Young People Get Osteoporosis Too 

 Frequently Asked Questions About Osteoporosis:

1. What are the types of osteoporosis ?
2. What are the osteoporosis risk factors?
3. What causes osteoporosis?
4. What are the medical conditions that increase the risk of osteoporosis?
5. What medications can cause osteoporosis ?
6. Is it possible for a woman in her twenties to be diagnosed with severe osteoporosis?  
   What would cause this condition in someone so young? Could it be related to the use of birth-control pills?
7. Can osteoporosis be fatal?
8. What can be done about osteoporosis, and what are the consequences?
9. What information should I tell my doctor?
10. How can I find a doctor who treats osteoporosis?
11. What is Osteopenia? How is it different from osteoporosis?
12. What's happening inside our bodies in regards to our bones?
13. Why is calcium used to treat osteoporosis?
14. If I am lactose intolerant, how can I get the calcium I need?
15. Where can I find out more about osteoporosis?
16. Once you have lost bone, can you get it back?
17.  In regard to young women with osteoporosis who would like to start a family, is there any medication that can be taken for osteoporosis while she's pregnant?
     

1. What are the types of osteoporosis?

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2. What are the osteoporosis risk factors?

• being female
• a small thin frame
• advanced age
• a family history of osteoporosis
• early menopause
• abnormal absence of menstrual periods (amenorrhea)
• anorexia nervosa or bulimia
• a diet low in calcium
• use of certain medications (steroids, anticonvulsants, excessive thyroid hormones, certain cancer treatments)
• low testosterone levels in men
• a sedentary lifestyle
• cigarette smoking
• excessive alcohol intake

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3. What causes osteoporosis?

Our bones are made of a strong outer case. On the inside of this casing, is a mesh which looks a bit like
a sponge, with blood vessels and bone marrow in the space in between bone. Quite simply - osteoporosis
occurs when the holes in this mesh become bigger, making it weak. It's widely recognised that the condition
effects elderly women, the reason for this is because woman have smaller bones which are less dense and
women also experience the menopause (when the ovaries stop producing the female oestrogen, which is vital
in bone development and health). But potentially we are all at risk, regardless of age and sex. Risk factors in
women include early menopause (before age 45) missing periods for more than six months
(excluding pregnancy), over dieting and over-exercising, smoking and drinking. Long-term use
of oral corticosteroids (often prescribed for conditions such as asthma and Crohns) is a risk factor for both
men and women.

When osteoporosis happens in men it is often caused by another health problem such as smoking, heavy drinking,
Cushing's syndrome, intestinal diseases, liver and thyroid problems. Testosterone deficiency is one of the most common
reasons for osteoporosis.

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4. What are the medical conditions that increase the risk of osteoporosis?

• Acromegaly
• Cushing's syndrome
• Diabetes mellitus
• Ehlers-Danlos syndrome
• Gastrectomy
• Hepatobilliary disease and cirrhosis
• Homocysternuria
• Hyperthyroidism
• Hypogonadism
• Hypothyroidism
• Intestinal by-pass surgery
• Malabsorption
• Marfan's syndrome
• Menkes' syndrome
• Osteogenesis imperfecta
• Scurvy

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5. What medications can cause osteoporosis?

• Alcohol
• Aluminum-containing antacids
• Anticonvulsants
• Caffeine
• Corticosteroids
• GNRH agonist
• Heparin
• Isoniazid
• Lasix
• Lithium
• Methotrexate
• Progesterone
• Thyroid hormone

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6. Is it possible for a woman in her twenties to be diagnosed with severe osteoporosis? What would cause this condition in someone so young? Could it be related to use of birth-control pills?

We usually associate osteoporosis with older women after menopause, since estrogen deficiency is the most common cause of this condition. When men or younger women get osteoporosis, they tend to have a hormonal problem or take medications that weaken bones. 

Young women can develop weak bones from low hormone levels related to heavy exercise, weight loss or conditions such as anorexia or bulimia. Loss of periods or irregular periods can signal low estrogen levels associated with these conditions. If anything, birth-control pills should increase your bone mass. They are often prescribed for women with irregular or absent periods to help protect them from bone loss. Because there is usually another condition responsible for osteoporosis in young women, you should make sure you have had a thorough evaluation for any of the potential causes listed above.

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 7. Can osteoporosis be fatal?

1 in 3 women and at least 1 in 12 men will develop the disease during their lifetime. Every 3 minutes someone has a fracture as a result of osteoporosis. Osteoporosis can be fatal - more women die after hip fractures than from cancer of the ovaries, cervix and uterus combined.   Osteoporosis is a potentially fatal disease. Osteoporosis not only affects quality of life but claims lives. In the United States, 250 000 hip fractures annually are attributable to osteoporosis, resulting in a 10% to 20% mortality rate over the subsequent 6 months. This means that osteoporotic fractures pose a lifetime risk for death similar to that of breast cancer

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8. what can be done about osteoporosis, and what are the consequences?

Not only is osteoporosis disabling, it can be painful and disfiguring. Although there is no cure for this crippling disease, it can be prevented. By eating calcium-rich foods, maintaining a well-balanced diet and exercising, you can build strong bones that will support and carry you for the rest of your life.

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9. What information should I tell my doctor?

Inform him or her of all the prescription or over the counter medications that you are taking

Inform your doctor of any medical conditions, allergies, pregnancy or breast-feeding

Inform your doctor if you have a history of hypocalcemia (amount of calcium in the bloodstream is below normal range), severe kidney disease, blood clots or problems with the esophagus

Inform your doctor if you are allergic to any other substances, such as foods, preservatives, or dyes  

View the sited located at the following link for even more information about what you should discuss or ask your physician    ask a doctor

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10. How can I find a doctor who treats osteoporosis?

According to the National Osteoporosis Foundation, it has been a problem for many individuals to find a doctor who is knowledgeable about osteoporosis. There is no physician specialty dedicated to osteoporosis, nor is there a certification
 program for health professionals who treat the disease. Therefore, a variety of medical specialists are treating people with osteoporosis, including internists, gynecologists, family physicians, endocrinologists, rheumatologists, physiatrists and orthopedists.

There are a number of ways to find a doctor who treats osteoporosis patients. If you have a primary care physician or a family doctor, discuss your concerns with him or her. Your doctor may be able to refer you to an osteoporosis specialist.

If you are enrolled in an HMO or managed care health plan, consult your assigned physician about osteoporosis. This doctor should be able to give you an appropriate referral.

If you do not have a personal physician or your doctor cannot help you, you may contact your nearest university hospital or  health center and ask for the department that cares for patients with osteoporosis. The department will vary from institution to institution. For example, in some facilities, the department of endocrinology or metabolic bone disease treats osteoporosis patients. In other medical centers, the appropriate department may be rheumatology, orthopedics, or gynecology. Some hospitals have a separate osteoporosis program or women's clinic that treats osteoporosis patients.

You can also find a doctor by using the National Osteoporosis Foundation's Professional Partners Network Directory

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11. What is Osteopenia? How is it different from osteoporosis?

What’s the difference? Osteoporosis is a disease that breaks down the tissue in our bones, making them fragile and more likely to break. Osteopenia is not a disease, but a term that describes low bone density. Both can lead to painful fractures. Every day we learn more about both of these conditions and how to prevent them.

While osteopenia is not considered a disease, being diagnosed with osteopenia requires further monitoring. Preventive measures should be taken since osteoporosis may develop if bone density loss increases.

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12. What's happening inside our bodies in regards to our bones?
Inside each of us, old bone is always being removed and new bone is made and put in its place.  Doctors call this the "bone-remodeling cycle," and it keeps bones strong when it works right.  There are two types of cells that do all this work:  "osteoclast" cells get rid of old bone by digging pits in the bone, and other cells called "osteoblasts" fill in the pits with new bone.

The following links are to two sites that contain animated pictures to show just what's going on in your body when osteoporosis takes hold
Osteoporosis and animated pictures

The bone cycle gets out of balance over time
As you get older, the bone remodeling cycle changes.  Old bone breaks down faster than new bone can be formed.  Think of it as a bank account, where you can "deposit" and "withdraw" bone.  As you age, you withdraw more than you deposit.  Some people withdraw so much bone that it leads to osteoporosis.  Without treatment, bones can get so weak that they might break from standing, walking, sitting, or even sleeping.  Simply hugging your grandchild of reaching down to pick up a newspaper can cause a fracture.

Osteoporosis can start early in life, but most symptoms do not show up until later.  Some people are at greater risk than others for losing bone.  For example, women get osteoporosis more often than men because they have smaller, thinner bones and lose bone quickly after menopause.  Your family history can also play a part.

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13. Why is calcium used to treat osteoporosis?
Calcium, combined with vitamin D and phosphorus, maintains or helps reduce the rate of bone loss that occurs with osteoporosis.

Vitamin D must be taken with calcium in order for the calcium to be properly absorbed into your body. You need 400 IU of vitamin D per day if you are an adult. If you are over the age of 61 years, you may need up to 800 IU per day of vitamin D. You can get enough vitamin D through 10 to 15 minutes per day of sun exposure a few days a week. You can also get vitamin D in foods such as egg yolks, liver, saltwater fish, and vitamin D-fortified dairy products. If you do not eat these foods or do not get sun exposure, taking a vitamin D supplement along with your calcium can help strengthen your bones.

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14. If I am lactose intolerant, how can I get the calcium I need?
For women who are lactose intolerant (where the body lacks the enzyme that digests sugar in milk), aged cheeses, such as Swiss and cheddar, and yogurt with live and active cultures are good calcium sources. Many people who cannot drink regular milk do fine with lactose-reduced or lactose-free milk. You can also add lactase drops to your regular milk or chew some lactase tablets before drinking it.

Look for lactase products at your drugstore or health food store. You could also try calcium-fortified soy milk or orange juice. If you are not getting enough calcium in your diet and are thinking about taking calcium supplements, talk to your health care provider.

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15. Where can I find out more about osteoporosis?
The National Osteoporosis Society offers support and advice to people with the condition, their families and caregivers. They operate a national telephone helpline (call 0845 450 0230 between 10am-5pm, Monday and 9.30am-5pm Tuesday-Friday) and a network of regional support groups. In addition the society works with the medical profession and health authorities.

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16. Once you have lost bone, can you get it back?
The latest treatments can actually restore bone.  I'm not saying that a woman with osteoporosis can recover all the bone she's lost--we don't yet have treatments that effective.  But even small gains in bone density can make a meaningful difference in the chances of a fracture.  HRT and newer medications can reduce the odds by an astonishing 50 to 75 percent.  And there's evidence that a combination of medication, exercise,  and nutritional measures is even more effective.

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 17. In regard to young women with osteoporosis who would like to start a family, is there any medication that can be taken for osteoporosis while she's pregnant?

Unfortunately, no osteoporosis medications have been tested for safety in pregnant women.  Since young women may become pregnant unexpectedly , doctors usually don't prescribe Fosamax for them--that's because the drug stays in your body for a long time, and could affect a developing fetus.  Doctors might suggest using nasal calcitonin, which leaves the body very quickly; the doctor is likely  to recommend that she go off the medication prior to conception and resume after you stop nursing.

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