Osteoporosis

Osteoporosis

causes bones to become weak and brittle - so brittle that a fall or even mild stresses such as
bending over or coughing can cause a fracture. Osteoporosis related fractures most commonly
occur in the hip, wrist or spine. Bone is living tissue that is constantly being broken down and
replaced.
 TYPES OF
OSTEOPOROSIS
Primary Osteoporosis

 Primary osteoporosis makes up the vast majority of the cases. There are many factors that contribute to its
severity such as age, nutrition and activity level. Gender is often also a factor, as primary osteoporosis is
more prevalent in women than men.
 
 As bones reach their peak density around age 30, there is a gradual decline over time that occurs if one’s
activity level does not help offset the amount breakdown-taking place. This occurs secondary to hormone
levels decreasing, mainly testosterone (which promotes bone growth) and estrogen.
 
 While we often associate this type of osteoporosis with the elderly population, it can happen in younger
adults as well if activity levels are not enough to stimulate bone growth activity. Additionally, if hormone
levels drop secondarily to overtraining or malnutrition, bone breakdown may also start as early as high
school such as is seen in conditions associated with the Triad in male and female student-athletes.
Secondary Osteoporosis

 Secondary osteoporosis is very similar to primary except that it occurs in response to a

particular disease, normally one that will affect hormone levels within the body such as
conditions that interfere with thyroid health. While primary may be addressed through a
gradual change in activity levels and diet, secondary osteoporosis is often treated by
hormone replacement therapy and other more extreme measures.

 It is important to note that secondary osteoporosis may occur subsequently with primary,
but must have an etiological mechanism to be classified as secondary.
Osteogenesis Imperfecta

 Osteogenesis imperfecta is a condition that is the result of a genetic mutation, affecting

roughly 6-7 out of every 100,000 people. It has eight known types ranging from mild to
severe and mainly affects bone health, causing conditions to manifest similar to traditional
osteoporosis.
 
 The condition will normally exist with other symptoms such as respiratory issues, height
defects, and an abnormally small rib cage. Depending on the severity, bones can break
often with very little stress applied. Also, in severe cases, the associated respiratory issues
may decrease life expectancy in accordance with all of the other comorbidities present.
Idiopathic Juvenile Osteoporosis

 This pediatric condition has no known cause and usually has an onset just before puberty.
In essence, it is brittle and porous bones with no other associated symptoms and will
usually resolve without medical treatment after a relatively short amount of time.
Symptoms of Osteoporosis

There typically are no symptoms in the early stages of bone loss. But once your bones have
been weakened by osteoporosis, you might have signs and symptoms that include:
 Back pain, caused by a fractured or collapsed vertebra
 Loss of height over time
 A stooped posture
 A bone that breaks much more easily than expected
 Risk Factors

A number of factors can increase the likelihood that you'll develop osteoporosis including your age, race, lifestyle choices, and medical conditions and treatments.

Unchangeable risks
 Some risk factors for osteoporosis are out of your control, including:
 Your sex. Women are much more likely to develop osteoporosis than are men.
 Age. The older you get, the greater your risk of osteoporosis.
 Race. You're at greatest risk of osteoporosis if you're white or of Asian descent.
 Family history. Having a parent or sibling with osteoporosis puts you at greater risk, especially if your mother or father fractured a hip.
 Body frame size. Men and women who have small body frames tend to have a higher risk because they might have less bone mass to draw from as they age.
 Dietary factors
Osteoporosis is more likely to occur in people who have:
 Low calcium intake. A lifelong lack of calcium plays a role in the development of osteoporosis. Low calcium intake contributes to diminished bone density, early bone loss
and an increased risk of fractures. Eating disorders. Severely restricting food intake and being underweight weakens bone in both men and women. Gastrointestinal surgery.
Surgery to reduce the size of your stomach or to remove part of the intestine limits the amount of surface area available to absorb nutrients, including calcium. These surgeries
include those to help you lose weight and for other gastrointestinal disorders .
 Treatment for Osteoporosis

The goal of most osteoporosis medicines is to help your bones stay as strong as possible. But each of them works in different ways:
 Bisphosphonates, like alendronate (Binosto, Fosamax), ibandronate acid (Boniva), and risedronic acid (Actonel, Atelva) treat osteoporosis by keeping the
body from breaking down bone. You take Boniva once a month, while the others can be taken weekly. If you take these medicines incorrectly, they can
lead to ulcers in your esophagus, so it’s important to follow the instructions exactly.
 Zoledronic acid (Reclast, Zometa) is a once-yearly 15-minute infusion you get through a vein. It is a bisphosphonate that can increase bone strength and
reduce fractures in the hip, spine, wrist, arm, leg, or rib. The most common side effects include bone pain, nausea, and vomiting. People whose kidneys
don’t work very well should avoid it or use it with caution.
 Raloxifene (Evista) is an osteoporosis treatment that acts like the hormone estrogen and can help maintain bone mass. But studies have shown that it
doesn't have some of the downsides of estrogen, like increasing the risk of breast or uterine cancers. Evista often causes hot flashes and makes you more
likely to have blood clots. 
 Abaloparatide (Tymlos) or teriparatide (Forteo) treat osteoporosis in postmenopausal women and men who are more likely to get severe fractures. It’s a
man-made form of the parathyroid hormone that your body produces, and is the first drug shown to make the body form new bone and increase bone
mineral density. You take it as a daily injection for up to 2 years. Side effects include nausea, leg cramps, and dizziness.
 Romosozumab-aqqg (Evenity) is a monoclonal antibody used to treat osteoporosis in postmenopausal women at high risk of fracture. It blocks the effects
of the protein sclerostin and works mainly by increasing new bone formation. It is taken by injection once a month with a limit of 12 doses.
 Denosumab (Prolia, Xgeva) treats osteoporosis by interfering with the body's bone-breakdown process. It's for women with a higher chance of fracture
who’ve tried other osteoporosis drugs that have not worked. Side effects can include pain in the back, arms, and legs. You get an injection of this drug
twice a year.
How to reduce your risk of Osteoporosis

 Diet, vitamin D and weight-bearing exercise can help to prevent osteoporosis.

 If you have osteoporosis, medical treatment can prevent further bone loss and reduce your
risk of bone fractures.
 Treatment options for osteoporosis include dietary changes, exercise, lifestyle changes,
falls prevention, supplements and medications.