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General
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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Important Nutrients
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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Evaluation Methods
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.

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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.

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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.

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Exercise
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.

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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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Groups and Organizations
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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