OSTEOPOROSIS - INTRODUCTION

Osteoporosis

Osteoporosis is a systemic skeletal disease characterized by low bone density and microarchitectural deterioration of bone tissue with a consequent increase in bone fragility . Early osteoporosis is not usually diagnosed and remains asymptomatic; it does not become clinically evident until fractures occur. Loss of bone density occurs with advancing age and rates of fracture increase markedly with age, giving rise to significant morbidity and some mortality . Osteoporosis is three times more common in women than in men, partly because women have a lower peak bone mass and partly because of the hormonal changes that occur at the menopause. Estrogens have an important function in preserving bone mass during adulthood, and bone loss occurs as levels decline, usually from around the age of 50 years. In addition, women live longer than men and therefore have greater reductions in bone mass. Increasing life expectancy in many parts of the world means that women now live more than one-third of their lives after the menopause, and that the number of postmenopausal women is increasing.

Types of Osteiporosis

There are two types of osteoporosis. The first type, Primary, occurs spontaneously and contains three subtypes. The other type is Secondary osteoporosis, which is caused by a disease or medication.

Primary Osteoporosis

Primary osteoporosis occurs spontaneously. There are three types of primary osteoporosis:

1) Postmenopausal Osteoporosis (Type I Osteoporosis)

Postmenopausal osteoporosis normally occurs in individuals between the ages of 50 and 75. It is caused by a lack of estrogen. Although it is more likely to occur in women, postmenopausal osteoporosis also occurs in men with low levels of testosterone.

Increased risk factors for postmenopausal osteoporosis include:

• low body weight, which is usually associated with smaller bones and lower estrogen levels

• advanced age

• women where menopause occurred early in life

• anorexia

Fosamax is a popular medication which is often prescribed for postmenopausal osteoporosis. However, studies have shown that Fosamax can lead to a very serious and painful jawbone side effect, resulting in osteonecrosis of the jaw. New studies point to Fosamax also causing osteonecrosis of the hip, knee and shoulder. Fosamax lawsuit claims are currently being investigating against the manufacturer for failing to warn patients and dentists of the known risks associated with these medications.

2) Involuntional or Senile Osteoporosis (Type II Osteoporosis)

Type 2 Osteoporosis typically occurs in patients over the age of 60 and is associated with the normal process of aging. As individuals age, it is common to lose bone density. Involuntional osteoporosis often results in fractures of the neck, vertebrae, humerous, tibia and pelvis.

3) Idiopathic Osteoporosis

This type of osteoporosis is uncommon. It is associated with occurrence in children and young adults.

Secondary Osteoporosis

Secondary osteoporosis only accounts for approximately 5% of all people with osteoporosis. It is caused or brought about by a disease or medication.

Some diseases which may cause secondary osteoporosis include:

• kidney failure
• Cushing’s disease
• hyperparathyroidism
• hyperthyroidism
• hypogonadism
• diabetes mellitus
• hormonal disorders
  

Some medication or drugs which may cause secondary osteoporosis include:

• corticosteroids
• barbiturates
• anticonvulsants
• excessive alcohol consumption
• cigarette smoking