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Young People Get Osteoporosis Too 

Butterfly1b1  REALITY OF BRITTLE BONE DISEASEButterfly1b5

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When most people hear about osteoporosis, a disorder that leaves bones weak and prone to fractures, they often think of elderly women whose disease results from hormonal changes following menopause. Many people may be surprised to learn that "brittle bone disease," as osteoporosis is sometimes called, often affects many other groups of people. 

Osteoporosis affects approximately 25 million Americans and causes nearly 1.5 million fractures each year, according to a recent National Institutes of Health report. People with kidney disease and those on long-term medication, including transplant recipients, are at increased risk of developing the disease. These people often develop osteoporosis as a result of medications or a disease process rather than menopause or through the normal aging process. 

Bone is a continually changing throughout life, explains Jill Lindberg, MD, CO-director of the Metabolic Bone Clinic at the Ochsner Medical Clinic in New Orleans, Louisiana. Dr. Lindberg has done extensive research on osteoporosis that is not related to aging. Most recently, she has studied loss of bone mass among marathon runners and military academy cadets. 

In healthy bone tissue, according to Dr. Lindberg, calcium and other minerals from a strong supportive network where sugar, protein and minerals are stored and blood cells are produced. To maintain the strength of this network, the body continually breaks down old bone and replaces it with new stronger tissue in an ongoing bone renewal program. Although this renewal process continues throughout life, bone strength is greatest in early adulthood. "There is evidence that shows everyone reaches peak bone density in their mid-20s, says Dr. Lindberg. "After that, we all begin to slowly lose bone mass." For most people who have developed strong, healthy bones during their youth, the loss of bone tissue is so gradual that it does not affect bone strength. However, osteoporosis occurs if bone breaks down too rapidly; if there is not enough calcium for the bone to replenish what is lost or if calcium is not absorbed into the bone. The supportive structure weakens and fractures and can result in disfiguration, pain, or a loss in height, Lindberg says. 

Anyone who takes steroids is at increased risk of osteoporosis and more than 80% develop some form of the disease Steroids are common, effective medications for treating many diseases, They suppress the immune system and are therefore effective in controlling diseases in which the immune system is harmful to the body's own tissue, such as with asthma, arthritis, lupus erythematosus, and some forms of kidney disease. Steroids are also commonly used to help guard against rejection following organ transplantation. However, steroids also suppress bone formation and cause the kidneys to waste calcium by blocking its absorption from the gastrointestinal tract. 

Unfortunately, many of the people who must take steroids to suppress the immune system already have other risk factors for osteoporosis. An older, post-menopausal woman with arthritis already is at risk for developing osteoporosis. Steroids, while helping control the arthritis, will have a negative effect on her bone density. 


Transplant patients, especially kidney recipients, often face additional risk of developing osteoporosis. Kidney disease prior to transplant may have already caused a loss of bone mass. In addition, medications taken to prevent organ rejection can accelerate bone loss and inhibit the reformation of new bone. These medications represent a multi-prolonged attack on the bone. Prolonged use of some seizure control medications, such as Dilantin, also can contribute to osteoporosis, Dr. Lindberg notes because they may interfere with vitamin D metabolism. Also, heparin, used to prolong clotting times, can speed up the natural mechanism that breaks down bone cells. Because these medications are vital to a patient's well-being, their use may not be able to be discontinued or even lessened. Therapies for osteoporosis, which must take into account the patient's complete medical needs, could include supplemental calcium and biologically activated vitamin D, administration of other medications, or surgery, if the parathyroid gland is enlarged. 


Researchers are seeking to develop new medications that stimulate bone growth. At present, these medications are still in the investigational stages. Diet and exercise also have important therapeutic value. Bone, especially those areas at risk, such as the wrist, spine and hip, responds well to exercise. Walking, water exercise, stationary bicycling or weight training may be effective in maintaining bone density. It's important for all people to be aware of the possible indicators of osteoporosis, including cessation of a menstrual period or low sex drive, pain or repeated bone fractures. Those who are at increased risk of bone disease due to their age, a particular health condition or medications should discuss these risk factors with their physician. Testing for osteoporosis can be as simple as having a low-dose X-ray taken and a blood sample checked for calcium levels. Dr. Lindberg says that prevention against osteoporosis must begin during childhood and teenage years. "A healthy diet that is strong in calcium for young people is a good way to build up bone mass for later years." 


Unfortunately, many of the people who must take steroids to suppress the immune system already have other risk factors for osteoporosis. An older, post-menopausal woman with arthritis already is at risk for developing osteoporosis. Steroids, while helping control the arthritis, will have a negative effect on her bone density. 


Transplant patients, especially kidney recipients, often face additional risk of developing osteoporosis. Kidney disease prior to transplant may have already caused a loss of bone mass. In addition, medications taken to prevent organ rejection can accelerate bone loss and inhibit the reformation of new bone. These medications represent a multi-prolonged attack on the bone. Prolonged use of some seizure control medications, such as Dilantin, also can contribute to osteoporosis, Dr. Lindberg notes because they may interfere with vitamin D metabolism. Also, heparin, used to prolong clotting times, can speed up the natural mechanism that breaks down bon e cells. Because these medications are vital to a patient's well-being, their use may not be able to be discontinued or even lessened. Therapies for osteoporosis, which must take into account the patient's complete medical needs, could include supplemental calcium and biologically activated vitamin D, administration of other medications, or surgery, if the parathyroid gland is enlarged. 


Researchers are seeking to develop new medications that stimulate bone growth. At present, these medications are still in the investigational stages. Diet and exercise also have important therapeutic value. Bone, especially those areas at risk, such as the wrist, spine and hip, responds well to exercise. Walking, water exercise, stationary bicycling or weight training may be effective in maintaining bone density. It's important for all people to be aware of the possible indicators of osteoporosis, including cessation of a menstrual period or low sex drive, pain or repeated bone fractures. Those who are at increased risk of bone disease due to their age, a particular health condition or medications should discuss these risk factors with their physician. Testing for osteoporosis can be as simple as having a low-dose X-ray taken and a blood sample checked for calcium levels. Dr. Lindberg says that prevention against osteoporosis must begin during childhood and teenage years. "A healthy diet that is strong in calcium for young people is a good way to build up bone mass for later years." 

Osteoporosis: The reality of brittle bone disease 
was authored by: Dr. Jill Lindberg 


the above article is included on this web site with Dr. Lindberg's permission 
 
 

Young People Get Osteoporosis Too Organization
Copyright 2001  All rights reserved.
Revised: 03/11/08.