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OSTEOPOROSIS: Should we be Should we be concerned?concerned?
What is osteoporosis?
Osteoporosis is a disease of bone where there is a decrease in bone
density
Normal Osteoporosis
Why is bone density important?
With decreased bone density, bones are more fragile and are
more likely to break (Fracture)
Why is bone density important?
With decreased bone density, vertebral bones may collapse and
cause excessive curvature of the spine
Osteoporosis is a growing problem
Millions of Filipinos have osteoporosis…
…but will not know it until they get a fracture
Osteoporosis is a growing problem
Of the Filipinos who are diagnosed with osteoporosis..
…only a small percentage will receive adequate medical treatment
COULD I HAVE OSTEOPOROSIS?
COULD SOMEONEI LOVE HAVE
OSTEOPOROSIS?
What are the risk factors for developing osteoporosis?
Age
• The older you are, the greater your risk of osteoporosis.
• Your bones start to become weaker and less dense after the age of 35.
Being female
• Women are 4x more likely to develop osteoporosis than men
• Women have less bone tissue and lose bone more rapidly than men because of the changes involved in menopause
Family History and Personal History of Fractures as an Adult
• Young women whose mothers have a history of vertebral fractures also seem to have reduced bone mass.
• A personal history of a fracture as an adult also increases your fracture risk.
Bone structure and body weight
• Small-boned and thin women(under 127 pounds) are at greater risk.
Menopause / Menstrual historyMenopause / Menstrual history• Normal or early menopause (brought about
naturally or because of surgery) increases your risk
• Normal or early menopause (brought about naturally or because of surgery) increases your risk
Lifestyle/modifiable risk factors
Smoking Excessive alcohol
Inadequate calcium Lack of exercise
Medications
• Steroids (Prednisone, dexamethasone..)• Excessive thyroid hormones (Thyroxine)• Anticonvulsants• Antacids containing aluminum• Others:
– GnRH used for treatment of endometriosis– Methotrexate for cancer treatment– Cyclosporine A, an immunosuppressive drug– Heparin and– Cholestyramine, taken to control blood
cholesterol levels.
Can osteoporosis be prevented?
How you can prevent osteoporosis
• Take adequate amounts of calcium– Low-fat milk– Cheese– Broccoli– Orange juice– Cereals– Breakfast bars – Calcium supplements (Caltrate, Calci-
aid, Calvit..)
How you can prevent osteoporosis
• Adequate amounts of Vitamin D• Sunlight• Vitamin D rich foods
– Dairy products– Egg yolks– Saltwater fish– Liver
• Recommend 400-800IU/day, but not more than 800IU/day
How you can prevent osteoporosis
• Stop smoking
• Drink alcohol in moderation
• Exercise!– Bone becomes stronger and denser
when you place demands on it
What should I do? I might
have osteoporosis!
ME TOO!
Your doctor my request a bone mineral density test
to evaluate your bones
Bone Mineral Density Test
• The best way to diagnose osteoporosis
• Compares your bone density with– A young normal person – A person your age and body size
Based on your doctor’s evaluation and your tests,
you may need to take medications for osteoporosis
Some medications used for the treatment of
osteoporosis:• Bisphosphonates:
– Alendronate (Fosamax)– Risedronate (Actonel)– Ibandronate (Bonviva)
• Hormone Replacement• SERMs
– Raloxifene (Evista)
• Others:– Strontium (Protos)– PTH– Cacitonin
What else can be done?Prevent falls!
• Floors.– Remove all loose wires, cords, and throw
rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its accustomed place.
• Bathrooms.– Install grab bars and non-skid tape
• Lighting.– Make sure halls, stairways, and entrances
are well lit. Install a night light in your bathroom. Turn lights on if you get up in the middle of the night.
What else can be done?Prevent falls!
• Kitchen.– Install non-skid rubber mats near sink and
stove. Clean spills immediately.
• Stairs.– Make sure treads, rails, and rugs are secure.
• Other precautions.– Wear sturdy, rubber-soled shoes. Keep your
intake of alcoholic beverages to a minimum. Ask your doctor whether any of your medications might cause you to fall.
The Philippine College of Physicians wishes to acknowledge the following for their invaluable efforts in the preparation
of this module
Gabriel Jasul, MDJose Ma Ibarra Co, MDRosa Allyn G. Sy, MD
Committee on Advocacy & Public Relations
Philippine Society of Endocrinology and Metabolism