AT MY AGE, SHOULD I BE CONCERNED ABOUT OSTEOPOROSIS?

Osteoporosis is the thinning of bone tissue and loss of bone density, literally meaning "porous bones," and is perhaps the most feared condition in the postmenopausal community. It occurs when the body fails to form enough new bone, or when too much old bone is reabsorbed by the body, or both. Unfortunately, osteoporosis is not always preventable and is a classic symptom of aging. Normally, in the life of a healthy woman, by her late thirties and forties her bones become less dense. By the time she reaches her fifties, she may begin to experience bone loss in her teeth and become more susceptible to wrist fractures. Gradually, the bones in her spine weaken, fracture, and compress, causing upper back curvature and loss of height, known as a "dowager's hump." Osteoporosis is unfortunately more common in women than men because when a woman's skeletal growth is completed, she typically has 15 percent lower bone mineral density and 30 percent less bone mass than a man has of the same age. Studies also show that women lose more trabecular bone (the inner, spongy part making up the internal support of the bone) at a higher rate than men do.

There are three types of osteoporosis women are prone to: postmenopausal, senile, and secondary.

Postmenopausal osteoporosis usually develops roughly ten to fifteen years after the onset of menopause. In this case, estrogen loss interferes with calcium absorption, and you begin to lose trabecular bone three times faster than the normal rate. You will also begin to lose parts of your cortical (the outer shell of the bone), but not as quickly.

Senile osteoporosis affects men and women. Here, you lose cortical and trabecular bone because of a decrease in bone cell activity that results from aging. Hip fractures are seen most often with this kind of osteoporosis. The decrease in bone cell activity affects your capacity to rebuild bone in the first place, but is also aggravated by low calcium intake.

In secondary osteoporosis, an underlying condition causes bone loss. These conditions include chronic renal disease, hypogonadism (an underactivity of the sex glands), hyperthyroidism (an overactive thyroid gland), some forms of cancer, gastrectomy (removal of parts of the stomach which interferes with calcium absorption), and the use of anticonvulsants.

Osteoporosis Pictures

Healthy bone                                                     Bone effected with osteoporosis

Our bones are always regenerating. This process helps to maintain a constant level of calcium in the blood, essential for a healthy heart, blood circulation, and blood clotting. About 99 percent of all the body's calcium is in the bones and teeth; when blood calcium drops below a certain level, the body will take calcium from the bones to replenish it. But by the time we reach our late thirties, our bones lose calcium faster than it can be replaced. The pace of bone calcium loss speeds up for "freshly postmenopausal" women who are three to seven years beyond menopause. The pace then slows once again, but as we age, the body is less able to absorb calcium from food. One of the most influential factors affecting bone loss is estrogen; it slows or even halts the loss of bone mass by improving our absorption of calcium from the intestinal tract, which allows us to maintain a higher level of calcium in our blood. In men, testosterone does the same thing for them regarding calcium absorption, but unlike women, men never reach a particular age when their testes stop producing testosterone. If they did, they would be just as prone to osteoporosis as women are.

A long list of other factors affects bone loss. One of the most obvious is calcium in our diet. Calcium is regularly lost to urine, feces, and dead skin. We need to continuously account for this loss in our diet. The less calcium we ingest, the more we force our body into taking it out of our bones.

Calcium and phosphate are two minerals that are essential for normal bone formation. Throughout youth, the body uses these minerals to produce bones. If calcium intake in not sufficient, or if the body does not absorb enough calcium from the diet, bone production and bone tissues may suffer.

As people age, calcium and phosphate may be reabsorbed back into the body from the bones, which makes the bone tissue weaker. Both situations can result in brittle, fragile bones that are subject to fractures, even in the absence of trauma. Usually, the bone loss occurs gradually over years. Many times, a person will sustain a fracture before becoming aware that the disease is present. By the time this occurs, the disease is in its advanced stages and the damage is profound.

The leading causes are a drop in estrogen in women at the time of menopause, and a drop in testosterone in men. Women, especially those over the age of 50, get osteoporosis more often than men.

Women who are white, especially those with a family history of osteoporosis, have a greater risk of developing osteoporosis. Several other physical conditions and external factors help to weaken our bones, further contributing to bone loss later in life, they include:

• Heavy caffeine and alcohol intake . These are diuretics; they cause you to lose more calcium in your urine.
  
  
• Smoking . Research shows that smokers tend to go into earlier menopause, while older smokers have 20 to 30 percent less bone mass than nonsmokers.
  
  
• Women in surgical menopause who are not on ERT . Losing estrogen earlier than you would have naturally increases your bone loss.
  
  
• Antacids containing aluminum and corticosteriods . These interfere with calcium absorption.
  
  
• Diseases of the small intestine, liver, and pancreas . These prevent the body from absorbing adequate amounts of calcium from the intestine.
  
  
• Lymphoma, leukemia, and multiple myeloma.
  
  
• Chronic diarrhea from ulcerative colitis or Crohn's disease . This causes calcium loss through feces.
  
  
• Surgical removal of part of the stomach or small intestine . This affects absorption.
  
  
• Hypercalciuria . This is a condition where one loses too much calcium through the urine.
  
  
• Early menopause (before age forty-five). The earlier you stop producing estrogen, the more likely you are to lose calcium.
  
  
• Lighter complexions . Women with darker pigmentation have roughly 10 percent more bone mass than do women with fairer pigmentation because the former produce more calcitonin, the hormone that strengthens bones.
  
  
• Low weight . Women with less body fat store less estrogen, which makes the bones less dense to begin with and more vulnerable to calcium loss.
  
  
• Women with eating disorders (yo-yo dieting, starvation diets, binge/purge eaters). When there isn't enough calcium in the bloodstream through diet, the body will take what it needs from the bones. These women also have lower weight.
  
  
• Family history of osteoporosis . Studies show that women born to mothers with spinal fractures have lower bone mineral density in the spine, neck, and midshaft.
  
  
• High-protein diet . This contributes to a loss of calcium through the urine.
  
  
• Women who have never been pregnant . They haven't experienced the same bursts of estrogen in their bodies as women who have been pregnant.
  
  
• Amenorrhea in childbearing years. (typically affects women athletes who do endurance activities). Studies show that women with amenorrhea have 20 to 30 percent less bone mineral content than have those with regular cycles, which is associated with faster bone resorption seen with estrogen deficiency.
  
  
• Athletes. Athletes have a low percentage of body fat needed for menstruation (see above), while excessive exercise releases B-endorphin, which researchers believe may suppress estrogen circulation.
  
  
• Lactose intolerance . Since so much calcium is in dairy foods, this allergy is a significant risk factor.
  
  
• Teenage pregnancy . When a woman is pregnant in her teens, her bones are not yet fully developed and she can lose as much as 10 percent of her bone mass unless she has an adequate calcium intake of roughly 2,000 mg a day during the pregnancy and 2,200 mg a day while breast-feeding.
  
  
• Scoliosis.
  

There are no symptoms of osteoporosis in the early stages of the disease. Symptoms occurring late in the disease include:

• Fractures of the vertebrae, wrists, or hips (usually the first indication)
• Low back pain
• Neck pain
• Bone pain or tenderness
• Loss of height over time
• Stooped posture

Currently, it's estimated that half of all women over the age of fifty are affected by osteoporosis, while more than 1.5 million fractures are caused by osteoporosis each year. Five to twenty percent of these women die from complications. These fractures usually involve the spine, hip, or wrist. This might sound like a pretty bleak picture, but there are certainly things we can do to help offset and combat osteoporosis and possibly even prevent it altogether.

Saliva testing can easily test for imbalances in each of the major hormones that have an impact upon bone health – particularly, testosterone, DHEA, cortical, estrogen and progesterone. Bone is a hormonally sensitive tissue that is affected by age-related decline in production of these hormones. Many studies show that as they age, both men and women begin to lose bone as the androgens – testosterone and DHEAs in particular – start to fall off. And when these hormones are low and cortical is high, bone loss increases at an even more rapid pace.

In addition to the BioHRT therapy, the following may be helpful in the prevention of osteoporosis.

Exercise . This should include a routine regime four or more times per week. Regular exercise can reduce the likelihood of bone fractures associated with osteoporosis. Studies show that exercises requiring muscles to pull on bones cause the bones to retain, and even gain density. Researchers found that women who walk a mile a day have four to seven more years of bone density than women who don't. Any exercise that presents a risk of falling should be avoided! Some of the recommended exercises include:

• Weight-bearing exercises – walking, jogging, playing tennis, dancing, riding stationary bicycles, using rowing machines and the elliptical trainer, etc.
• Resistance exercises – free weights, weight machines, rubber stretch bands
• Balancing exercises – tai chi, yoga, pilates
• Riding stationary bicycles

Ingest more calcium . As boring and repetitive as it may sound, the best way to prevent osteoporosis is to ingest more calcium. It's not enough to just take calcium supplements or eat high-calcium foods; you need to cut down on diuretic foods such as caffeine and alcohol. How much is "enough"? According to the National Institutes of Health Consensus Panel on Osteoporosis, premenopausal women require roughly 1,000 mg of calcium a day; for perimenopausal or postmenopausal women already on HRT, 1,000 mg a day; and for peri- and postmenopausal women not taking estrogen, roughly 1,500 mg a day. For women who have already been diagnosed with osteoporosis, the panel recommends 2,500 mg of calcium a day. Foods rich in calcium include all dairy products (an 8-ounce glass of milk contains 300 mg of calcium), fish, shellfish, oysters, shrimp, sardines, salmon, soybeans, tofu, broccoli, dark green vegetables (except spinach, which contains oxalic acid, preventing calcium absorption). It's crucial to determine how much calcium you're getting in your diet before you start any calcium supplements; too much calcium can cause kidney stones in people who are at risk for them.

Stop unhealthy habits . If you smoke, quit smoking. Also, limit the intake of alcohol. Too much alcohol can damage your bones.

Avoid stress . Too much stress raises cortical output, interfering with calcium absorption and bone-building activity, while at the same time stepping up the activity of bone destroying cells.

Be aware of the foods that you eat . Limit the consumption of simple carbohydrates, soda, alcohol, and sugar, as well as high protein diets. Ensure that your diet includes an adequate amount of calcium, vitamin D, and protein. Supplemental calcium should be taken as needed to achieve recommended daily calcium dietary intake. High calcium foods include low-fat milk, yogurt, tofu, salmon and sardines (with the bones), and leafy green vegetables, such as collard greens. Vitamin D aids in the absorption of calcium, and 400-800 IU per day should be taken by all individuals with increased risk of calcium deficiency and osteoporosis.

Visit www.biohrt.com for more information on treatment programs for osteoporosis. Detecting this disease early is one of the more important factors in reversing it.

Written by

BioHRT Medical Staff
Under supervision of:
Dr. Jamal Raza. MD, FACP, FAAAAM

www.biohrt.com

1-800-828-0553