Osteoporosis is the most common metabolic bone disease in the United States. It is clinically silent until there is a fracture of the bone. It is due to the insufficient bone formation or excessive bone absorption or a combination of the two. It is a progressive loss of trabeculae and decreases the ability of the bone to withstand loading. There are two classifications.
Type 1 or postmenopausal
Type 2 or senile which is associated with the elderly
hematologic and neoplastic disorders
Bone mineral density (BMD) is measured with a central DXA test
T-score within 1 SD (+1 or -1) of young adult mean is normal
T – score of -1 to -2.5 osteopenia
T-score of -2.5 SD or more below the young adult indicates osteoporosis
T-score of -2.5 SD or more below with fragility fractures indicates severe osteoporosis
Z scores adjust for age, sex, ethnicity or race
Z-scores of -2.0 or lower are below the expected range for age
Z-scores above -2.0 are within the expected range for age.
• Risk factors that are associated with osteoporosis are genetics, female, family weight of less than 85% of the norm or 127 lbs. Other factors include early or surgical menopause , pregnancy at a young age, sedentary lifestyle, alcoholism, poor nutrient absorption (celiac), low body fat, low calcium intake, low vitamin D levels, prolonged bed rest and anorexia.
• Vitamin D
• Medication such as corticosteroids, thyroid hormone medication and diuretics can increase bone loss.
• Exercise early in life, resistance and high impact exercises and aerobic activity is beneficial in reducing bone loss.