骨骼疏松癥專題知識講座::introduction::Osteoporosisisadiseaseinwhichbonesbecomefragileandmorelikelytobreak.Ifnotpreventedorifleftuntreated,osteoporosiscanprogresspainlesslyuntilabonebreaks.Thesebrokenbones,alsoknownasfractures,occurtypicallyinthehip,spine,andwrist.Anybonecanbeaffected,butofspecialconcernarefracturesofthehipandspine.Ahipfracturealmostalwaysrequireshospitalizationandmajorsurgery.Itcanimpairaperson'sabilitytowalkunassistedmaycauseprolongedorpermanentdisabilityorevendeath.Spinalorvertebralfracturesalsohaveseriousconsequences,includinglossofheight,severebackpain,anddeformityHIPHIPSSPINEWRISTOsteoporosismakesyourbonesweakandmorelikelytobreak.Anyonecandeveloposteoporosis,butitiscommoninolderwomen.Asmanyashalfofallwomenandaquarterofmenolderthan50willbreakaboneduetoosteoporosis

::whatcausesosteoporosisatthe1stplace::Bonesarelivingtissuesthatmustbeconstantlyrebuiltviaatwopartprocess,bywhichbothofosteoblastandosteclastfunctionnormally.Osteoclastsandosteoblastsareactivatedbyparathyroidhormone(PTH)whichsignalsosteoclaststopullcalciumfromthebones.Calcitoninisthehormonethatstimulatesosteoblaststodepositcalciumintothebones.TheproblemsbeginwhenthedelicatebalancebetweenPTHandCalcitoninisdisrupted.::WhoisatRisK??::Riskfactorsyoucannotchangeinclude:Gender.Womengetosteoporosismoreoftenthanmen.Age.Theolderyouare,thegreateryourriskofosteoporosis.Bodysize.Small,thinwomenareatgreaterrisk.Ethnicity.WhiteandAsianwomenareathighestrisk.BlackandHispanicwomenhavealowerrisk.Familyhistory.Osteoporosistendstoruninfamilies.Ifafamilymemberhasosteoporosisorbreaksabone,thereisagreaterchancethatyouwilltoo.Activitylevel.Lackofexerciseorlong-termbedrestcancauseweakbones.Smoking.Cigarettesarebadforbones,heart,andlungs.Drinkingalcohol.Toomuchalcoholcancausebonelossand brokenbones.

Lackofmagnesiummaybethecauseofosteoporosis. Calcitoninreliesonmagnesiumtofunctionproperly.Whenwelackmagnesium,thebalancebetweenPTHandcalcitonintiltstoofartowardPTH.Thisresultsinexcessivestimulationofosteoclasts,whichcausesnetboneloss.Magnesiumsuppressesthehormonethattellsyourbodytopullcalciumfromthebones,andstimulatesthehormonethattellsthebodytoputcalciuminyourbones.

InMalaysia,itisestimatedthatover1millionpeopleareatriskfromosteoporosis,outofwhich20%aremen.

ReportedbyArthritisFoundation,Malaysia::SyMPTOmpS::Osteoporosisiscalledthe"silentdisease“becauseboneislostwithnosigns.Youmaynotknowthatyouhaveosteoporosisuntilastrain,bump,orfallcausesabonetobreak.::DiagnosE::PREVENTIONEnoughcalciumintakedaily;800-1000mg,alsootherimportantnutrients;proteins,zinc,mg&vitaminDforhealthyandstrongboneVitaminDisimportantinabsorptionofCafromfoodandincorporateitintobones

1glassofhighCamilk=500mgCaBoneexamination–freeduringWorldOsteoporosisDay–accessriskoflossofmassofboneExercisesbutnotexcessive!!!(3-4timesaweek)Exercisealtershormonalbalances,favoringthehormonesthatprotectsboneSo,walkratherthanride,climbthestairsratherthanusinglift,standratherthansitwhenappropriate:P

4.Campaigntoincreaseawarenessamongtheciviliansregardingosteoporosis.4.

Importanceofgoodposture

Properwaytosit

-Supportyourlowerbackwithapilloworbyastraighthigh-backedchair.Whendrivingorreading,avoidbendingtheneckforward.Whenrisingfromachair,doitslowly.

Properwaytowalkandstand-Keepyourheadhigh,lookforwardwiththechinin.Pullyourshouldersback,pullyourstomachintomaintainthenaturalarchofthelowerback,andtightenyourbuttocks.Wearlow-heeledshoeswithrubbersolesProperwaytolift-Youmustbendyourkneeswhenliftingheavyobjectstoavoidbackstrainandfurthercompressionfractures.UseyourLegmusclesratherthanyourback!

5.

Avoidtakingtoomuchcoffee,teaorchocolate,becausetheyhelpinlossofCa.HighproteinwillreducetheabilityofCaresorption.Alcoholdestroyscellsformingbone.SmokingreducesestrogenItisimportanttorememberthatwecannotavoidhormonal

andgeneticfactorthus,wecontroltheenvironmentanddietfactor,sothatwecanovercometheosteoporosisproblem.TREATMENTCalciumandvitaminDintake–reducefracturesbymaintainingBMD(bonemineraldensity)VitaminDisnecessaryforourbodytoabsorbcalciumoptimumintakecombinationofdietaryCasourceandCainpillsformPhysicalactivity–essentialforbonegrowthandmaintenance-improvesmusclestrengthandbalance,thus,decreasetheriskoffractureandfallsBisphosphontes-atypeofmedicationknownasantiresporptivemedications,takenorallyorininjectableform-preventbonelossbyinhibitingthenormalfunctionofcellscalledosteoclasts.Thesearethecellsresponsibleforremovingoldbone.-Sideeffectsofbisphosphonatesincludemuscleandjointpain,nausea,andheartburn-commonbisphosphontes;fosamax,reclast,boniva4.Calcitonin-isnaturallymadeinyourbodywhenbloodcalciumlevelsarehigh.Thus,retainscalciumwithintheskeleton,ratherthanreplenishthecalciuminthebloodstream.-administeredbyanasalspray.-Sideeffects-runnynose,headachesandnosebleeds.EstrogenTreatment(ET)orHormoneTreatment(HT)

-effectivetreatmentsforpreventingbonelossandreducingriskoffracture.-Unfortunately,ETincreasedtheriskofuterinecancer,thereforeusedinpatientswithpriorhysterectomy(removeuterus)-Concernsaboutincreasedriskofbreastcancer,stroke,andbloodclotshavesurroundedtheuseofthesem