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Osteoporosis
The most common form of osteoporosis in women is postmenopausal osteoporosis which occurs as a result of loss of ovarian function at the time of menopause. However, if a woman has surgical removal of her ovaries at a young age, she is susceptible to osteoporosis at a young age. Some women experience premature ovarian failure in their twenties or thirties. Consequently, these women are also at a high risk for the development of osteoporosis at a younger age.
Causes of Osteoporosis:
Do I have osteoporosis?
The best way to find out whether you have osteoporosis is by doing special testing, called bone density testing. Most frequently, bone density testing is done by using a technique called DEXA (dual energy x-rays absorptiometry) scanning.
Where can I have bone density testing done?
Bone density testing is available at most hospitals in the US. This test is very much dependent upon the technician and the type of machine used. So, have it done at a reputable place. Repeat testing in about 1-2 years should be done at the same place using the same machine in order to monitor the effects of therapy.
Who should have bone density testing done?
Do I need any more tests in addition to bone density testing?
Yes. The Bone density test can only diagnose whether or not you have osteoporosis. The next step is to find out the cause for osteoporosis. In most postmenopausal women, estrogen deficiency is the cause of osteoporosis. However, other causes of osteoporosis should also be investigated as many of these causes, such as overactive thyroid, parathyroid glands or vitamin D deficiency, are usually not clinically apparent. Therefore, special laboratory tests need to be done to diagnose these conditions.
Osteoporosis in Men
Osteoporosis in men is usually discovered incidentally, such as the discovery of pathologic fractures (fractures with little on no trauma ) of the ribs, hip or spine on x-rays taken for some other reasons. To determine the extent of bone loss, bone density measurement is carried out, usually by a bone DEXA test. Appropriate testing should be done in order to determine the cause of osteoporosis, as treatment will depend upon the cause discovered in the individual patient.
Causes of Osteoporosis
In women, menopause is the most common cause of osteoporosis. In men, low testosterone level is the most common cause of osteoporosis.
Other causes of osteoporosis for both men and women include:
Excess of thyroid hormone from taking medication to treat a thyroid disorder. If you are being treated for a thyroid disorder, it is very important to have a thyroid function test (a blood test) done on a regular basis. Your physician will recommend changes in the dose of thyroid hormone based upon the thyroid function test. Please note that in many patients with thyroid cancer, thyroid hormone is intentionally given in large doses to prevent the recurrence of the cancer. In such cases, measures taken to prevent or minimize bone loss should be discussed with the physician, preferably an endocrinologist. Overactive thyroid gland, such as Graves' disease. Prolonged use of steroids, such as Prednisone, which if used in a daily dose of more than 7.5 mg for more than a few weeks, can cause significant bone loss. Overactive parathyroid gland, which is usually discovered incidentally on routine blood testing. Vitamin D deficiency and Calcium deficiency: Vitamin deficiency is very common which unfortunately usually remains undiagnosed. The main natural source of vitamin D is sun. The hysteria about skin cancer and indoor life-style has led to the epidemic of vitamin D deficiency. The situation is even worse in nursing home patients and patients with malabsorption syndrome. Spontaneous lack of menses for more than 6 months (pregnancy is an exception). Wasting of Calcium in the urine (idiopathic renal calcium leak). Certain drugs such as Dilantin.
Diagnosis of Osteoporosis
In the US, osteoporosis is most commonly diagnosed with the use of a widely available test called DEXA (dual energy x-ray absorptiometry) test. It is important to note that the reliability of this test is dependent upon the technician. Interpretation of the test requires a physician knowledgeable in the field of osteoporosis, such as an endocrinologist, a rheumatologist or a radiologist. Therefore, do your home work and use a reputable place before undergoing this test. The next step after the diagnosis of osteoporosis is to determine the cause of it.
Treatment of Osteoporosis
Treatment of osteoporosis depends upon it's underlying cause. That is why it is important to determine the exact cause for osteoporosis. Drugs available to treat osteoporosis in the US are:
In severe cases of osteoporosis, these drugs can be used in combination. |