Osteoporosis In Postmenopausal Women — An Outline

Heart Disease and Lifestyle Improvement For Women

o Osteoporosis, or porous bone, is a illness characterised by low bone mass and structural deterioration of bone tissue, resulting in bone fragility and an elevated susceptibility to fractures, particularly of the hip, backbone and wrist, though any bone may be affected.

Types of Osteoporosis
Primary Osteoporosis
Secondary Osteoporosis

Primary Osteoporosis:
1) PMO — Postmenopausal Osteoporosis
2) Senile Osteoporosis (Age associated)
3) Idiopathic Osteoporosis

o We are within the midst of a world osteoporosis epidemic. 200 million folks worldwide are affected by this situation.
o National Osteoporosis Foundation (NOF) findings are as follows:
-Osteoporosis associated damaged bones have an effect on extra girls than breast most cancers, uterine most cancers and ovarian most cancers mixed. One out of two girls may have an Osteoporosis associated bone fracture in her lifetime.
o Bone well being should be thought-about a prime precedence for everybody over the age of fifty all through the world.
o Osteoporosis is 100% preventable. Osteoporosis is 100% treatable, however Osteoporosis can’t be utterly cured.

Prevention is all the time the most effective remedy, so discuss to your physician and get a BONE MINERAL DENSITY (BMD) take a look at now to see what you must do to maintain your bones wholesome, robust and exquisite.

o Our physique achieves its peak bone mass (Maximum bone density and energy) by the point we’re 25 and 30, it does a reasonably good job by figuring out a exact steadiness between resorption (the elimination of outdated bone) and formation (the addition of latest bone).
o When a lady reaches the age of menopause her bone loss accelerates from about 3% as much as 7% a 12 months.
o Think of it this fashion: If you might have been recognized with low bone mass or density, which means your bones have much less mineral per sq. inch than they need to which is named Osteopenia — means thinning of bones.
o Osteoporosis is commonly referred to as a "silent disease" as a result of bone loss happens with out signs. Women could not know that they’ve osteoporosis till their bones turn into so weak {that a} sudden pressure, bump or fall causes a fracture or a vertebra to break down. Collapsed vertebrae could initially be felt or seen within the type of extreme again ache, lack of top, or spinal deformities resembling kyphosis or stooped posture.
Risk Factors
Body — kind threat issue
o Tall, skinny, truthful-skinned girls have a excessive threat of creating Osteoporosis.
Weight threat issue
o Sudden weight reduction after menopause (More than 10% of your physique weight) can double your probabilities of creating Osteoporosis.
o If you must drop extra pounds after menopause, do it slowly and below the care of your physician.
Risk components you may change
DXA testing
o Lack of train
o Smoking
o Alcohol
o Caffeine
o Low calcium and Vitamin D
o Low physique weight
o Certain drugs
o Specialized exams referred to as bone mineral density (BMD) exams can measure bone density in varied websites of the physique. A BMD take a look at can:
o Detect osteoporosis earlier than a fracture happens
o Predict probabilities of fracturing sooner or later
o Determine price of bone loss and / or monitor the consequences of remedy if a DXA BMD take a look at is performed at intervals of 1 12 months or extra.
Postmenopausal Osteoporosis
o Affects solely girls related to the lack of estrogen, that happens after menopause.
o Affects trabecular (porous, spongy) bones of 1. Wrist 2. Spine
Hormone Replacement Therapy: Yes, No or Maybe.
o Especially estrogen, to postmenopausal girls, which decreases dramatically after menopause.
o ERT = Estrogen Replacement Therapy
o When estrogen is mixed with progesterone it’s usually referred to as Hormone Replacement Therapy (HRT)

Age: 50 to 75
Type of bone loss: Trabecular
Site of fracture: Wrist and backbone
Rate of bone loss: Accelerated
Calcium absorption: Decreased

o Metabolic bone degeneration (Osteoporosis) impacts thousands and thousands of individuals and is instantly accountable for debilitating hip, vertebral and limb fractures within the aged.
o The magnitude of the Osteoporosis downside has been been realized lately; and the worth of early detection and therapeutic intervention has turn into clear.
Why we get Osteoporosis?
o Osteoporosis is a degenerative illness which suggests porous bone. What occurs is that when our physique stops getting the CALCIUM that it wants (Which does are likely to occur as we become old). It steals the wanted calcium from our bones, over a time period when our bones have misplaced extra calcium than they’ll exchange Osteopenia (Thinning of the bone) develops. If not handled, this turns into full blown Osteoporosis, it’s truly the long run damaging results of a brief time period coping mechanism.
o The secret to stopping Osteoporosis is to provide your physique all of the calcium it wants, in order that it doesn't must steal calcium from bones.
o Vitamin D and train are additionally crucial.
o Your physique can’t survive with out satisfactory ranges of

1. Calcium

2. Phosphorous

3. Magnesium

4. Sodium
o These substances are usually saved in your bones. When the degrees of those minerals and vitamins get too low in your blood, your bones give them as much as restore a wholesome steadiness of them in your bloodstream.
o When your blood mineral ranges are restored to regular, your physique can go on functioning in a wholesome means.
o Bones are givers. The most charitable of all our bones are people who have a excessive trabecular content material, just like the jaw, pelvis, wrist and backbone. Sometimes the primary signal of systemic bone loss is receding gums. The wrist and vertebrae additionally are likely to fracture earlier than the hip, as a result of they’re composed largely of trabecular bone.

o Inadequate diet
o Smoking
o Alcohol abuse
o Minimal train
Some drugs
o Some surgical procedures
o Irregular intervals
o Exposure to toxins within the atmosphere.

o Researchers are numer discovering that the standard mineral calcium performs a serious function in averting main diseases from hypertension to colon most cancers. You identify the illness and calcium is starting to have a spot there, says David M., a nephrologist at Oregon Health Sciences University.
o Americans are in a serious calcium deficiency disaster.
o Calcium is crucial for bones and enamel.
o It regulates coronary heart rhythm.
o Helps blood clot correctly.
o Maintains correct nerve and muscle perform.
o May decrease blood stress.
o Eases insomnia.
o Keeps cell membranes wholesome.
o Helps us metabolize fats.
o May scale back the chance of breast and colon most cancers.

o Learn tips on how to enhance the quantity of absorbable calcium in your weight-reduction plan on a regular basis.
o About 98% of the calcium in our physique is saved in our bones.
o Approximately 1% of it’s in our enamel.
o Other 1% circulates within the bloodstream and different tissues.

o Dietary Reference Intake (DRI) — 1500 mg / day in divided doses.
o Countries resembling USA, whose inhabitants eat giant portions of dairy merchandise and calcium, have a lot larger charges of Osteoporosis than international locations which eat little or no dairy merchandise and little calcium.

o Excess calcium in postmenopausal girls may cause
o Kidney stone formation
o Hypercalcemia
o Fractures
o Excessive calcium excretion is the reason for bone loss. Eg quantity of calcium ingested is greater than what’s absorbed or required inflicting damaging steadiness which is the same as bone loss.
o However if extra calcium is consumed than is misplaced then one is alleged to be in optimistic steadiness.
o Anyone having a illness of the parathyroid gland mustn’t take calcium and seek the advice of their well being skilled.

o Consumption of enormous portions of animal protein causes better lack of calcium.
o Urinary calcium excretion on a excessive protein weight-reduction plan is about 90-100gms which will increase the chance of Osteoporosis in most girls.
o Vegetable proteins are secure and don’t trigger damaging calcium steadiness.
o Calcium is a very powerful mineral in your physique, however most of us aren’t getting sufficient of it in an absorbable type.
o Please attempt to be sure to are getting the next essential vitamins in your weight-reduction plan every day:
Calcium 1000-1500 mg

(In divided doses)
o Phosphorous 500 — 700 mg
o Magnesium 750 mg
o Vitamin D 400 — 800 IU

(When you may't get 15 minutes of daylight.)
o Vitamin C 1000 mg

(In divided doses)
o Vitamin Okay 100 — 300 mcg
Zinc 12 mg
DXA — Dual X-ray Absorptiometry

This take a look at is easy, non-invasive to measure bone density, which is a measure of bone energy.
o Serum calcium
o Serum Vitamin D


Calcium Carbonate 40% calcium
Calcium Citrate 20-24% calcium
Calcium Lactate 13% calcium
Eg For each pill that comprises 1000 mg of Calcium Carbonate, solely 400 mg (40%) of the quantity is offered to us for absorption. The remaining 60% of the pill is made up of oxygen and carbon.

American Journal of Therapeutic & Journal of Clinical Pharmacology have linked that Calcium Citrate is healthier absorbed than Calcium Carbonate, which is a most popular complement for the aged.



DRI = 1000 mg / day

(In divided doses)
Absorption of calcium is correct if there’s an acidic medium. If not then calcium will deposit and trigger atherosclerosis.
Caution: Do not take Vitamin C when you have kidney stones, gout or iron deficiency illness.

DRI = 500 — 700 mg
Phosphorus may be very important for the synthesis of protein, carbohydrates and fat.
Calcium: Phosphorus

2: 1
Deficiency of phosphorus: Osteoporosis, nervousness, despair, nerve and mind capabilities are affected.
eg walnuts, almonds, ragi and so forth.
o Excessive consumption of phosphorus (Eg pink meat and carbonated drinks) can lower and contribute to bone illnesses, as there’s phosphoric acid within the drinks.


DRI = 320 mg / day
o This hint mineral facilitates bone formation, protein synthesis, muscle perform and regulation.
o Magnesium has a job within the manufacturing of a bone hormone referred to as parathyroid hormone (PTH).
o Normal ranges of PTH ends in bone formation.
o High ranges of PTH ends in calcium loss.
o Low magnesium ends in low PTH.

Sources of Magnesium
o Wheat germ
o Almonds
o Flaxseed
o Soya Products
o Nuts
o Apples and bananas


400 IU / day
o Five to fifteen minutes of daylight a day ensures all of the important Vitamin D that you simply want.
o Fifteen minutes of daylight a day on truthful pores and skin ought to consequence within the manufacturing of 100-200 items

of Vitamin D3.
o It can enhance calcium absorption by as much as 65%
o When folks on weight reduction medication, which reduces the absorption of fats develop deficiencies of

fats soluble nutritional vitamins like Vitamin A, D, E and Okay.


DRI = 700 mgm / day
o Vitamin A is crucial in low doses, however in excessive doses is dangerous.
o Recent research recommend that consuming greater than 1.5 mg / day of Vitamin A from a complement

will increase the chance of fracture.
o Vegetarians are liable to not consuming sufficient Vitamin A, as discovered by The Institute of Medical

Panel, USA, as vegetarians must depend on carrots and candy potatoes for his or her Vitamin A



DRI = 100 -300 mg / day
o Necessary for the physique to make the protein Osteocalcin, which performs an essential function in binding

calcium crystals within the bone.
o It helps towards bone loss in postmenopausal girls.
o Vitamin Okay additionally seems to play a serious function within the therapeutic of fractures.
Food sources:
o Green leafy greens
o Whole wheat
o Oats
o Green Tea

DRI = 12 mg / day
o Low ranges of zinc have been related to Osteoporosis.
o In one examine, girls with osteoporosis had 30% much less zinc of their bloodstream than non-osteoporotic girls.
o You should take a diverse weight-reduction plan to have all vitamins and minerals as a substitute of dietary supplements.
Food sources:
o Whole grains
o Bran
o Cashew nuts and peanuts
o Pumpkin seeds
o Sesame seeds

DRI = 2-Three mcg / day
o Latest research point out that hint mineral boron can train nice affect on Osteoporosis.
o Boron deficiency can hamper calcium metabolism and thus make the bones brittle. It serves

as a light type of 'Estrogen Replacement Therapy'.
Food sources:
o Avocado
o Broccoli
o Carrots
o Spinach
o Kidney beans
o Almonds
o Oranges

o Reduce the animal protein in your weight-reduction plan.
o Reduce the additional salt in your weight-reduction plan. Try to maintain it to 2,000 mg / day.
o Reduce meals excessive in saturated fats.
o Reduce caffeine. Switch from common to decaffeinated espresso.
o Increase greens, fruits, legumes, beans, entire grains & inexperienced leafy

o Increase calcium-wealthy meals.
o Increase water consumption to 8-10 glasses per day.
o Eat in a relaxed setting. Chew your meals slowly and properly.
o Stop smoking.
o Reduce alcohol consumption.
o Osteoporosis, a situation of decreased bone that will increase the probability of fracture, locations a

vital burden on our society when it comes to well being price and morbidity.
o Estrogen deficiency is probably the most dominant issue within the pathogenesis of postmenopausal


Responsible components:
o Bone loss
o Estrogen deficiency
o Negative calcium steadiness
o Variety of genetic and environmental components

The finest method to the administration of Osteoporosis is to develop a lifelong technique that maximizes peak bone mass and minimizes postmenopausal bone loss.