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​Osteoporosis in Women
Quality Life Forum​ Age-Related Health Challenge Series
November, 2019

Osteoporosis are far more common in women than men. There are multiple reasons, such as less bone mass and aging, but menopause is the most common cause of osteoporosis in women. Preventing bone loss is an important concern in the menopause and during post-menopausal stages. Menopause significantly speeds bone loss and increases the risk for osteoporosis, due to the decrease of estrogen, which prevent bones from getting weaker by slowing the natural breakdown of bone. 

Symptoms

Osteoporosis is a disease that weakens bones to the point where they break easily—most often, bones in the hip, backbone (spine), and wrist. Osteoporosis is called a “silent disease” because there typically are no symptoms in the early stages of bone loss, until developing fractures or collapsed vertebra results in back pain. 

​Diagnosis 

A bone density test is commonly used for screening and diagnosis:
-1 and above: normal bone density
-1 to -2.5 Low bone mass (below normal)
-2.5 and below: osteoporosis

Medical Treatment

There are many medications available to treat osteoporosis and reduce the risk of fracture. They fall into two basic categories: antiresorptives and anabolics.
  • With antiresorptive medicines, the goal of treatment is to prevent further bone loss and reduce the risk of fractures. Antiresorptive drugs include bisphosphonates (alendronate, ibandronate, risedronate, zoledronic acid), denosumab, calcitonin, estrogen/estrogen-progestin, an estrogen agonist/antagonist (raloxifene), and a tissue specific estrogen complex (estrogen/bazedoxifene). Antiresorptive drugs work by slowing the resorption or breakdown part of the remodeling cycle.
  • With anabolic medicine, the goal of treatment is to rebuild bone, increase bone mass, repair microscopic defects in bone, and reduce the risk of fractures. Anabolics work by stimulating the formation part of the remodeling process. More bone is formed than is taken away. The result is stronger bone that is less likely to break. Teriparatide, a parathyroid hormone analog, and abaloparatide, a parathyroid hormone-related protein analog, are the FDA-approved anabolic medicines available on the market.
All of these drugs reduce the likelihood of having fragility fractures. They come in a range of formulations, from daily tablets to yearly intravenous infusions. There is no best medication for everyone. Individual health history and preferences are taking into considerations by the health care provider.

How Long to Take Osteoporosis Medications?

Teriparatide and Abaloparatide are the only drugs for osteoporosis that have a defined treatment length. The FDA recommends that treatment be limited to no more than two years. There is a great deal of variability in terms of ideal treatment duration for other medications. Some drugs, like raloxifene and denosumab, leave the body quickly. Their effects generally disappear after one stops taking them. Some drugs, like bisphosphonates, stay in the bones after stop taking them — some longer (alendronate, zoledronic acid) than others (risedronate, ibandronate). They may continue to work and offer protection even after one stops taking them. The most effective regimen and duration depends on the individual drug, the individual patient, and her/his level of fracture risk.

With effective drug treatment, bone density stays the same or improves without additional fractures.

Maintain Normal Calcium and Vitamin D Levels

Annual physical and blood work is important to check calcium and vitamin D levels. Bone density screening should be planned at least every two years or as recommended by the Doctor, who will also recommend supplements for your needs. These preventive measures are covered by most health insurance policy. 

Whatever medication prescribed to protect your bones, it won’t work without enough calcium and vitamin D. Calcium tablets are good for filling in when you can’t get enough in your diet, but it is always better to get calcium from food. Because there are not as many food sources of vitamin D, supplements are generally recommended for most people.

There are many varieties of calcium supplement. The most popular are outlined below, with pros and cons compared:
  • Calcium citrate (Citrical, Solgar) 21% calcium : Most easily absorbed, but most expensive and doesn’t contain much elemental calcium
  • Calcium carbonate (Tums, Caltrate, Rolaids) 40% calcium: Least expensive and has more elemental, but note must be taken with meals or glass of acidic (orange) juice; may cause gas or constipation
  • Calcium phosphate (Posture) 39% calcium:  Does not cause gas or constipation and easily absorbed, but more expensive than calcium carbonate.
​
Practical considerations:
  • Don’t take more than 1,200 mg of calcium (in supplement form) a day, unless instructed by a MD or Dietitian.
  • Take multiple smaller dose (500 mg or less) a day, if needed, as human body can absorb only 500 mg at a time.
  • Vitamin D is essential for calcium efficiency; learn more about Vitamin D deficiency.

Prevention

Although there are effective treatments, primary prevention is mostly based on lifestyle changes:
  • Balance diet with rich protein, calcium and vitamin D. Eat more vegetables, fruits and whole grains. Choose healthy sources of protein and fat
  • Limit sugar, salt and phosphate additives: Too much salt in your diet also can be harmful. Not only can salt cause high blood pressure, but too much salt also can increase the amount of calcium you excrete from your body with urination. Aim for a limit of 2,300 mg of salt daily — the equivalent of about one teaspoon. Phosphorus is used as an additive in many processed foods. Too much phosphorus in your diet can interfere with how much calcium is absorbed through your small intestine.
  • Take calcium and vitamin D supplements, if dietary intake is insufficient. Women over 50 and all adults over 70 should get at least 1,200 mg of calcium each day, as recommended by NIH.
  • Sunshine is important to maintain adequate vitamin D levels, as sun exposure is the natural way the body makes vitamin D.
  • Exercise regimen including weight- bearing physical activities (walking/jogging), resistance and balance.
  • Maintain normal BMI/body weight, not smoking, limit alcohol and caffeine consumption. 

Action call: Take action for your bone health today; don’t put it off. Contact QualityLifeForum@outlook.com for a free call. An individualized coaching program can help you achieving your personal health goals.
​
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​Summary

Osteoporosis are far more common in women than men. Menopause is the most common cause of osteoporosis in women. Preventing bone loss is an important concern in the menopause and during post-menopausal stages. Osteoporosis is a disease that weakens bones to the point where they break easily—most often, bones in the hip, backbone (spine), and wrist. Osteoporosis is called a “silent disease” because there typically are no symptoms in the early stages of bone loss, until developing fractures or collapsed vertebra results in back pain. Medications are available for effective treatment.  Maintain adequate calcium and vitamin D levels are essential. Healthy and active life style benefits bone health for life time.

© All rights reserved

References:
https://www.hormone.org/diseases-and-conditions/menopause/post-menopause-and-osteoporosis
https://www.nia.nih.gov/health/osteoporosis
https://www.mayoclinic.org/diseases-conditions/osteoporosis/in-depth/osteoporosis/art-20304599
https://www.nof.org/patients/treatment/medicationadherence/
https://www.arthritis.org/about-arthritis/types/osteoporosis/articles/calcium-supplements.php
https://www.premierformulas.com/the-ultimate-guide-to-healing-osteoporosis-naturally/

Disclaimer: This information is for educational and informational purposes only. It is not medical advice. Consult your healthcare professional for personal conditions.

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      • 2021 March Make a Self-Care Plan for Your Golden Years
      • 2018 Jan The Golden Keys for the Golden Years
      • 2018 July Golden Mindset
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      • 2018 Feb loneliness Breakthrough
      • 2016 Feb Wellness Mindset
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      • 2019 Sept Time for change
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      • 2021 Sept Aging Brain
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      • 2021 Oct Muscle Memory and Cognition
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      • 2019 March Body Image and Self-Care After Midlife
      • 2020 Nov Moderation
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      • 2021 Nov Gratitude Power for Wellbeing
      • 2019 Dec Dealing with Difficult Emotions in Holiday Season
      • 2022 Dec Holiday Homecoming
    • Healthy Living >
      • 2022 Jan Health: the Cornerstone for Quality of Life
      • 2017 April Longevity and Quality of Life
      • Blog Are You Motivated for a Healthy Life Style?
      • 2018 June TLC Transformation
      • 2022 July Daily Routine for Healthy Aging
      • 2017 June Sleep Well
      • 2021 May Simplify Life for healthy aging
      • 2019 Aug Downsizing in the Golden Years
      • 2017 Sept Music Learning for older adults
    • Healthy Eating >
      • 2022 Sept Your Decision Power for Food Choices and Eating Behavior
      • 2022 Oct Hydration for Healthy Aging
      • 2018 Aug Nourish Your Body for Healthy Living
      • 2017 Oct Better to Eat Meat or Plant Food
      • 2020 Jan The Key Role of Protein in Healthy Aging
      • 2020 Feb Healthy Fat for Healthy Aging
      • 2020 March Healthy Aging Energy Source Carbohydrate
      • 2017 July Intermittent Fasting
      • 2020 Sept Time-Restricted Feeding Is A Healthy Lifestyle Choice
      • 2022 Nov Go green for health: A Green Tea Invitation
      • 2019 June Dietary Supplements Are Not Drugs
      • 2015 Nov Blog The Value of Vitamin and Dietary Supplements
    • Golden Age Fitness >
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      • 2017 March Exercise for Blood Sugar Regulation
      • 2017 Jan Willness Attitude and Winterizing Fitness
      • 2016 Apr Balance Training
      • 2016 Mar Get Active
      • 2018 Sept Keep Life in Motion
      • 2020 Aug Keep Fit for Your Age
      • 2023 Feb Benefits of Swimming for Healthy Aging
    • Age-related Health Challenges >
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      • 2018 May Blood Sugar Self-Management
      • 2018 April Lowering Cholesterol
      • 2017 Nov Immunity and Aging
      • 2016 June Vitamin D Deficiency
      • 2022 May Aging Skin and Sun Safety
      • 2022 Feb Aging Eye Facts
      • 2017 May How to Reduce Aging Eye Fatigue
      • 2022 Mar Age-Related Hearing Loss
      • 2022 April Aging and Oral Health
      • 2017 Feb Live with Thyroid Nodules
      • 2021 July Range of Motion Recovery from Frozen Shoulder
      • 2019 Nov Osteoporosis in Women
      • 2019 Feb Food Safety and H. pylori Infection
      • 2019 July GERD
      • 2016 Oct Significant Health Indicators
      • 2018 Oct Tough Fight for the Belly Fat
      • 2016 July Weight Management
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