May Issue, 2016


What is Osteoporosis?
Osteoporosis which means "porous bones" is a condition that causes formerly strong bones to gradually thin and weaken, leaving them susceptible to fractures. About 1.5 million fractures occur each year due to osteoporosis.

Who gets Osteoporosis?
Of the 1.5 million people who are diagnosed annually, 80% are women. Although osteoporosis is more common in women, it also occurs in men after the age of 70. Although all bones can be affected by the disease, those of the spine, hip and wrist are most likely to break. In elderly people, hip fractures can be particularly dangerous because the prolonged immobility required during the healing process often leads to blood clots or pneumonia, both of which can be fatal.

What causes Osteoporosis?
Although the exact cause is unknown, the process by which the bone becomes porous is called remodeling. Remodeling is a process when the body breaks down and remakes bones continually. In the mid 30s, the body loses calcium, less remodeling occurs and the bones begin to thin.

Some women are more prone to the bone thinning; those who are thin have a small frame, smoke, drink alcohol excessively or live a sedentary lifestyle.

How can Osteoporosis be prevented?
Eat foods rich in calcium
Avoid foods that interfere with body's absorption of calcium –
Do weight bearing exercises to 30-40 minutes at least 3 times per week.
Do not smoke. Some studies show smoking increases the risk of osteoporosis by 50%.
Avoid antacids that contain aluminum as it prevents absorption calcium.
Maintain daily calcium intake 1000-1500mg.The higher dose is recommended for post menopausal women and older men. Take Vitamin D and Magnesium
Avoid high phosphorous foods; red meats, carbonated beverages, excessive amounts of alcohol.

What are the symptoms of Osteoporosis? Most people are not aware until a fracture occurs, however there are some symptoms:
Gradual loss of height and accompanying stooped posture.
Fractures of the spine, hip, or wrist.
Dental X-rays may reveal a loss of bone in the jaw.

How do I know if I have Osteoporosis?
Measure to check for loss of height – The vertebrae is often the first bones affected.
Bone density measurement (DEXA) is the most often used test, designed to screen for early signs of the disorder.

How is Osteoporosis treated?
Calcium is the cornerstone of treatment. The amount varies based on your overall health, medical conditions and current medications, your physician will be able to guide to on appropriate dosing. Avoid using dolomite or bone meal as calcium supplements or calcium carbonate supplements labeled as "oyster Shell" as they may contain lead and other toxic materials.

Evista is a drug that has some actions similar to estrogen in that it has the ability to maintain bone mass, however, it does not increase the risk of breast or uterine cancer.

Actonel/Fosamax/ Boniva are drugs that are approved for prevention and treatment of Osteoporosis. If not taken correctly they can cause ulcerations of the esophagus. Currently the length of treatment should be limited.

Calcitonin is a naturally occurring hormone that inhibits bone loss. It is expensive, available as an injection or via nasal spray.

Reclast is a drug that is given once annually by infusion at a Dr.'s office. Side effects include Headaches, nausea, vomiting, muscle and joint pain.

Forteo is a drug that is given by injection daily for up to2 years. It is the only drug that stimulates new bone growth and increase bone mineral density. Side effects include nausea, leg cramps, and dizziness.

Prolia is a drug that is administered by injection every 6 months. Side effects include back & joint pain, rash, and pancreatitis.

What is Osteoarthritis?
This is a joint disease where there is loss of cartilage, the slippery tissue that cushions the ends of the bones within the joints. Healthy cartilage allows bones to glide over each other and it absorbs shock of movement. In osteoarthritis, the top layer of cartilage breaks down and wears away. This allows bones under the cartilage to rub together which causes pain, swelling, and loss of motion of the joint.

Who gets Osteoarthritis?
It is the most common form of arthritis affecting both men and women. It occurs more often over the age of 65 and is the most frequent cause of disability among older adults.

Where does it occur?
It affects the joints of the hands, knees hips and spine. It does not affect other parts of the body such as internal organs.

What are the symptoms?
People usually experience joint pain, swelling and stiffness. It is also described as a crunching feeling or sound of bone rubbing on bone.

How can it be treated?
The goal is to maintain function and minimize pain. The best treatment is exercising which: 1.) strengthens muscles supporting joints; 2.) maintains and improves flexibility; 3.) Improves balance and range of motion.
TENS unit
Glucosamine chondroitin
Surgery to resurface or replace joints.

For More Information:

1 AMS Circle
Bethesda, MD 20892-3675
Phone: 301-495-4484
Toll free: 877-22-NIAMS (877-226-4267)
TTY: 301-565-2966
Fax: 301-718-6366

From the Desk of Melissa Skaff- Schultz ARNP-C