Juvenile osteoporosis

Osteoporosis is a disease that can cause a reduction in bone mass that puts you at risk for bone fracture. In most cases, osteoporosis is seen in adult women after menopause. However, in children and adolescents may develop juvenile osteoporosis. This often occurs in children between the ages of 8 to 14 years. But sometimes the disease progresses, and at an earlier age, during growth spurts.

Juvenile osteoporosis in children is difficult to detect. Pictures of bone density are the most accurate way to determine the premature loss of bone mass. But this type of survey can not hold as well as adults, that would make an accurate diagnosis of the child. Doctors usually diagnose juvenile osteoporosis, if there are signs of the fragility of the skeleton. This can occur when fractures occur without trauma, such as a significant drop, and an indicator of bone mineral density below -2.0.

Types of juvenile osteoporosis

There are two types of juvenile osteoporosis: secondary and unknown origin.

Secondary osteoporosis refers to osteoporosis, which developed as a result of another disease. This is the most common type of juvenile osteoporosis. Some illnesses may lead to the development of osteoporosis in children, including:

    Juvenile arthritis
    Diabetes
    Cystic Fibrosis
    Leukemia
    Brittle bones ("glass bones")
    Homocystinuria (genetic metabolic disease)
    Hyperthyroidism
    Hyperparathyroidism
    Cushing's syndrome
    Malabsorption syndromes
    Anorexia nervosa
    Kidney disease

Sometimes juvenile osteoporosis is a direct result of the disease. In rheumatoid arthritis, for example, children may have lower bone density than it should be, especially in arthritic joints. Certain medications can also lead to a youthful osteoporosis. This may include chemotherapy for cancer, anti seizure anticonvulsants or steroids for arthritis. If your child suffers from one of these diseases, talk to your doctor about carrying out a thorough examination of bone density.

Osteoporosis of unknown origin means that the cause of the disease is unknown. This type of juvenile osteoporosis is less common. As of 1997, in the medical literature, it was reported 150 cases. In boys, the disease occurs more frequently than girls. The disease most often develops just before the onset of puberty. Bone density in children increases during puberty. Although at the time of puberty, most of the density of bone mass may be resumed, in children with juvenile osteoporosis is usually a lower peak bone mass than adults.

Whatever the reason, juvenile osteoporosis is a serious disease. 90% of your bone mass is formed at the age of 18 - 20 years. Loss of bone mass in the process of bone formation may expose the child at serious risk of complications in the future, such as fractures.

The symptoms of juvenile osteoporosis

Symptoms of the disease juvenile osteoporosis include:

    Back pain, hip, knee, ankle and foot
    Difficulty in walking
    Breaks legs, ankles or feet

Treatment for juvenile osteoporosis

The type of treatment your child depends on the cause of the disease. If the cause of the disease juvenile osteoporosis is a disease, the best way to treat osteoporosis is the treatment of this disease. If a cure for the disease is another factor of juvenile osteoporosis, a transition to another medication. If the other does not exist, it is possible to reduce the destruction of bones by taking a smaller, but also an effective dose of medication.

To date, there is no medicine or surgery in the case of juvenile osteoporosis disease of unknown origin. It is important to protect your child from the skeleton fractures. Perhaps he will have to use crutches or other support. And perhaps he should avoid contact sports, which exposed him to the risk of fractures.

None of the drugs that are taken for the treatment of adult osteoporosis, is encouraged not to accept children. To date, one study conducted on the drug Fosamax, which can help children with juvenile osteoporosis.

All children, including those with juvenile osteoporosis, it is necessary to maintain such a lifestyle that promotes a healthy skeleton. It includes a diet rich in calcium and vitamin D, protein, and safe exercise. Many experts also believe that children with juvenile osteoporosis should undergo bone density screening at least every year during adulthood.

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Osteoporosis Myths

Osteoporosis is an insidious, initially totally painless disease. Therefore, the first signs in advance of the disease are often not taken seriously enough. Furthermore, circulating the false idea that osteoporosis is not treatable.

Myth 1: Osteoporosis is a rare disease.

The opposite is true: In developed countries, osteoporosis has become an endemic disease. Almost eight million people in Germany alone that, but only a minority is treated. The number of osteoporotic hip fractures in Germany amounted to about 100,000 per year. Approximately 30% of all women suffer once in their lives caused by osteoporosis vertebral fracture.

Myth 2: I'm too young to me to worry about osteoporosis.

Wrong! Prevention begins at a young age, because even at this time, the foundation for future disease can be determined. Especially with young people play an adequate calcium intake, adequate supply of the body with vitamin D and regular exercise is an important role to build an optimum bone mass. Also, a healthy lifestyle is useful: For successful prevention of osteoporosis, it is recommended not to smoke, consume less alcohol and avoid phosphate-rich foods (such as cola drinks, sweets, fast food), since they prevent the absorption of calcium in the bones.

Myth 3: Osteoporosis is a women's disease.

Wrong! Also, the "stronger sex" may suffer from osteoporosis. About 20% of osteoporosis patients in Germany are men. Although omitted in men, estrogen deficiency in menopause as an important risk factor that are otherwise in the risk factors - physical inactivity and poor diets included, barely. Often appears in men of testosterone decrease in old age or long-term use of cortisone for the disease outbreak to be responsible, but also a high alcohol and nicotine consumption may play a role.

Myth 4: If osteoporosis is detected, you can do nothing against the disease.

But! To bone and spinal fractures, excruciating pain and permanent disability must not happen. If the bone loss observed in the early stages, it can be stopped frequently by drug treatment. Even at an advanced stage bone fractures can often be prevented by drugs and the quality of life improved significantly. In addition, it is never too late to counter with an individual exercise program and healthy diet rich in calcium for osteoporosis.

Myth 5: Osteoporosis is not so serious that they should worry about.

Osteoporosis is a serious disease because it causes a progressive weakening of the bones. This goes so far that even a slight shock may or innocuous case to cause painful fractures, especially in the hip or the spine, but also at other skeletal sites.
One in four patients with femoral neck fracture die within the first twelve months after the fracture. Half is now walking dependent on foreign aid and a further quarter of the patients is nursing care.

Myth 6: I'm healthy, so I'm not at risk.

Unfortunately we have no indication of how strong your bones are. Unbeknownst to lose the body's natural bone density, although it is believed to live healthy. Especially when there are family preloads, you should be talking to his doctor about a possible osteoporosis and make a bone density test. This method allows the inference of osteoporotic fracture susceptibility of the bone. However, take the public health insurance costs for a bone density measurement is not often, but still there is no fracture.




I Suggest you read "The Myth of Osteoporosis"

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Smoking and Osteoporosis

There are many health problems that are caused by smoking. Centers for Disease Control and Prevention reported that the disease associated with smoking in the United States spend more than $ 75 billion each year. Smoking causes heart disease, lung cancer and stomach cancer, chronic lung disease. In addition, some studies have identified smoking as a risk factor for osteoporosis and susceptibility to fracture.

Osteoporosis

In osteoporosis the bones are weakened and more susceptible to fractures. Fractures from osteoporosis can result in significant pain, disability and sometimes death. Osteoporosis is a major health threat for an estimated 44 million Americans, 68% of whom are women. In addition to smoking, there are several risk factors for osteoporosis:

•     thin or small size
•     the presence of disease or cases of fracture after 50 years of family history
•     or postmenopausal onset of premature menopause
•     abnormal absence of menstrual periods
•     using certain medications, including corticosteroids, long-term
•     calcium deficiency
•     lack of physical activity
•     alcohol abuse.

Osteoporosis can be prevented. Osteoporosis is a silent disease: it can progress for many years without symptoms, until such time until fracture occurs. He was named the children's illness, the consequences of which manifest themselves in old age, as the maintenance of bone health in young people helps prevent osteoporosis and fractures later. But never too late to learn new habits and to protect bone health.

Smoking and Osteoporosis

Tobacco was first designated as a risk factor for osteoporosis more than 20 years ago. Recent studies have shown a direct link between smoking and reduced bone density. It is difficult to analyze the impact of smoking on bone health, because it is difficult to determine whether the reduced bone density is due to smoking or other risk factors inherent in smokers. For example, in many cases, smokers have lower body weight than non-smokers tend to consume more alcohol, less physically active and have nutritional deficiencies. Women who smoke are also at menopause earlier than it happens in non-smokers. These factors are also subjected to many smokers at increased risk of osteoporosis, along with tobacco.

In addition, many studies concerning the effects of smoking suggest that smoking increases the risk of fractures. Not all studies support these findings, but the evidence is increasing. For example:

1.     The longer you smoke, and the more cigarettes you consume, the greater the risk that you'll be prone to fractures in the elderly.
2.     Fractures in smokers grow together longer than non-smokers, and they have a more complications in the process of accretion.
3.     Significant bone loss in elderly men and women who smoke.
4.     At least one study suggests that passive smoking in youth may increase the risk of low bone mass.
5.     Women who smoke often produce less estrogen (hormone), and they tend to attack premature menopause, unlike smoking, which can lead to increased bone loss.
6.     Quitting smoking reduces the risk of bone loss and fractures. However, the process of reducing the risk for people who quit smoking can take several years.

Strategies for managing osteoporosis

Quit smoking: The best thing a smoker can do to protect their bones, it is to quit smoking. Quitting smoking, even in adulthood, can help reduce bone loss, which is associated with smoking. There are many resources available to aid in smoking cessation, some of them are listed below.

Eat a balanced diet, foods fortified with calcium and vitamin D: Sources of calcium include dairy products low in fat, dark green, leafy vegetables, and foods and drinks that are fortified with calcium. Also, supplements can provide the necessary amount of calcium per day. Institute of Medicine recommends a daily calcium consumed at a rate of 1000 mg for men and women, and increase the dose to 1200 mg after the age of 50 years. Vitamin D plays an important role in calcium absorption and bone health. Vitamin D can be obtained in its natural form as a result of exposure to sunlight, as well as foods and food additives. Sources of vitamin D include egg yolks, saltwater fish and liver. Some people can take supplements containing vitamin D, to get the recommended dose of 400 - 800 IU (international units) daily.

Work out for strong bones: Like muscles, bones consist of living tissue that responds to physical activity, becoming stronger. Weight loads, when you overcome the force of gravity, the best way to train the bone tissue. Some examples include: walking, climbing stairs, dancing and lifting weights. Regular exercise such as walking, can help prevent bone loss and provide many other benefits to enhance your overall health.

Avoid excessive use of alcohol: Chronic alcoholism may be associated with increased susceptibility to fractures of the hip, spine and wrist. Alcohol in large doses acts on the calcium balance in the body. It also affects the hormones that protect the bones, and vitamins that are needed for calcium absorption. Excessive alcohol consumption can also lead to falls associated with the occurrence of fractures.

Talk to your doctor to conduct a survey of bone mineral density: A survey of bone mineral density indicates the density of bones in different parts of the body. These tests can detect the presence of osteoporosis before a fracture occurs, and can show your chances of fractures in the future. If you smoke, or smoke before, ask your doctor whether you should undergo bone density screening.

Should you take medicines: from osteoporosis, there is no cure. However, there are some medications that can prevent and cure disease in women after menopause and in men. Your doctor can help you decide whether you fit these medicines.

Resources to aid in smoking cessation

Smokefree.gov: Smokefree.gov, created by the National Cancer Institute, is designed to aid in smoking cessation. Different people need different resources as they try to quit smoking. The information and professional help that is available on this website can help you support your immediate and long-term needs at the start of smoking, the smoking process, and smoking cessation. Go to: www.smokefree.gov.

Path to Freedom: Be a winner in the fight against smoking: Designed for African Americans, this guide was developed by the U.S. Centers for Disease Control and Prevention, in conjunction with the major segments of the African American community, including churches, service organizations and educational institutions. The development and processing of this guide were caused concern at the national level, a high level of smoking among African Americans, and the lack of suitable materials. The guide presents many aspects that are relevant to African Americans, such as targeted advertising campaigns and historical, cultural and socio-economic impact. This resource offers proven strategies for those who want to quit smoking, information on how this can help friends and family, as well as ideas of how society and its leaders can assist in establishing the value of a life without tobacco. Go to: www.cdc.gov / tobacco / quit / pathways.htm or call the following number: 1-800-232-1311 and request a free copy.

A breath of fresh air: Independence from smoking: Developed by the National Women's Health Information Center, this online program of support and education focused on smoking cessation in women. Information is also provided in Spanish. Go to: www.4woman.gov/QuitSmoking.

Forget about smoking: Written specifically for Latino families, "Forget about smoking" is part of bilingual brochures that explain the steps to be followed by people who want to reduce the risk of heart attacks or strokes. The information is presented in a friendly style that helps the reader to dispel the most common myths. Go to: www.nhlbi.nih.gov / health / public / heart / other / sp_smok.htm or please call: 301-592-8573 or 240-629-3255 (text telephone).

For the latest information and any questions about medications you are taking, please contact the Office of the Food and Drug Administration United States by number 1-888-INFO-FDA (1-888-463-6332, toll free) or visit their Web site: www.fda.gov.

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Choosing the right medication for your osteoporosis

Consider the six types of drugs for osteoporosis.

When it comes time to choose what medicine to take for osteoporosis, you have many options. Over the past 10 years, science has come a long way to assist women to cure bone disease.

First step: Make sure you consume enough calcium and vitamin D, advises Eve Skopelitis, doctor, therapist Ochsner Medical Center in New Orleans. "Vitamin D is a major component in the treatment of osteoporosis. Even if patients taking calcium with vitamin D, may still be a lack of vitamin D. In this case, they may need to take vitamin D, which is a prescription - so it's important.

In fact, even if you begin to undergo treatment for osteoporosis, you just need to continue taking these supplements, said Holly Tucker, Doctor, Director, Center for Women's Health at Cleveland Clinic. "Women, after menopause, you need 1,500 milligrams of calcium each day, plus 1,000 units of vitamin D. Some people need vitamin D, a prescribed [Calcitriol]. Lack of vitamin is a serious problem."

Also important: Do weight exercise, do not smoke or abuse alcohol.

Second step: Talk to your doctor about the survey on the label of bone resorption - a blood test or urine test, says Mary Rupp, doctor, endocrinologist at the health center at the University of Texas at Houston.

Bone resorption is a loss of bone mass - and the test can show whether your medicine for osteoporosis, effective on the effects on bone, she explains. "The first survey shows your original data. Take it before you start taking drugs. Then go after a few months of taking the drug again to see if there are changes." Insurance usually covers the cost of two such surveys during the first year of treatment.

Now let's look at the advantages and disadvantages of the six major types of drugs for osteoporosis.

1: Bisphosphonates: Fosamax, Actonel, Boniva, zoledronic acid (Reclast or Zometa)

Bisphosphonates are the basis for the treatment of osteoporosis today. "They are a fundamental component in the treatment of osteoporosis," says Bobo Tanner, Dr., Director of the Osteoporosis Clinic at the University of Vanderbilt in Nashville, Tennessee. "These drugs give patients a lot of choices."

Fosamax was the first cure for osteoporosis, which was approved by the Office for Quality Control of Food and Drug Administration United States 10 years ago, three years after it was approved and Actonel. Boniva and Reclast been approved recently. "Actonel and Fosamax have good results," - says Tanner, "But the information about Boniva and Reclast we do not have."

How they work: These drugs have shown the ability to increase bone density - and Fosamax and Actonel also reduce the risk of fractures of the spine and hip. Actonel works pretty quickly, reducing the risk of fractures within six months, according to Tanner.

"Boniva is not yet shown results in reducing hip fractures, which are concerned," - she added.

Reclast or Zometa increases bone mineral density and showed the property to reduce hip fractures and spine - reduced risk of susceptibility to fractures of spine persists for more than three years. According to information from the manufacturer, Reclast also reduces the susceptibility to fracture wrists, arms, legs and ribs. Reclast demonstrated the properties to reduce mortality among people who have already been broken, said Tanner.

Options dose: Taking bisphosphonates can be very flexible - depending on whether you want to take medicine for osteoporosis once a day, once a week or once a month - well, you can take the drug by injection, which is done once a year in the office of your physician.

Options:
    Fosamax can be taken once a day or once a week in tablet form.
    Fosamax in liquid form can be taken once a week.
    Actonel can be taken once a day, once a week or once a month.
    Boniva can be taken once a day or once a month in tablet form.
    Intravenous injection of Boniva can be done once a year.
    Reclast or Zometa can be taken once a year in the form of intravenous injection.

With intravenous injection involved a needle that is inserted in your hand and drip - this is what you put in the hospital. And though this may seem extreme in some way of taking the medicine, it does have its advantages. "Intravenous drug goes directly into the bone, completely bypassing the gastrointestinal tract," - said Skopelitis.

The procedure itself takes about 5 minutes in the case of Boniva, and 5 minutes in the case of Reclast - and you're free for a year. "For some patients, this is a very practical option," - says Tanner.

Mode of taking the pills: Medication for osteoporosis in tablet form is not so simple. You do not just have to swallow a pill. You must comply with specific instructions.

    A pill - it's the first thing you should do in the morning - on an empty stomach.
    After the reception you can not sit or lie down.
    You can not eat and drink.
    Wait 30 - 60 minutes, until the body absorbs the medicine.
    After that, you can take other medicines.

The longer it will take before you have something to eat, the greater the chance that a cure for osteoporosis, better digestion by the body. "Your stomach must be empty," - said Skopelitis. "You must be sure that your competitors do not have gastrointestinal medicine." You can take other drugs later - but not before taking drugs for osteoporosis.

Such a strict regime of taking is very important, says Tanner, as the body can absorb quite a bit of medication. The body absorbs only about 1% of the drug - "so, make sure you get the most out of each dose," - she said.

Selecting: When deciding on the admission of bisphosphonates, you should ask themselves eight questions:

1.     How often do you want to take medicine for osteoporosis?
2.     Do not forget if you take the medicine?
3.     Will you follow a strict regime of taking the pills in the morning?
4.     Do you take other medicines on a regular basis?
5.     Do you have any problems with the digestive tract?
6.     Do you have difficulty swallowing?
7.     Would you like to take medicine once a year?
8.      Does your insurance cover the cost of such drugs for osteoporosis?

Bisphosphonates tablets are not recommended for people who have problems with the gastrointestinal tract, such as gastritis or ulcers - as well as people who have serious problems with the esophagus, such as stenosis. "We want to be sure that the patient will be able to learn medicine," - says Tanner. "If they suffer from other diseases, then it is better to consider a variant with an intravenous technique."

Also, for patients who are not subject to concessional pharmaceutical plan - under the terms of health insurance or government programs to provide free medical care to the elderly - intravenous administration of Reclast and Boniva are the best option, says Tanner. "Since it happens in the doctor's office, the cost will be covered." However, you must comply with the terms of their own insured retention and surcharges.

Generic Fosamax: If you have no problem with taking the drug in tablet form, Fosamax is now possible to buy cheaper, generic form. This is a great option if there are financial problems, says Tanner. "Some people can not afford to spend more than $ 4 a month." However, we must know that the generic drug must meet 80% of the original drug, it is not 100% identical to, she says. "For a drug that worked so hard absorbed by our body, I think it's risky."

Possible side effects: These drugs for osteoporosis can lead to stomach upset, cause heartburn for a day or two. "Actonel, it seems, leads to fewer side effects in the gastrointestinal tract," says Rupp.

Some patients complain of pain in muscles and joints during the course of treatment for osteoporosis, but there are some serious problems. "It's not a reason not to take medicine," - says Tanner.

However, side effects are the main reason why people refuse to continue taking drugs for osteoporosis, according to Rupp. In this case study may help to label bone resorption. "It can show the effectiveness of drugs, whether it affects the disease. Some people just need to see this again. It's a positive thing to continue taking the medicine."

Since Reclast in the treatment of osteoporosis is introduced every year, some people are nervous because of side effects - whether they occur throughout the year, says Tanner. "About 20% have flu-like illness, during the first few days after drug administration. In very rare cases, a pain in the bones, which may continue for some time. But this happens in less than 1% of cases. This is a rarity" . Treatment of ibuprofen (eg Advil, Mortin) or acetaminophen (eg Tylenol) helps in the manifestation of these symptoms.

Existing Risks: Anxiety can cause arrhythmia (abnormal heartbeat rhythm). A major study has shown that some patients who were treated with zoledronic acid (Reclast or Zometa), heart rate deviated from the norm more than those who received placebo. Follow-up studies did not give such results. Office of the Food and Drug Administration has advised the U.S. not to stop the patients taking bisphosphonates - but to report on the manifestation of side effects and symptoms to their doctors.

There is also a small risk of osteonecrosis of the jawbone, which can cause pain, swelling, the vulnerability of the bone, local infection and a broken jaw. However, osteonecrosis is rare and occurs in few patients who have undergone chemotherapy or radiation therapy, and for a long time took bisphosphonates, says Tanner. "It happens very rarely," - she said. "The benefit of preventing bone fractures than the risk of osteonecrosis of the jaw bone."

Tucker agrees: "The risk of developing osteonecrosis of the jaw bone is too exaggerated. Horizon Trial Group examined the effects of Reclast 8,000 postmenopausal women and found no increased risk of osteonecrosis of the jaw bone."

2: Evista: Prevention of breast cancer and osteoporosis

Women with osteopenia [low bone density, but not osteoporosis] - or those who have problems with the digestive tract and they can not take bisphosphonates - can choose the drug Evista. Evista - is a selective estrogen receptor modulator (SMRE), which is used to treat breast cancer. The drug is approved by the Office of the Food and Drug Administration United States for use in the treatment and prevention of osteoporosis.

The drug binds to estrogen receptors in the body and has a similar effect of estrogen - including the prevention of bone loss.

Evista helps prevent vertebral fractures but not hip, according to Tucker. "Evista is not as effective as hormone therapy or bisphosphonates for the skeleton. But the Office for Quality Control of Food and Drug Administration United States encouraged the drug for the treatment of osteoporosis, as well as to reduce the risk of breast cancer. So, for women there are additional benefits of Evista ".

Possible side effects: Rarely, but there is a risk of deep vein thrombosis.

3: Forteo: "Builder" of bone
If you have a severe degree of osteoporosis, you may want to take a drug called Forteo. Forteo - a hormone pair of the thyroid gland, which increases bone density and bone strength, in order to avoid fractures. Forteo stimulates kosteformiruyuschie cells called osteoblasts to form bone tissue. This is a cure for osteoporosis, a significant effect on bone density in the spine, reducing fractures and 90%.

Forteo is taken daily for a period of time, and administered by injection. This medication is usually prescribed for osteoporosis for people with severe osteoporosis, or those who had been one or more fractures. You can enter injections themselves at home or with someone.

"Forteo" builds "the bone, while the other drugs, just to protect from fractures" - explains Skopelitis. "Women with severe osteoporosis refuse other drugs and start taking Forteo, which is much stronger."

Possible side effects: Some people complain of dizziness or weakness, rapid heart rate when administered in the form of injection drugs, or nausea, vomiting, constipation, and muscle weakness.

4: Denosumab: In the pipeline
As well as Forteo, a medication for osteoporosis, "builds" of the bone. Tests showed three phases of a reduced level of vertebral fractures and hip. The drug activates osteoblasts kosteformiruyuschie different from Forteo way. This is a new drug for osteoporosis administered as injections, but these injections should be done several times a year. The drug will be available from 2009, according to Rupp.

"Preliminary information on denosumabe we like" - says Tanner. "It may be useful for people who can not tolerate or who do not help other medications."

5: Calcitonin: For a comprehensive treatment
Calcitonin is the first drug for osteoporosis, which was approved in 1984 - and still take it sometimes. This hormone is produced from salmon calcitonin, which helps slow down bone loss, increases bone density and relieves pain. In the process of impact it binds osteoclasts, cells that break down bone, and this prevents loss of bone mass. The major advantage of calcitonin is that it reduces the risk of vertebral fractures.

Calcitonin is often used as an additional medication for osteoporosis or if people can not tolerate bisphosphonates. You can enter in the form of injections.

Possible side effects: diarrhea. Redness of the face or hands, increased urination, loss of appetite.

6: The Hormone Estrogen: Prevention of tides and prevention of osteoporosis

Women who want to get rid of the tides - and prevent osteoporosis - may choose hormone replacement therapy (HRT). However, there are serious risks of heart disease, stroke and of blood clots in the lungs. Also, there is an increased risk of breast cancer, as well as, possibly, other cancers.

These risks disappear once women stop taking HRT, according to new research. But doctors prescribe the smallest possible dose of HRT for the shortest possible period of time, women who delivered tidal restlessness. The benefits of HRT are kosteformirovaniya plus - as it is known that it preserves bone mass and prevent fractures.

Tanner does not support the use of HRT for osteoporosis. "HRT has been quite criticized by the Office for Quality Control of Food and Drug Administration United States - and is classified only for short-term use," - says Tanner. "Another aspect is the fact that HRT has no lasting effect. As soon as you stop taking it, your skeleton menopause, unlike bisphosphonates, which provide long-term effect for several months if not years, after you stop them to take. " Fosamax is in the bones are not over 10 years, he adds.

But Tucker said that "too much hormone is ignored." She is the author of the book, Women's Health: Your body, your hormones, your choice. "It can reduce the susceptibility to all types of fractures in women. If you're 50, you are a woman and you are threatened by osteoporosis, you have hot flashes and other menopause symptoms, think about hormone therapy. If you are under 60 years of age, the benefits outweigh risks."

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Risk Factors for Osteoporosis

Risk Factors for Congenital

Gender: Women are more likely to suffer from osteoporosis than men the same age

Family history: the children of women who experience osteoporotic fractures, the average have a lower bone mass than normal age. (3-7%).

Elderly over 70 years of age: the older, the body's ability to absorb calcium by the intestines decreases.

Race: White women are more susceptible to osteoporosis. Results showed that women from northern Europe, Japan, and China, are more susceptible to osteoporosis than those from Africa, Spain and the Mediterranean. While white women who live far from the equator (Sweden, Norway, etc.) have a higher risk of osteoporosis. Unlike the case with the women of Africa. Mixed-race African Americans have the highest bone mass. Had the lowest bone mass while the white race, especially Northern Europe. Being among the American races. Also note also that while a decrease in bone mass in older African-Americans more slowly than other races.

Menopause: a decrease in estrogen in women leads to reduced absorption of calcium is beneficial for maintaining bone density.

Early Menopause: due to removal of the ovaries before menopause actually. This accelerated bone loss. Or into menopause before age 45.

Body size: race and the African and African-Americans have a large body frame. They are less susceptible to Osteoporosis, because excess weight is greater pressure on the bone, thus stimulating new bone formation. Osteoporosis affects men more often petite and small framed.

Risk Factors that Caused By Lifestyle

Lack of physical exercise: weight training, especially that put pressure on the body frame, thus stimulating new bone formation. Men and women who exercise regularly have a lower risk of fracture.

Alcoholics: excessive alcohol consumed in the long run leads to reduced bone density. In postmenopausal women, reduced bone density will be even greater. Coupled with poor nutritional intake (diet usually drunk is not good), so that bone mass is getting worse. In addition, the drunkard prone to liver disease, so the absorption of vitamin C is disrupted and causes abnormal and weak bones. Drunken men and women tend to have osteoporosis at the age of 30 years.

Addicts Coffee: Coffee reduces the levels of calcium in the bones, so that drinking coffee causes excessive bone loss come faster.

Dietary deficiencies of protein: protein and vitamin D deficiency is prolonged in children will have a big impact on bone formation. Moreover, it also will slow the arrival of puberty. This triggers the arrival of faster osteoporosis.

Deficient intake of calcium: calcium is important for bone formation, especially in postmenopausal women. The average American woman needs calcium intake 450 mg / day at age 45, and 1200 mg / day at age 75

Deficiencies in the morning sun exposure with vitamin D: the need for calcium must be accompanied by the intake of vitamin D. Without Vitamin D, calcium is probably absorbed by the intestine. The results showed, 500 mg calcium / day plus 800 IU vitamin D / day, is sufficient to reduce the risk of osteoporosis.

Birth control pills: a 30-year study showed that women who consume birth control pills have stronger bones than those who do not. Oral contraceptives containing estrogen and progesterone. Estrogen is essential for preventing osteoporosis.

High protein diet: eating too much animal protein cause increased acidity in the gut, thereby reducing the absorption of calcium. Similarly, if you eat too much fiber, then the calcium will be absorbed go wasted.

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What is Osteoporosis?

Definition of Osteoporosis

The layman is often put forward the definition of osteoporosis. Various limits are given by experts, including the following.

1. Osteoporosis is a disease with characteristic properties of low bone mass, accompanied by changes in bone micro-architecture, and decreased quality of bone tissue, which in turn lead to increased bone fragility due to the risk of fractures. This definition was proposed by the WHO in the International Consensus Development Conference, in Rome, Italy, 1992.


2. Osteoporosis is a disorder framework, characterized by bone strength is worrying and is affected by the increased risk of fractures.
While bone strength reflects a combination of two factors, namely bone density (bone quality). These definitions are made by consensus by the National Institutes of Health (NIH) in 2001.

In summary, osteoporosis is a metabolic bone disorder characterized by progressive loss of bone density, so it becomes very reduced bone strength and fracture easily.

Bone contains several minerals, including calcium and phosphate, and organic form of collagen fibers in large numbers. Both minerals are throwing hard and dense bone, whereas bone collagen throw pliable / flexible

declining production of estrogen at menopause can  reduce bone density

To maintain bone density, it takes a sufficient intake of calcium and some minerals, the body's production of some hormones such as parathyroid hormone, growth hormone, calcitonin, estrogen in women and testosterone in men. Also required calcium intake of vitamin D to be absorbed by the intestine. Without vitamin D, calcium can not be absorbed for bone formation.

Bone loss occurs when bone mass begins to decline, so that bones become brittle and break easily at risk. World Health Organization (WHO) defines osteoporosis based on bone density in the hip bone. Standard size of a normal bone density is 833 mg/cm2. Between 833-648 mg/cm2 called osteopenia, and osteoporosis in patients with hip bone density is less than 648 mg/cm2.

Why does osteoporosis occur?

Bone consists of two types of materials, namely:

1. Mineral-rich matrix (70%), a bone that has been cooked (bone).

2. Organic materials (30%) consisting of:

Cells (2%)
- Mon osteoblasts:
Cells that make bone matrix
- Mon osteocytes:
Cells that maintain the bone matrix.
- Mon osteoclasts:
Cells that absorb osteoid (matrix destruction).


Osteoid (98%)
Matrix containing a small amount of bone mineral (cartilage).

At first, the formation of bone (by osteoblasts) and bone resorption process (by osteoclasts) in balance. However, at the time of entering the age of 35 years, the osteoclasts become more dominant, resulting in bone resorption occurs more frequently than bone formation. So that the density (density) of bone is reduced, the bone was becoming increasingly fragile and porous.

Briefly told that progressively increases bone density, and reaches maximum density (peak bone mass) at the age of 30 years. As we get older, slowly begin to lose bone density.
If the body is unable to regulate the intake of minerals and vitamins needed bone, the bone loses its density will be even faster and become weak. This lead to osteoporosis (brittle bones). Brittle bone loss despite having only a mild impact. To note, 15% of American women lose bone mass at an average age of 50 years, and 30% by age 60.

Judging from the cause, osteoporosis can be clarified as follows.

1. Primary Osteoporosis

The cause:

•     Menopause, either naturally or because of surgery. Known as Type 1 or postmenopausal osteoporosis.
•     Elderly, experienced by the elderly women and men, especially those aged over 70 years. Known as Type 2 or senile osteoporosis.The cause is unknown, it could happen to anyone and at any age. This type is known as Osteoporosis Diopatik.

2. Secondary Osteoporosis

The cause:

•     The use of corticosteroid drugs (eg Prednisone), dilantin (sedative), gonadoptropin (medicine for women, for complaints gonad), loop diuretics (eg Lasix), methotrexate, thyroxine, heparin, depo-medroxyprogesterone acetate (hormonal drugs), anti- -neoplastic agent (anticancer drug), siklospori.
•     Hereditary connective tissue diseases: osteogenesis imperfecta, rickets, hipofosfatasia, Marfan's syndrome
•     Endrokin and metabolic: hipogonadisma, hyperparathyroidism, hyperthyroidism, Cushing syndrome, acidosis, gaucer disease, haemochromatosis, a disease with insulin dependent diabetes, androgen insensitivity.
•     Aneroksia
•     Poor absorption or poor nutrition.
•     Fribosis cystic
•     Bone marrow diseases: myeloma, mastocytosis, thalassemia, leukemia.
•     Insafisiensi kidney
•     Hypercalciuria
•     Hepatic disease
•     Chronic lung disease
•     Injury to the spinal cord.
•     Rheumatic diseases: systemic lupus, rheumatoid arthiritis.
•     Organ transplantation

Secondary osteoporosis treatment is much more complicated than the treatment of primary osteoporosis, and depending on the main causes of disease.

Avoid foods that contain sugar , fat and poor nutrition

The period of peak bone (Peak Bone Mass)

Achievement of peak bone mass is the maximum bone density at the end of the maturity of the bone. To get the perfect peak bone mass, need to consume enough calcium during childhood, so that deposits of calcium in bones is quite high. High bone mass means that bones strong and healthy so it does not easily fragile and porous.


From the research it is known that peak bone mass is reached in their late twenties and early thirties. It occurs in women and men. After their thirties, bone mass will decrease gradually, especially in women in line with the decrease in the hormone estrogen a few years before menopause.

Bone in the body in charge of forming the framework as follows.

•     Points of attachment of the muscle tissue for movement.
•     Protect various vital tool in the body, including the spinal cord
•     As a backup, and where the metabolism of various minerals, especially calcium and phosphate.
•     Place the formation of blood cells.

Normally, the bones gradually become brittle along with the older. Usually it's the fragility of the range of 0.7% per year. In postmenopausal women, bone loss occurs more rapidly than bone formation. Also on those at high risk.
There are two types of risk factors for osteoporosis, which is congenital and is caused by lifestyle.

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