There are two types of primary osteoporosis. Type 1 occurs
only in women, typically in the years immediately following
menopause, from age 50 to 70. Type 1 is related to decreased
estrogen and is characterized by rapid bone loss, especially
in trabecular bones (vertebrae and flat bones, such as
the pelvis). At greatest risk are thin, small-boned Caucasian
or Asian women who have had a hysterectomy or reached
natural menopause before age 45 and have a family history
of the condition.
Lifestyle factors that may contribute to or worsen
Type 1 osteoporosis include low calcium intake, a sedentary
lifestyle (weight-bearing exercise promotes bone disposition),
cigarette smoking (heavy smokers have lower blood levels
of estrogen), and excessive alcohol consumption (alcohol
inhibits calcium absorption).
Type 2 primary osteoporosis affects nearly half of
all people over the age of 75. It is the only type of
primary osteoporosis that men get; however, it is twice
as common in women. Type 2 is characterized by reduced
osteoblast cell activity and decreased formation of
bone. Loss occurs in both trabecular and cortical bones
(hip and long bones, such as those in the leg). Over
the expected lifespan, women typically lose as much
as 35% of cortical bone and up to half of trabecular
bone; men, who have denser bones to begin with, lose
only about 23 % of cortical bone and 33% of trabecular
bone. Experts say that everyone who lives long enough
will develop Type 2 primary osteoporosis. But the extent
of its severity is very individual. The same lifestyle
factors that play a role in Type 1 primary osteoporosis
can also cause an acceleration of bone loss in those
with type 2.
Secondary osteoporosis may occur as a side effect of
such drugs as corticosteroids and heparin. Hyperthyroidism,
rheumatoid arthritis, kidney disease, and certain cancers
such as lymphoma and leukemia are among the disorders
that also contribute to secondary osteoporosis.
Because osteoporosis is a "silent" disease,
you may have it for years and not find out until you
suffer one or more broken bones from a minor injury.
These fractures can be painful and disabling, and may
eventually threaten your lifestyle, your mobility, and
your independence.
The number of fractures related to osteoporosis is
alarming. More than half a million spinal fractures
occur every year. In addition, there are more than 250,000
hip fractures and 240,000 wrist fractures annually.
Spinal fractures are the most common type of fracture
caused by osteoporosis and can occur as the result of
something as minor as a cough or lifting an item. The
accumulation of many small fractures will cause the
spine to compress, resulting in loss of height, pain
and difficulty carrying out activities of daily living.
Eventually, the spine can become deformed and curve
forward, resulting in a condition known as a "dowager's
hump".
Hip fractures have the potential to cause even more
devastation than other types of osteoporotic fractures.
Hip fractures cost about 8.7 million dollars in the
United States annually. Ninety percent of these fractures
occur in people over the age of 70. These fractures
are expensive not only in terms of money but also in
regards to pain, suffering, functional impairment, psychological
trauma, and increased demands on the family. In elderly
women, a minor fall or an ordinary step off the curb
can result in a broken hip. About half of patients will
lose their independence and may require long term care.
Treatment
Lifetime Calcium Intake
Starting in childhood, a diet adequate in
calcium can maximize peak bone mass. The
more bone mass you have at maturity, the
more you can lose before you will succumb
to an osteoporotic fracture.
Estrogen Replacement
Estrogen prevents osteoporosis-related fractures.
Conjugated estrogensa mixture of estrogens
from natural sourcesreceived FDA approval
as a treatment for osteoporosis in 1988.
With long term use of the hormone, it may
increase the risk of breast and endometrial
cancers.
Alendronate Sodium
FOSAMAX is a significant advance in the
treatment of osteoporosis in post-menopausal
women. Clinical studies have shown that
FOSAMAX can help to build healthy bone and
reverse the progression of osteoporosis.
FOSAMAX works by inhibiting resorption of
bone, resulting in a progressive increase
in bone mass which decreases the risk of
fracture. FOSAMAX comes in tablet form and
is taken first thing in the morning with
a full glass of water, prior to taking any
other food, beverage or other medications.
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