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Osteoporosis & Bone Health Test


Overview

Bone Health

Bone is a living, growing tissue and mostly made up of collagen (a protein that provides a soft framework) and calcium phosphate (a mineral that adds strength and hardens the framework)

This combination of collagen and calcium makes bone both flexible and strong, which in turn helps bone to withstand stress. More than 99 percent of the body calcium is contained in the bones and teeth. The remaining 1 percent is found in the blood.

Bones play many important roles in the body like providing structure, protecting organs, anchoring muscles and storing calcium.

Throughout one’s lifetime, old bone is removed (resorption) and new bone is added to the skeleton (formation). During childhood and teenage years, new bone is added faster than old bone is removed. As a result, bones become larger, heavier, and denser. Bone formation outpaces resorption until peak bone mass (maximum bone density and strength) is reached around age 30. After that time, bone resorption slowly begins to exceed bone formation.

Osteoporosis

Osteoporosis or “porous bones” or “holey bones” is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased risk of fractures of the hip, spine, and wrist.

There are around 40 million osteoporosis patients in India.

  • Amount of calcium in diet: low calcium diet contributes to diminished bone density
  • Physical activity:people who are physically inactive are at a high risk of osteoporosis
  • Tobacco and alcohol use:tobacco use contributes to weak bone; alcohol interferes with the body's ability to absorb calcium
  • Gender: women are at a greater risk of osteoporosis due to less bone tissue than
  • Size: you're also at risk if you're extremely thin (with a body mass index of 19 or less) or have a small body frame because you might have less bone mass to draw from as you age
  • Age:bones become thinner and weaker as you age.
  • Race and family history:risk of osteoporosis is higher among white and Asian descent people; having osteoporosis in family also increases the risk
  • Hormone levels: high levels of thyroid hormone can cause bone loss. In women, bone loss increases dramatically at menopause due to dropping estrogen levels. Prolonged absence of menstruation (amenorrhea) before menopause also increases the risk of osteoporosis. In men, low testosterone levels can cause a loss of bone mass
  • Eating disorders and other conditions: people who have anorexia or bulimia are at risk of bone loss. In addition, stomach surgery (gastrectomy), weight-loss surgery and conditions such as Crohn's disease, celiac disease and Cushing's disease can affect body's ability to absorb calcium
  • Certain medications: long-term use of corticosteroid medications, such as prednisone, cortisone, prednisolone and dexamethasone, are damaging to bone. Other drugs that might increase the risk of osteoporosis include aromatase inhibitors to treat breast cancer, selective serotonin reuptake inhibitors, methotrexate, some anti-seizure medications, such as phenytoin (Dilantin) and phenobarbital, and proton pump inhibitors

Different types of bone problems are as follows:

  • Low bone density and osteoporosis
  • Osteogenesis imperfect that makes bones brittle
  • Paget’s disease of bone that makes bones weak
  • Bone cancer
  • Bone infections
  • Other bones diseases, which are caused by poor nutrition, genetics, or problems with the rate of bone growth or rebuilding
  • Known as a “silent disease” as there are no signs and symptoms that alerts its presence early
  • Generally it remains undiagnosed until a person’s bones become so weak that a sudden strain, bump, or fall causes a hip to fracture or a vertebra to collapse
  • The first indication is usually a fracture, but by time a fracture occurs osteoporosis is already at an advanced stage
  • A diet low in calcium, vitamin D and other vitamins and minerals
  • A diet very high in protein, caffeine and sodium
  • Low levels of sex hormones (estrogen in females and testosterone in males)
  • Certain medical conditions like intestinal problems (celiac disease and IBD can interfere with normal calcium and vitamin D absorption), kidney diseases (can cause decreased activation of vitamin D), parathyroid and thyroid problems
  • Severe, chronic pain
  • Loss of height
  • Stooped posture
  • Restricted mobility
  • Depression
  • Serum calcium
  • Bone mineral density test
  • Dual energy X-ray absorptiometry
  • Central DXA test
  • Biphosphonates like alendronate, zoledronic acid, risedronate
  • Vitamin D supplements
  • Calcium supplements
  • Hormonal supplements like raloxifene that mimics estrogen’s beneficial effects
  • Other medications like denosumab, teriparatide that improves bone density

Bone Health

i. What is a bone density test? What does it actually represent?+
ii. What is a healthy bone mineral density?+
iii. What all diagnostic tests are there for osteoporosis?+
iv. What is the correlation between vitamin D, calcium and healthy bones?+