Case Study: Osteoporosis
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bone physiology and bone remodeling cycle
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Bone remodels itself. Bone is living, growing tissue that is continuously renewing itself. Bone remodeling cycle: Basic multicellular unit (BMU) can sense bone damage and help assemble osteoclasts. Osteoclasts eat away the damaged bone. Osteoblasts will form new bone and replace the damaged area. osteoclasts - eat bone/resorption osteoblasts- form new bone
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relationship between calcium and bones
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Calcium is vital to the strength of bones. 99% of the body's calcium is stored in the bone. Calcium deficiency can affect bone strength.
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PTH (Parathyroid Hormone)
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Secreted by the parathyroid gland. It increases the calcium levels in the blood, which decreases calcium levels in the bone.
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Calcitonin
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Secreted by the thyroid gland. It decreases the calcium levels in the blood, which increases the calcium levels in the bone.
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osteoporosis
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Osteoclast activity is higher than osteoblast activity leaving holes in the bone. Bone resorption is greater than bone formation.
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genetics and osteoporosis
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Scientists believe some family history and genetics is involved.
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osteoporosis risk factors controllable
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- diet - exercise - caffeine, nicotine, alcohol - acid/base balance ( increase acidity can lead to bone loss)
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osteoporosis risk factors uncontrollable
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- gender (more in women) - body size ( smaller - more risk) - ethnicity (Asians and Caucasians - more risk) - Age
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signs and symptoms of osteoporosis
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- chronic pain - fractures without trauma - loss of height - loss of weight
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calcium and bone health
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Calcium is vital to the strength of bones. 99% of body's calcium is stored in the bone. Calcium deficiency can affect bone strength.
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sources of calcium
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- low fat dairy products - dark green, leafy vegetables (ex. broccoli, spinach) - almonds - tofu - salmon
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importance of Vitamin D to calcium
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Increases up to 30-80% of calcium absorption. Exposure to UV light (sun light) for about 15 minutes to get Vitamin D.
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calcium supplements
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Most common supplement: Calcium Carbonate - daily dose: 1,000-1,500 mg/day
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effects of alcohol, caffeine, and sodium on calcium
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Increases urine output and calcium loss occurs through urine.
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peak bone mass
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The maximum bone density a person will reach. Reaching one's peak bone mass is beneficial in preventing osteoporosis.
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preventative exercises for osteoporosis
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Walking. running, dancing, and weight bearing exercises can protect bone by increasing muscle and bone mass.
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steroids
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Drugs based on natural hormones. Medically used to treat asthma and rheumatoid arthritis. Also used to increase muscle mass.
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long term use of steroids increases risk for osteoporosis because...
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they reduce the absorption of calcium by intestines and increase the excretion of calcium by the kidneys.
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perimenopausal
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2-15 year span before menopause (stop of menstrual cycle)
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menopause and hormone levels
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Menopause average age in USA is 51. Menopause decreases levels of estrogen and progesterone.
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estrogen's effect on calcium levels in bones
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Estrogen helps to deactivate osteoclast activity and maintains normal rates of bone formation and resorption. Menopausal women lose up to 20% of bone mass.
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smoking effects on calcium levels
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Smokers have lower levels of estrogen compared to nonsmokers. estrogen helps deactivate osteoclast activity and maintains normal rates of bone formation and resorption.
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HRT
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Hormone Replacement Therapy. Made of estrogen and progesterone. Intended for menopausal women.
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pros of HRT
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- delayed breakdown of skin collagen - protected bone mass - relief of hot flashes
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cons of HRT
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- increased risk of: --> breast cancer --> gall stones --> Migraines --> breakthrough bleeding
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Drug alternatives to HRT
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- Calcitonin - Raloxifene - Alendronate - Risendronate
