis. the phosphoric acid in soda may contribute to bone loss by changing the acid balance in your blood. simple and gives accurate results. ou're postmenopausal and have at least one risk factor for osteoporosis. Depression . :4cess consumption of alcohol reduces bone formation and interferes with the body's ability to absorb calcium. but caffeine may interfere with calcium absorption and its diuretic effect may increase mineral loss. %his procedure is 5uick.. It measures the density of bones in your spine. be sure to get ade5uate calcium and vitamin 2 from other sources in your diet or from supplements. If you're a woman. Dual energy . hip and wrist — the areas most likely to be affected by osteoporosis — and it's used to accurately follow changes in these bones over time.-ray absorptiometry %he best screening test is dual energy >*ray absorptiometry /2:>A0. but that increases your risk of osteoporosis. =onsider your risk factors. it's best to do this well before menopause. Tests and diagnosis Osteopenia refers to mild bone loss that isn't severe enough to be called osteoporosis. the 1ational Osteoporosis $oundation recommends that you have a bone density test if you aren't taking estrogen and any of the following conditions apply to you" • • • ou're older than age A. In addition. Other tests that can accurately measure bone density include" • • • ?ltrasound @uantitative computeri&ed tomography /=%0 scanning Should you ha%e a test. Chronic alcoholism $or men. ou have a vertebral abnormality.
%hey often occur in your spine or hips — bones that directly support your weight. you can lose several inches of height as your posture becomes stooped. Although most people do relatively well with modern surgical treatment. If you have many such fractures. (rist fractures from falls also are common. 2iscuss the various options with your doctor to determine which might be best for you. 0rescription medications If 8% isn't for you. • Treatments and drugs /ormone therapy 8ormone therapy /8%0 was once the mainstay of treatment for osteoporosis. If you're interested in hormone therapy. In some cases. spinal fractures can occur without any fall or in<ury simply because the bones in your back /vertebrae0 become so weakened that they begin to compress. 6ost problems have been linked to certain oral types of 8%. either taken in combination with progestin or alone. ou have type B diabetes. • Complication $ractures are the most fre5uent and serious complication of osteoporosis. liver disease. such as prednisone. other forms are available. %hey include" . thyroid disease or a family history of osteoporosis. prescription drugs can help slow bone loss and may even increase bone density over time. hip fractures can result in disability and even death from postoperative complications. 8ip fractures usually result from a fall. including patches. that can cause osteoporosis. the role of hormone therapy in managing osteoporosis is changing. especially in older adults. creams and the vaginal ring. and lifestyle changes don't help control your osteoporosis.• • • ou use medications. =ompression fractures can cause severe pain and re5uire a long recovery. 2octors don't generally recommend osteoporosis screening for men because the disease is less common in men than it is in women. !ut because of concerns about its safety and because other treatments are available. ou e4perienced early menopause. kidney disease.
it's normally reserved for people who can't take other drugs. but it's also available as an in<ection. your doctor may recommend periodic intravenous infusions of bisphosphonate preparations. !ecause calcitonin isn't as potent as bisphosphonates. (hile there is currently no clear evidence that you should stop taking bisphosphonates before dental surgery. !isphosphonates that can be taken once a week or once a month may cause fewer stomach problems. breast cancer. It's usually administered as a nasal spray and causes nasal irritation in some people who use it. such as increased risk of uterine cancer and.• )isphosphonates 6uch like estrogen. %his drug is approved only for women with osteoporosis and is not currently approved for use in men. )ide effects. the $ood and 2rug Administration /$2A0 approved the first once*yearly drug for postmenopausal women with osteoporosis. an analog of parathyroid hormone. %hey're also used to prevent osteoporosis in people who re5uire long*term steroid treatment for a disease such as asthma or arthritis. A small number of cases of osteonecrosis of the <aw have been reported in people taking bisphosphonates for osteoporosis. is given intravenously at your doctor's office. 3isk appears to be higher in people who have received bisphosphonates intravenously. preserve bone mass. If you can't tolerate oral bisphosphonates. let your dentist know what medications you're taking and discuss your concerns. and the risk of an inflamed esophagus or esophageal ulcers. One published study found that &oledronic acid reduces the risk of spine fracture by 7. In -. treats osteoporosis in postmenopausal women and men who are at high . without some of the risks associated with estrogen. 8ot flashes are a common side effect of ralo4ifene. It may also prevent spine fractures. &oledronic acid /3eclast0. include nausea. !isphosphonates may be especially beneficial for men. which can be severe. %he medication. %hese cases have primarily occurred after trauma to the <aw. calcitonin reduces bone resorption and may slow bone loss. and may even provide some pain relief from compression fractures. this group of drugs can inhibit bone breakdown. or cancer treatment. percent and of hip fracture by 9B percent. abdominal pain. It takes about B. Teriparatide &Forteo( %his powerful drug. and you shouldn't use this drug if you have a history of blood clots. possibly. such as a tooth e4traction. especially if you've had acid reflu4 or ulcers in the past..7. and even increase bone density in your spine and hip. reducing the risk of fractures. 3alo4ifene mimics estrogen's beneficial effects on bone density in postmenopausal women. Calcitonin A hormone produced by your thyroid gland. minutes to get your annual dose. young adults and people with steroid*induced osteoporosis. • • • Raloxifene &$%ista( %his medication belongs to a class of drugs called selective estrogen receptor modulators /):36s0.
minutes in the afternoon and while performing B.remenopausal women and postmenopausal women who use 8% should consume at least B.. %he program combines the use of a device called a spinal weighted kypho*orthosis /(CO0 — a harness with a light weight attached — and specific back e4tension e4ercises. and you're more likely to take medications that interfere with calcium absorption. . . If you already have osteoporosis. so the $2A recommends restricting therapy to two years or less. international units /I?0 of vitamin 2 every day. In some cases you may even be able to replace bone you've lost.• risk of fractures. $merging therapies A new physical therapy program has been shown to significantly reduce back pain. /o* much calcium and %itamin D. minutes in the morning and +. #ong*term effects are still being studied. getting ade5uate calcium and vitamin 2. especially in women older than . As a result. ?nlike other available therapies for osteoporosis. %eriparatide is given once a day by in<ection under the skin on the thigh or abdomen. and all men and women older . . repetitions of back e4tension e4ercises. %he (CO is worn daily for +. and during pregnancy and breast*feeding.. our body's demand for calcium is greatest during childhood and adolescence. when your skeleton is growing rapidly. it has an estrogen*like effect on other cells in your body.. %he amount of calcium you need to stay healthy changes over your lifetime. Tamoxifen %his synthetic hormone is used to treat breast cancer and is given to certain high*risk women to help reduce their chances of developing breast cancer. improve posture and reduce the risk of falls in women with osteoporosis who also have curvature of the spine. stomach upset. tamo4ifen appears to reduce the risk of fractures. your body becomes less efficient at absorbing calcium.ossible side effects of tamo4ifen include hot flashes.. • 0re%ention Detting ade5uate calcium and vitamin 2 is an important factor in reducing your risk of osteoporosis. and vaginal dryness or discharge. including your bone cells.. anyone at risk of steroid*induced osteoporosis. As you age.ostmenopausal women and older men also need to consume more calcium. Although tamo4ifen blocks estrogen's effect on breast tissue. as opposed to preventing further bone loss. it works by stimulating new bone growth.. can help prevent your bones from becoming weaker. as well as taking other measures. . milligrams /mg0 of elemental calcium and a minimum of E.ostmenopausal women not using 8%.
cooked kale.. If you find it difficult to get enough calcium from your diet. hips and lower spine. but you'll gain the most benefits if you start e4ercising regularly when you're young and continue to e4ercise throughout your life. stair climbing. Although vitamin 2 is present in oily fish such as tuna and sardines and in egg yolks. or if you regularly use sunscreen or you avoid the sun entirely because of the risk of skin cancer.. check the type of calcium you're using.. )trength training helps strengthen muscles and bones in your arms and upper spine. =alcium supplements with added vitamin 2 are a good alternative. =alcium and vitamin 2 supplements are most effective taken together in divided doses with food. 1ot only does vitamin 2 improve bone health by helping calcium absorption. oats and soy products such as tofu also are rich in calcium. drink more water and try using a fiber supplement. I? of vitamin 2 daily. )ometimes calcium supplements can cause constipation. )upplements are ine4pensive and generally are well tolerated and well absorbed if taken properly. =alcium phosphate and calcium citrate tend to be less constipating. and weight*bearing e4ercises — such as walking. Detting enough vitamin 2 is <ust as important as getting ade5uate amounts of calcium. running.. consider calcium supplements. source. . Although many people get ade5uate amounts of vitamin 2 from sunlight. I? a day. If this is a problem for you.. broccoli. but because they're low impact. Almonds. but by no means the only. but it's safe to take up to -.than A. this may not be a good source if you live in high latitudes. you probably don't eat these on a daily basis. skiing and impact*producing sports — mainly affect the bones in your legs. but it also may improve muscle strength.. )wimming. <ogging.. In addition. =ombine strength training e4ercises with weight* bearing e4ercises. cycling and machines such as elliptical trainers can provide a good cardiovascular workout. Other tips for pre%ention %hese measures also may help you prevent bone loss" • • $xercise :4ercise can help you build strong bones and slow bone loss. )cientists are continuing to study vitamin 2 — which may also protect against certain types of cancer — to determine the optimal daily dose. dairy products are one. !dd soy to your diet %he plant estrogens found in soy help maintain bone density and may reduce the risk of fractures. should aim for B. skipping rope. they're not as helpful for improving bone health as weight*bearing e4ercises are. As for calcium. mg of elemental calcium and at least E. if you're housebound. canned salmon with the bones. :4ercise will benefit your bones no matter when you start.
and lift with your legs. perhaps by decreasing the amount of estrogen a woman's body makes and by reducing the absorption of calcium in your intestine. #ife style and home remedies %hese suggestions may help relieve symptoms and maintain your independence if you have osteoporosis" • • • • +aintain good posture Dood posture — which involves keeping your head held high. !ut because of the risk of side effects. Ceep rooms brightly lit. upper back flat and lower spine arched — helps you avoid stress on your spine. area rugs and slippery surfaces that might cause you to trip or fall. keeping your upper back straight. 2on't lean over while reading or doing handwork. %here's no clear link between moderate alcohol intake and osteoporosis. #imit caffeine 6oderate caffeine consumption — about two to three cups of coffee a day — won't harm you as long as your diet contains ade5uate calcium. %estosterone replacement therapy works only for men with osteoporosis caused by low testosterone levels. #eft untreated. install grab bars <ust inside and outside your shower door. chin in. 2on't ignore chronic pain. it can limit your mobility and cause even more pain. discuss the options with your doctor and decide what's best for you. (hen you sit or drive. %he effects on bone of secondhand smoke aren't yet known. +anage pain 2iscuss pain management strategies with your doctor. and make sure you can get in and out of your bed easily. Consider hormone therapy 8ormone therapy can reduce a woman's risk of osteoporosis during and after menopause. !%oid excessi%e alcohol =onsuming more than two alcoholic drinks a day may decrease bone formation and reduce your body's ability to absorb calcium. not your waist. shoulders back. 0re%ent falls (ear low*heeled shoes with nonslip soles and check your house for electrical cords. (hen lifting. http233*** mayoclinic com3health3osteoporosis3DS44567 . place a rolled towel in the small of your back.• • • • Don1t smoke )moking increases bone loss. %aking it when you have normal testosterone levels won't increase bone mass. bend at your knees.