Osteoporosis Leading bone disease

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OsteoporosisLeading bone disease

• Michele O Brien
• Irish Osteoporosis Society
• Home Economics
• October 2008

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Osteoporosis just old Lady's!
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Do you have Osteoporosis?

• Osteoporosis is a Silent Disease, NO ONE can say
  they do not have Osteoporosis unless they have
  had a DXA scan of their spine and hips recently

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What is Osteoporosis

• Osteoporosis is a Silent Disease
• It is the Commonest Bone Disease Worldwide
• Usually the First Sign is a Fracture of the
  Wrist, Spine or Hip

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Osteopenia I am fine

• This is the early stages of Osteoporosis
• Prevention of bone loss is essential
• Most people break bones between moderate and
  marked
• T score between -1.5 to -2.5

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Osteoporosis

• It is never too late to treat a person or too
  young to be diagnosed
• Calcium is not Enough
• Vitamin D weight bearing exercise are essential
• It is Preventable You can prevent yourselves
  and your families

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Osteoporosis Statistics

• 1 in 5 Men
• 1 in 3 Women
• 1 in 2 women over 65
• Develop during pregnancy
• It Can Affect all Age Groups
• It is Not Just an Old Ladys Disease

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Statistics

• More women die from the secondary affects of
  Osteoporosis than the combined deaths of women
• with cancer of the ovaries, cervix and uterus.

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Osteoporotic Hip Fractures

• 20 of people aged 60 who break a Hip will die
  of Complications Within a Year
• 50 are Unable to Look After Themselves Properly
• Only 30 regain their independence

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Osteoporotic Bone Normal
Bone
Normal trabecular bone
Osteoporotic trabecular bone
D1202
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Osteoporosis
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Signs of Osteoporosis

• A broken bone due to a trip and fall
• Most common areas are the Wrist, Hip and
  Vertebrae Or Any Other Bones
• Loss of Height due to Vertebral Fractures
• Hump on upper back pot belly

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Symptoms of Osteoporosis

• No Pain Until a Fracture
• Back/hip Pain due to Fractures
• Undiagnosed back pain

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Untreated Osteoporosis

• Severe Pain
• Loss of height 4 16 cm
• Deformity Dowagers hump
• Change in Body Shape and Size 8 to 18
• Poor bladder control

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Stop taking your medication?

• When you get re-scanned expect a poor result
• Multiple fractures
• Wheel chair bound
• Loss of independence

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Changes Due to Osteoporosis

• Difficulty in Breathing
• Abdominal Discomfort
• Poor Quality of Life

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The Most Common Cause

• in Females
• Is Oestrogen Deficiency
• In Males
• It is Testosterone Deficiency

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At Risk of Osteoporosis

• Endocrine Disorders
• Thyroid problems
• Gastrointestinal Disorders Coeliac, Chrons,
  Ulcerative Colitis
• Haemochromatosis
• Bone Marrow Disorders
• Connective Tissue Disease
• Turner Syndrome
• Klinefelter's Syndrome

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Drug Induced Osteoporosis

• These Occur in Both Men and Women and Children
• Corticosteroids
• Can Occur With long term Low Dose
• Main Loss Occurs in the First 3-6 Months
• Early Prevention

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Drug Induced Osteoporosis

• Chemotherapy or Radiation
• Antipsychotic
• Long Term Lithium Therapy
• Some water pills
• Asthmatic inhalers
• M.S
• Parkinson's

• Corticosteroids
• Thyroxine
• Post Transplant Therapy
• Anticonvulsants
• Chronic Heparin or Warfarin
• Rheu. Arthritis

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Osteoporosis
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Weight bearing Exercise
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Risk Factors

• Menopause
• Age 65 scan even if no risk factors
• First period after age 15
• Irregular Periods other than pregnancy
• Premature Menopause, this can happen in 20s
• Natural or Surgical
• Low Body Mass - under weight for height

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Risk Factors

• Genetic
• Family History

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Risk Factors

• Vegetarians or vegans
• Excessive caffeine or soft drinks
• Past or present eating disorders
• Intolerance/dislike of dairy products

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Risk Factors

• Inadequate Calcium
• Inadequate Vitamin D
• High Fibre Intake
• Smoking
• Excessive Alcohol 7 pints 11pints units a
  week
• Psychological / physiological Stress
• Wheel chair or bed bound for more than 6 weeks

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Osteoporotic Vertebral Fractures

• A Vertebral Fracture More than Doubles Risk of
  Another Fracture
• 50 of Irish women with vertebral fractures go
  undiagnosed
• 20 of men will get fractures

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Diagnosis of Osteoporosis

• Gold Standard for Testing Bone Density Throughout
  Europe is a DEXA scan
• It Measures the Spine
• And Hip
• At this time the IOS does NOT recommend any type
  of heel scan

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Contraindications to a DEXA

• Can not be pregnant
• Barium meal or enema within last week
• No metal
• _________________
• 10 radiation of a regular Chest X-Ray
• Under 21 years of age x-ray and soft ware

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Treatment Options

• Calcium Vitamin D For Everybody
• Preferably in food
• HRT 1 in 12 will get breast cancer
• Parathyroid Hormone (Forsteo)

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Prevention of Osteoporosis

• Bones Require
• Normal Hormone Levels
• Adequate Caloric Intake
• Adequate Protein
• Calcium and Vitamin D
• Regular Weight Bearing Exercise
• Treat Cause of Bone Loss
• Scan those at Risk usually every two years

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Good Intentions

• Moderate Exercise Protects Bone
• 30 Minutes or 3 sets of 10 Minutes, 6 sets of 5
  minutes Weight Bearing Exercise Daily is
  Essential
• Too Little or Excessive Exercise Results in Bone
  Loss

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Calcium and Vitamin D
supplements

• Calcichew D 3 Forte Chewable
• Osteofos Sachet drink
• Ideos Chewable
• Caltrate Plus Swallow
• Calvadin - Chewable