OSTEOPOROSIS: Should we be concerned?

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OSTEOPOROSIS Should we be concerned?
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What is osteoporosis?
Normal
Osteoporosis

• Osteoporosis is a disease of bone where there is
  a decrease in bone density

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Why is bone density important?

• With decreased bone density, bones are more
  fragile and are more likely to
  break (Fracture)

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Why is bone density important?

• With decreased bone density, vertebral bones may
  collapse and cause excessive curvature of the
  spine

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Osteoporosis is a growing problem

• Millions of Filipinos have osteoporosis

but will not know it until they get a fracture
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Osteoporosis is a growing problem

• Of the Filipinos who are diagnosed with
  osteoporosis..

only a small percentage will receive adequate
medical treatment
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COULD I HAVE OSTEOPOROSIS?
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What are the risk factors for developing
osteoporosis?
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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.

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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

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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.

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Bone structure and body weight

• Small-boned and thin women(under 127 pounds) are
  at greater risk.

Menopause / Menstrual history

• Normal or early menopause (brought about
  naturally or because of surgery) increases your
  risk

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Lifestyle/modifiable risk factors
Smoking
Excessive alcohol
Inadequate calcium
Lack of exercise
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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.

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Can osteoporosis be prevented?
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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..)

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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

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How you can prevent osteoporosis

• Stop smoking
• Drink alcohol in moderation
• Exercise!
• Bone becomes stronger and denserwhen you place
  demands on it

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ME TOO!
What should I do? I might have osteoporosis!
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Your doctor my request a bone mineral density
testto evaluate your bones
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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

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Based on your doctors evaluation and your
tests, you may need to take
medications for osteoporosis
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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

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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.

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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.

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• The Philippine College of Physicians wishes to
  acknowledge the following for their invaluable
  efforts in the preparation of this module
• Gabriel Jasul, MD
• Jose Ma Ibarra Co, MD
• Rosa Allyn G. Sy, MD
• Committee on Advocacy Public Relations
• Philippine Society of Endocrinology and
  Metabolism