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| Osteoporosis
(OP) |
Literally, porous bones,
loss of bone mineral density, resulting in a large difference
from the young normal level; t-score (see below) <-2.5
(World Health Organization guidelines) |
| Osteopenia |
A moderate deviation
from the young normal in bone mineral density where t-score
is -1.0 to -2.5. |
| t-score |
The size of the difference
between one's own bone mineral density and that of the young
(about age 30) normal standard. |
| Z-score
|
The size of the difference
between one's own bone mineral density and that of the standard
for the same age. |
| Peak
bone mass |
The greatest amount
of bone mass you will ever have in your lifetime, about age
30. |
| Bone
mineral density |
Amount of minerals
in a set area of bone, described as grams per centimeter squared
or g/c2. |
| Bone
remodeling |
Bone is a living, dynamic
tissue with a normal, continuous process of removal of old
bone and replacement with new bone, better known as remodeling.
|
| Osteoarthritis |
Chronic, degenerative
inflammation of joints, the cartilege at end of the bones,
not the bones themselves. Bones are involved when cartilege
gets completely worn away. Sometimes calcium deposits form
in the joints, as the disease progresses. |
| Steroid-induced
osteoporosis |
OP resulting from the
prolonged intake of glucocorticosteroids, such as Prednisone.
Other diseases, such as rheumatoid arthritis, lupus, asthma
and organ transplants, when treated with corticosteroids may
lead to increased risk of OP. |
| Vertebral
fracture |
A collapse of a vertebra
after significant loss of bone mineral density, also known
as a compression fracture. |
| Kyphosis |
Curvature of the upper
back often due to multiple compression fractures. Also known
as a "dowager's hump." |
| Kyphoplasty/Vertebroplasty
|
Surgical procedure
to stabilize a new vertebral fracture by injecting cement
into the collapsed bone and returning it to its normal height. |
|
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| Elemental
calcium |
The actual calcium
part in a calcium supplement. Calcium supplements usually
have calcium in combination with some other component. |
| Calcium
citrate |
one form of calcium
in supplements, can take with or without food. Brand names
include Citracal, GNC A-Z. |
| Calcium
carbonate |
one form of calcium
in supplements, should be taken with food. Brand names include:
Tums, OsCal, Viactiv |
| Calcium
dosage |
The total daily recommended
amount for postmenopausal women is 1200 - 1500 mg per day
from food and supplements. Take no more than 500 - 600 mg
of calcium at one time, as the body absorbs calcium better
in smaller doses. Spread your calcium intake throughout the
day. |
| Vitamin
D |
essential nutrient
that aids in calcium absorption. Recommended intake 400 -
600 IU; tolerable upper limit 1000 International Units (IU).
Higher doses may be prescribed by physician for Vitamin D
deficiency. Could be toxic at excessively high doses. |
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| DEXA |
Dual Energy X-ray Absorptiometry:
screening test that determines bone mineral density of hip
and spine and sometimes wrist, using low dose x-ray, known
as a central test, is simple and painless. Considered the
"gold" standard for diagnosing OP. |
| Heel
test |
screening test that
determines bone mineral density of heel using ultrasound,
known as a peripheral test. Other peripheral tests may scan
hand, finger, and/or wrist. Considered as a screening test
only.
|
Medications
approved for bone protection |
| Approved
for prevention |
| Hormone
Replacement Therapy (HRT) |
- Replaces the body's
natural supply of estrogen; sometimes combined with progesterone,
for postmenopausal women. Many types and combinations are
available including: pills, patches and gels. Brand names
include: Premarin, Estrace, Provesta, Activella, PremPro,
Climara, FemHRT, Cenestin, Menest, Estraderm |
| Approved
for prevention and treatment |
| Bisphosphonates |
class of medications,
including alendronate & risendronate, that help prevent
bone loss by reducing loss of calcium. Brand names include:
Actonel, Fosamax, which are both taken as pills. |
| Raloxifene |
class of medications
that also include as Tamoxifen; reduces calcium loss by imitating
some of estrogen's actions in bone; known as designer estrogen
or Selective Estrogen Receptor Modulator (SERM). Brand name
includes: Evista, which is taken as a pill. |
| Approved
for treatment |
| Calcitonin |
naturally occurring
hormone made by the thyroid gland in the body; it reduces
bone loss by reducing calcium loss. Brand name is Miacalcin,
which is delivered via a nasal spray. |
Bone
Protective medications
UNDER STUDY, not approved |
| PTH |
Parathyroid hormone,
which is a hormone made by the parathyroid gland. It is being
tested as a treatment for OP. It works by actually increasing
calcium in the bones, rather than reducing calcium loss. Brand
name is Forteo, which is delivered by injection. Potential
use may be for treatment of severe OP, as it appears to build
bone rapidly. |
| Zolendronate |
A bisphosphonate (see
above). Currently used for control of elevated calcium in
blood of bone cancer patients. Brand name is Zometa. One injection
per year led to increases in bone mineral density. |
| Statins |
commonly used to reduce
cholesterol levels, but under study for their effect on fracture
reduction. Results so far are mixed. |
| Phytoestrogens |
compounds from plants
that have estrogen-like effects in the body, includes isoflavones
and lignans. They are present in many plants, particularly
in soy as genistein and daidzein. |
| Ipriflavone |
synthetic compound
derived from daidzein, an isoflavone in soy. |
| |
| Weight
bearing exercise |
Activities where the
bones hold the body up against gravity. Good examples are
walking and jogging. This alone is not enough to stimulate
the building of bone mass in highly sensitive areas, such
as spine and hip. |
| Resistance
exercise |
a subgroup of weight
bearing exercise, which is extremely important for OP prevention
and treatment. Activity done with weights or stretch bands.
As muscle strength is gained, weights or resistance (less
stretchy) is increased. This type of exercise stimulates bone
to increase bone mineral density. |
Health
Care Providers concerned with osteoporosis
Alphabetized |
| Dietitian |
deals with diet and
nutrition, usually known as a registered dietitian or RD. |
| Endocrinologist |
physician who deals
with all endocrine hormones and related diseases. |
| Family
practitioner |
physician who deals
with the whole body; similar to general practitioner. |
| Geriatrician |
physician with additional
training in the aging process and the conditions and diseases
which often occur among the elderly. |
| Gynecologist |
physician who diagnoses
and treats conditions of the female reproductive system and
associated disorders. (see Ob-Gyn below) |
| Internist |
physician who deals
with general internal medicine. |
| Ob-Gyn
|
Obstetrician-gynecologist
- deals with reproductive organs and hormones. |
| Pharmacist |
can explain medications
and possible interactions of medications, should work with
your physician to get the right medications for your particular
condition. |
| Physiatrist |
deals with physical
medicine and rehabilitation. |
| Physical
therapist |
helps design appropriate
exercises to build muscle and bone strength, plus supervises
rehabilitation from injury. |
| Rheumatologist |
deals with diagnosis
and treatment of arthritis and other inflammatory diseases
of joints, muscles and bones. |
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| Interagency
Council on Osteoporosis |
Council appointed by
the Commissioner of Health to advise the State regarding OP
issues. |
| NOF
- National Osteoporosis Foundation |
non-profit organization
that supports OP education and research work nationwide. |
| Project
Healthy Bones |
A 24-week exercise
and educational group sponsored by New Jersey's DHSS in every
county of the state. Contact the county Retired and Senior
Volunteer Program (RSVP) for information. |
| Support
Groups |
Groups that meet on
a regular basis to discuss issues about OP, usually free and
open to newcomers at all times. Call New Jersey Self Help
Clearing house, NJ DHSS, local hospitals, or RSVP.
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