OSTEOPOROSIS: Should we be Should we be concerned?concerned?

What is osteoporosis?

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

density

Normal Osteoporosis

Why is bone density important?

With decreased bone density, bones are more fragile and are

more likely to break (Fracture)

Why is bone density important?

With decreased bone density, vertebral bones may collapse and

cause excessive curvature of the spine

Osteoporosis is a growing problem

Millions of Filipinos have osteoporosis…

…but will not know it until they get a fracture

Osteoporosis is a growing problem

Of the Filipinos who are diagnosed with osteoporosis..

…only a small percentage will receive adequate medical treatment

COULD I HAVE OSTEOPOROSIS?

COULD SOMEONEI LOVE HAVE

OSTEOPOROSIS?

What are the risk factors for developing osteoporosis?

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.

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

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.

Bone structure and body weight

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

Menopause / Menstrual historyMenopause / Menstrual history• Normal or early menopause (brought about

naturally or because of surgery) increases your risk

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

Lifestyle/modifiable risk factors

Smoking Excessive alcohol

Inadequate calcium Lack of exercise

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.

Can osteoporosis be prevented?

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..)

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

How you can prevent osteoporosis

• Stop smoking

• Drink alcohol in moderation

• Exercise!– Bone becomes stronger and denser

when you place demands on it

What should I do? I might

have osteoporosis!

ME TOO!

Your doctor my request a bone mineral density test

to evaluate your bones

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

Based on your doctor’s evaluation and your tests,

you may need to take medications for osteoporosis

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

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.

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.

The Philippine College of Physicians wishes to acknowledge the following for their invaluable efforts in the preparation

of this module

Gabriel Jasul, MDJose Ma Ibarra Co, MDRosa Allyn G. Sy, MD

Committee on Advocacy & Public Relations

Philippine Society of Endocrinology and Metabolism