Osteoporosis symptoms

Osteoporosis itself does not cause pain or noticeable symptoms, but frequent bone fractures that can alert us about this disease. The most common fractures in the elderly are the wrist and hip in postmenopausal women are prevalent vertebral fractures that cause a major back pain and deformities, together with loss of height due to reduced bone mass in the spine.

Diagnosis of osteoporosis

The diagnosis is made by densitometry that measures bone mineral content in order to determine its density and calcium content. It is therefore necessary densimetry adults ages 45 to 50 years, especially in menopausal women due to hormonal changes that lose more bone.

To diagnose osteoporosis is measured bone density in spine and hip, but can also be measured in the forearm.

Osteoporosis Treatment

To treat osteoporosis can go to pharmacological measures such as antiresorptive drugs (bisphosphonates, raloxifene, calcitonin, parathyroid hormone, strontium salts) Nonpharmacologic measures consist of a diet rich in calcium and vitamin D, physical exercise and smoking cessation if applicable.

Osteoporosis in men

Bone mass in men is stable over time and therefore is less common this part of the population. The loss of bone mass from age 70 to be then greater than in women, other factors that increase bone loss include smoking, alcohol and sedentary lifestyle coupled with lack of exercise.

Osteoporosis in men is also caused by an excess of glucocorticoids, it is known that these substances produce a decrease calcium in the body causing a relative state of hypogonadism.

Medical treatment is most commonly prescribed hormone replacement therapy. Prescribed estrogen with or without progestins, at low doses with the idea of recovering the lost endogenous hormone levels with menopause or after surgery in which the ovaries have been removed. Other treatments include calcitonin, bisphosphonates, vitamin D and PTH.

The best treatment for osteoporosis is prevention. An adequate intake of calcium and physical activity during adolescence and youth, may increase the peak bone mass, resulting in reduced bone loss and lower fracture risk in later years. Adequate intake of calcium and vitamins during maturation is essential for bone health.

In cases of early menopause, women should take estrogen to prevent post-menopausal loss of bone is due to add a progestogen if uterus is intact.

Estrogen replacement therapy is effective in preventing post-menopausal loss of bone and is also effective in preventing osteoporotic fractures. Hormone replacement therapy requires close monitoring and careful gynecologic patient selection.

Post-menopausal women with low bone mass or osteoporosis and have established contraindication to hormone replacement therapy, bisphosphonates (alendronate or etidronate) and calcitonin are effective medications to prevent bone loss.

Walking and stretching exercises of the spine may stabilize or even slightly increase bone mass and improve balance and muscle strength, preventing falls and fractures.

Vertebral fractures should be treated initially with rest, analgesics, lumbostato and rehabilitation. Other possible treatments being studied include vitamin D, fluoride and parathyroid hormone.

The debate centers on the possibility that this type of food results in a lower bone mass, as some studies, compared to other investigations that have found no statistical significance in this relationship.

The issue concerned because BMD is the strongest and most consistent predictor of fractures associated with osteoporosis.

In Western countries, a considerable proportion of the population has adopted a vegetarian diet that includes foods not found in traditional diets as the best for the formation and growth of bones.

The quality and quantity of ingested nutrients (calcium, phosphorus, magnesium, vitamin D, A, K) and the consumption of other dietary elements that promote or hinder the absorption of minerals that nourish the bone, have a significant imprint on health marrow.

These factors add up to each individual’s genetic predisposition to develop bone disorders.

The latest review on the possible association between diet and bone mineral density, a controversial issue, is a meta-analysis conducted by the Bone and Mineral Research Program Garvan Institute of Medical Research, picked up this October in the American Journal of Clinical Nutrition.

It is estimated that osteoporosis affects 3.5 million people in Spain and more than 200 million people worldwide. In our country every year is responsible for at least 100,000 bone fractures.

“It is a major problem for its prevalence, morbidity and mortality caused by it and by the consumption of medical resources involved,” specifies Manuel Diaz Curiel, president of the Hispanic Foundation for Osteoporosis and Metabolic Bone Diseases (FHOEMO).

To combat its consequences, this organization has promoted a campaign in collaboration with the pharmaceutical industry and throughout the Spanish territory, which emphasizes the need to maintain adequate levels of vitamin D and calcium to maintain good bone health .

Aware of their magnitude

Supplementation of therapies that prevent bone resorption (total or partial loss of bone tissue) vitamin D dramatically reduces the risk of bone fractures in the elderly as a result of osteoporosis.

Follow a few simple hygienic-dietary measures and generalized tests that measure bone density in patients at risk, not only helps to prevent development but minimize associated complications, among which are primarily bone fractures.

Therefore, this campaign serves several purposes. First, it seeks to raise public awareness, since osteoporosis is highly prevalent and causes complications that affect quality of life of persons or may cause increased mortality (especially for hip fractures ). “Another objective is to make the major risk factors for osteoporosis and show how these profiles can be modified by simple lifestyle and from an early disease diagnosis,” says Diaz Curiel.

Preventing the incurable

Because both men and women are living longer, disorders resulting from poor bone health are growing in number and complexity increases. The aging, a decline of sex hormones or improper lifestyle are major risk factors that point to a low bone mass and, therefore, are behind much of osteoporotic fractures.

Physical inactivity, dietary changes and hormonal changes due to aging and inactivity often redound in a marked reduction in bone mass. According to Diaz Curiel, is crucial to detect at an early stage asymptomatic patients, but with risk factors for developing osteoporosis, “Preventive work is the best therapy, especially in people with risk factors and may ignore the danger they expose their bones. ”

This specialist explained that the screening tests are bloodless and can treat the patient with the best drug for their personal circumstances. In some cases, osteoporosis is due to genetic factors can not be changed, but there are other factors that it can and should be correct: the overweight or obese, smoking, early menopause in the case of women, sedentary or a dietary deficiency of calcium and vitamin D.

Low levels of vitamin D

Vitamin D is key to the prevention of osteoporotic fractures, especially when taking into account the deficit of this prohormone (no hormone activity itself) in the elderly population and associated with calcium, studies have shown clinicians be able to reduce the risk of bone fractures. It is also essential for the maintenance of muscle function because it facilitates the absorption of calcium and phosphorus from ion channels. A sharp deficit of calcium intake and vitamin D in the diet contributes to bone loss, reduction of bone strength and, ultimately, shoot the risk of fractures.

Although in many treatment guidelines recommend osteoporosis with vitamin D supplementation in patients at risk, the deficit is the Achilles heel in the prevention of disease. This has been highlighted in a study presented at the annual meeting of the American Society for Bone and Mineral Research (ASBMR), conducted by experts from France and Spain. The work has evaluated the level of vitamin D and calcium in a total of 414 osteoporotic women older than age 50.

It highlights that the majority of patients, despite being diagnosed, did not meet the recommended levels of vitamin D. The researchers also show that an inadequate level of vitamin negatively impact the absorption of calcium, accelerated bone loss and fracture risk. “Indeed,” added FHOEMO-president, has shown that combined administration of vitamin D and calcium reduces the incidence of osteoporotic fractures and that adequate levels of this vitamin are necessary to optimize the results obtained in osteoporotic patients treated with bisphosphonates . Bisphosphonates are a drug used in preventing and treating bone resorption diseases like osteoporosis.

Although vitamin D is synthesized by the skin and has always been thought that in Spain the solar intensity allowed a major contribution in this, the study reports that levels in our country are generally quite low. For this reason, we need a greater contribution to the intestines absorb calcium and it can be fixed to bone. The problem is that not always get an adequate intake of calcium and vitamin D only through the diet. From FHOEMO advised to use supplementation of both “excellent also to overcome drug resistance to anti-osteoporotic bone.

The bone is strengthened or weakened, depending on whether it does or does not exercise and the type of exercise performed. Other influences are food, nutritional supplements such as soy isoflavones, sunlight exposure, heredity and age. The areas mainly involved with bone demineralization are the lumbar vertebrae and the upper end of the femur. This is mainly due to the predominance of trabecular bone or spongy bone on the compact. Since trabecular bone is influenced by mechanical forces it is subjected, a sure way to accelerate bone loss is inactive bedridden. The way to increase bone density is exercise.

This provides an osteogenic effect, ie bone formation. This effect occurs when activity is performed above what normally accustomed. It must then reach a minimum threshold stimulus for osteogenic effect. Weight training is an excellent form of exercise to increase bone density. Different protocols have been tried weight training and some are definitely better than others on osteogenic effect. The human body has an impressive resilience, as the proper exercise with weights increases bone density in children, adults, elderly people, both in previously sedentary people and athletes. When you want to increase bone density, exercise programs should be designed focusing mechanical force that stimulates an area of interest. For example, the jog would be an exercise for the femur but inadequate to increase bone density in the wrist.

Program of weight training designed to induce an adequate osteogenic effect should be selected exercises, the order of these, the sets per exercise and maximum repetitions per set, ie the volume and intensity.
If this is accompanied with a proper diet and nutritional supplements such as soy isoflavones, we are forming strong bones in adulthood and old age results in a better quality of life.

One in two women and one in four men over age 50 will suffer a bone fracture due to osteoporosis

A quarter of people who break a hip die within the first anniversary of the injury. A study of the Spanish Society of Orthopedics and Traumatology warns that one in two women and one in four men over age 50 will suffer a bone fracture due to osteoporosis. The broken bone is the result “more serious” of this disease as “one of every four people who fracture a hip die before the year,” said study coordinator, Dr. Manuel Mesa Ramos.

The researchers stressed the importance of preventing a disorder that affects a majority of females from menopause. Once menstruation is lost, it creates a deficit in the production of estrogen or female hormones that, among other functions, has a mission to fix calcium to the bones. This explains why the patient type of osteoporosis is a woman who is over 60 years and goes to the consultation because it hurts his back, in the area of the dorsal vertebrae, the height of the blades, detailed the department head of Orthopedic Surgery Chiron and Traumatology Hospital of Bilbao, Inaki Mínguez.

The first step is usually medical X-rays to analyze whether the cause of pain is poor bone health, due to loss of density. If radiological evidence confirms the suspicion, it is recommended to the patient an active life, including the practice of sport is not aggressive, a balanced diet that is reinforced with calcium-based treatments, and sunbathing for calcium is set at bones due to vitamin D.

“For some women, bone demineralization occurs at a high tempo from the menopause, which usually takes place in around 51 years,” said the head of department for Gynecology and Assisted Reproduction in the same clinic, Dr. Barrenetxea Gorka. Although most bone fragility is linked directly with the production of estrogen deficiency, other risk factors. The first is the excessive thinness. Without actually being overweight, body mass protects against osteoporosis, said Barrenetxea. Smoking is another point against it. “Smokers suffer more osteoporosis,” said the doctor, who also recommended practice moderate exercise. The alcohol abuse is also a negative factor, he added.

Importance of food

“Food is fundamental, but throughout life,” said Inigo Sainz-Arregui, a physician specializing in Nutrition and Family Medicine. “Consuming adequate amounts of calcium is shown to protect against osteoporosis,” he said. Although the peak bone mass is determined by genetics, the density is related to calcium intake during the period of bone accumulation, which occurs from birth to 25 or 30 years. It is therefore important to ensure adequate intake of calcium to avoid risks, said Sainz-Arregui.

Calcium not only found in dairy products like milk, yogurt or cheese, but also green leafy vegetables like cabbage, spinach or watercress. Furthermore, it should consume vitamin D rich foods like fish, eggs and fortified cereals and dairy products to help calcium absorption. Phosphorus fish, eggs, vegetables, meat and cereals also plays an important role in bone health. “In short, a varied and balanced diet with little salt and accompanied by physical exercise is the best option,” summarized the nutritionist.