OSTEOPOROSIS CLINIC

What is osteoporosis?

Osteoporosis is a condition in which the bones become thin, brittle and weak. These changes can increase the risk of fractures lead to disability and an increased risk of death.

Is osteoporosis more common in women or in men?

Osteoporosis occurs five times more often in women than in men.

Is everybody affected?

Ageing reduces the bone strength, but risk factors worsen the condition. One can take control over the modifying factors.
Modifiable Factors — Low BMI,Smoking and,More than 3 drinks of alcohol per day , Environmental Factors like Nutrition (calcium intake, protein) Sunlight exposure Physical activity, Excercise, Relevance of risk of falling increases with ageing.
Non-modifiable Factors – Female Gender, Advancing age, Prior fragility fracture or Family history of fracture, certain medications and medical disorders.

What are the symptoms?

Generally none till fracture occurs, aches and pains, backache. Loss of height, stooping.

How to diagnose?

The gold standard is by DXA MACHINE.
Risk assessment  is done based on the risk factors for osteoporosis by tools like the FRAX followed by DXA.

Who should get the DXA done?

  • All women 5 years beyond the age of natural menopause.
  • Women less than 5 years since Menopause with a particular risk factor.
  • Women with fragility fractures.
  • Women in Menopause transition with secondary causes
Radiological evidence of osteopenia & presence of vertebral compression fractures
Before initiating pharmacotherapy for osteoporosis
To monitor therapy – the interval to the next test should depend on the calculated individual risk and would mostly be scheduled between 1 years and 5 years later.
Emerging indications are to measure total body fat and lean tissue mass

Is there any way to prevent?

Yes! “Prevention is better than cure” — IT STARTS IN THE WOMB THROUGH LIFESPAN-BY A HEALTHY LIFESTYLE
Nutrition — Healthy Diet,Calcium/Vitamin D. Adequate protein
Active lifestyle – Maintaining healthy weight, Exposure to Sunlight, Positive attitude, Routine checkups/screening, Bone robbers Posture Exercise

What is the treatment?

Goal—Prevent first fragility fracture or future fractures if one has already occurred. Relieve symptoms of fracture and/or skeletal deformities], Improve mobility, functional status, and psychological well being.
Initiate lifestyle changes to enhance prevention of fractures.
Reduction of Caffeine, Tobacco and alcohol.
Fall Prevention-Fitness, balance, alertness,Vision and Hearing,Environmental hazards,Reduce impact of falls.
Lifestyle At Home – remove or anchor rugs,Good lighting Electrical and telephone cords out of walking paths.
Personal safety-Slow walking for good balance, Wear shoes that grip well, Always look where you are going and watch where you are stepping, At night avoid walking in poorly lighted areas or use torch.
Use hand rails while going up and down stairs. Avoid taking medication that alter your sense of balance, Keep a night lamp and a flash light by the bed for night use – check batteries. Don’t go to the bathroom in the night without wearing glasses.

Medication

Calcium requirement – Post menopause : 1300mg/day.
Source – calcium rich diet, supplements
Vit D requirement – 1000-2000IU/day
Source – sunlight exposure for 20 min, supplement .

Specific Medication

HormoneTherapy, Bisphosphonates, Teriparitide, Denosumab

IT IS NEVER TOO EARLY TO START PREVENTION OF OSTEOPOROSIS,

IT IS NEVER TOO LATE TO START TREATMENT OF OSTEOPOROSIS

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