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Post Menopausal Osteoporosis

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Menopause & Osteoporosis
There is a direct relationship between the lack of estrogen after menopause and the development of osteoporosis. Fortunately, there are steps you can take to prevent osteoporosis, and treatments are available to slow the rate of bone loss if you have osteoporosis.

What is osteoporosis?
Osteoporosis is a disease that weakens bones, increasing the risk of sudden and unexpected fractures. Literally meaning "porous bone," it results in an increased loss of bone mass and strength. The disease often progresses without any symptoms or pain. Generally, osteoporosis is not discovered until weakened bones cause painful fractures (bone breakage), often in the back (causing chronic back pain) or hips. Unfortunately, once you have an osteoporotic fracture, you are at high risk of having another. These fractures can be debilitating. Fortunately, there are steps you can take to prevent osteoporosis from ever occurring. Treatments can also slow the rate of bone loss if you have osteoporosis.

What causes osteoporosis?
Though we do not know the exact cause of osteoporosis, we do know how the disease develops. Your bones are made of living, growing tissue. An outer shell of cortical or dense bone wraps trabecular bone, a sponge-like bone. When a bone is weakened by osteoporosis, the "holes" in the "sponge" grow larger and more numerous, weakening the inside of the bone.

Until about age 30, a person normally builds more bone than he or she loses. After age 35, bone breakdown overtakes bone buildup, which causes a gradual loss of bone mass. Once this loss of bone reaches a certain point, a person has osteoporosis.

How is osteoporosis related to menopause?
There is a direct relationship between the lack of estrogen after menopause and the development of osteoporosis. After menopause, bone resorption (breakdown) overtakes the building of new bone. Early menopause (before age 45) and any long phases in which the woman has low hormone levels and no or infrequent menstrual periods can cause loss of bone mass.

What are the symptoms of osteoporosis?
Osteoporosis is often called the "silent disease" because bone loss occurs without symptoms. People may not know that they have osteoporosis until their bones become so weak that a sudden strain, bump, or fall causes a fracture or a vertebra to collapse. Collapsed vertebrae may be first noticed when the person suffers severe back pain, loss of height, or spinal deformities such as stooped posture.

Who gets osteoporosis?
Important risk factors for osteoporosis include:

Age. After maximum bone density and strength is reached (generally around age 30), bone mass begins to naturally drop with age.
Gender. Women over the age of 50 have the greatest risk of developing osteoporosis. In fact, women are four times more likely than men to develop osteoporosis. Women’s lighter, thinner bones and longer life spans are some of the reasons why they are at high risk for osteoporosis
Race. Research has shown that Caucasian and Asian women are more likely to develop osteoporosis. Additionally, hip fractures are twice as likely to occur in Caucasian women as in black women. However, women of color are more likely to die after a hip fracture
Bone structure and body weight. Petite and thin women have a greater risk of developing osteoporosis because they have less bone to lose than women with more body weight and larger frames. Similarly, small-boned, thin men are at greater risk than men with larger frames and more body weight
Family history. Heredity is one of the most important risk factors for osteoporosis. If your parents or grandparents have had any signs of osteoporosis, such as a fractured hip after a minor fall, you may be at greater risk of developing the disease
How can I know if I have osteoporosis?
A painless and accurate test can provide information about your bone health before problems begin. Bone mineral density (BMD) tests, or bone measurements, are X-rays that use very small amounts of radiation to determine bone density. In addition to measuring bone health, the test can determine how severe any osteoporosis is.

Please note that women with no other risk factors whose BMD T-scores are below -2.5 should begin treatment to reduce the risk of fractures. (T-scores compare a person’s BMD to the optimal, or best, density of a healthy 30-year-old woman to determine the risk of fracture.) Women with BMD T-scores below -1.1 and who have other risk factors should also consider beginning treatment to reduce the risk of fractures. Your doctor will talk to you about your own risks for fracture to determine if you need medication.

Who should have a bone mineral density test?
All post-menopausal women who suffer a fracture that is suspicious for osteoporosis.
All post-menopausal women under age 65 who have one or more additional risk factors.
All post-menopausal women age 65 and over, regardless of additional risk factors.

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Osteoporosis

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Osteoporosis is a bone disease that occurs when the body loses too much bone, makes too little bone, or both. As a result, bones become weak and may break from a fall or, in serious cases, from sneezing or minor bumps.

Osteoporosis means “porous bone.” Viewed under a microscope, healthy bone looks like a honeycomb. When osteoporosis occurs, the holes and spaces in the honeycomb are much larger than in healthy bone. Osteoporotic bones have lost density or mass and contain abnormal tissue structure. As bones become less dense, they weaken and are more likely to break. If you’re 50 or older and have broken a bone, ask your doctor or healthcare provider about a bone density test.

Osteoporosis causes
A few key causes lead to most cases of osteoporosis.

Age
The biggest cause of osteoporosis is age. Throughout your life, your body breaks down old bone and grows new bone. However, when you’re in your 30s, your body starts breaking down bone faster than it’s able to replace it. This leads to bone that’s less dense and more fragile, and thus more prone to breakage.

Menopause
Another primary cause of osteoporosis is menopause, which occurs in women around the ages of 45 to 55 years. Due to the change in hormone levels associated with it, menopause can cause a woman’s body to lose bone even more quickly.

Men continue to lose bone at this age, but at a slower rate than women do. However, by the time they reach the ages of 65 to 70, women and men are usually losing bone at the same rate.

Medical conditions or medications
Other causes of osteoporosis include certain medical conditions such as hyperthyroidism. They also include the use of certain medications. Examples of these medications include long-term oral or injected corticosteroids such as prednisone or cortisone.

Age, menopause, certain health conditions, and the use of certain medications may be the primary causes of osteoporosis, but they’re not the only ones. Read more about these and other causes of osteoporosis, as well as the role of vitamin D in bone health.

Osteoporosis risk factors
The biggest risk factors for osteoporosis include:

being female
being an older adult
being Caucasian or Asian
having a family history of osteoporosis
poor nutrition
physical inactivity
smoking
taking certain medications
low body weight
small-boned frame
You can control some of these risk factors for osteoporosis, such as poor nutrition and inactivity. For instance, improving your diet and starting an exercise program can benefit your bone health. However, you can’t control other risk factors, such as your age or gender. Learn more about all of these risk factors, and ways to lower your risk of osteoporosis.

Senile osteoporosis
You may have heard of senile osteoporosis. This isn’t a separate type of this disease — it’s simply osteoporosis that’s caused by aging. As mentioned above, age is a primary cause of osteoporosis. Unless proper prevention or treatment efforts are made, your body’s increasing breakdown of bone can lead to weakened bones and osteoporosis.

According to global statistics from the International Osteoporosis Foundation, about one-tenth of women aged 60 have osteoporosis, while two-fifths of women aged 80 have the disease.

Bone density test for diagnosis
To check for osteoporosis, your doctor will review your medical history and do a physical exam. They may also run tests of your blood and urine to check for conditions that may cause bone loss. If your doctor thinks you may have osteoporosis or that you’re at risk of developing it, they’ll likely suggest a bone density test.

This test is called bone densitometry, or dual-energy X-ray absorptiometry (DEXA). It uses X-rays to measure the density of the bones in your wrists, hips, or spine. These are the three areas most at risk of osteoporosis.

This painless test can take from 10 to 30 minutes. Learn what to expect during a bone density test and how to prepare for it.

Osteoporosis treatment
If your testing shows that you have osteoporosis, your doctor will work with you to create a treatment plan. Your doctor will likely prescribe medications as well as lifestyle changes. These lifestyle changes can include increasing your intake of calcium and vitamin D, as well as getting appropriate exercise.

There’s no cure for osteoporosis, but proper treatment can help protect and strengthen your bones. These treatments can help slow the breakdown of bone in your body, and some treatments can spur the growth of new bone. Find out more about how treatment can help support the health of your bones.

Osteoporosis medications
The most common drugs used to treat osteoporosis are called bisphosphonates. Bisphosphonates are used to prevent the loss of bone mass. They may be taken orally or by injection. They include:

alendronate (Fosamax)
ibandronate (Boniva)
zoledronic acid (Reclast)
Other medications may be used to prevent bone loss or stimulate bone growth. They include:

Testosterone: In men, testosterone therapy may help increase bone density.
Hormone therapy: For women, estrogen used during and after menopause can help stop bone density loss. Unfortunately, estrogen therapy has also been associated with increased risk of blood clots, heart disease, and certain types of cancer.
Raloxifene (Evista): This medication has been found to provide the benefits of estrogen without many of the risks, although there is still an increased risk of blood clots.
Denosumab (Xgeva or Prolia): This drug is taken by injection and may prove even more promising than bisphosphonates at reducing bone loss.
Teriparatide (Forteo): This drug is also taken by injection and stimulates bone growth.
Calcitonin salmon (Fortical and Miacalcin) This drug is taken as a nasal spray and reduces bone reabsorption. Talk to your doctor about any increased risk of cancer with this drug.
Prescription medication is the most aggressive way to treat osteoporosis. Learn about other medications used to treat osteoporosis, as well as possible side effects.

Osteoporosis natural treatments
Because osteoporosis medications can have side effects, you may prefer to try other treatments instead of medication.

Several supplements, such as red clover, soy, and black cohosh, may be used to help promote bone health and ease the symptoms of osteoporosis. However, before using these supplements, be sure to talk to your doctor or pharmacist. This is for two main reasons:

There are few, if any, studies supporting the use of these supplements for treating osteoporosis. As a result, we don’t have proof that they work.
These supplements can cause side effects, as well as interact with medications you’re taking. You’ll want to make sure you know what side effects could occur, and if you’re taking any medications that could interact with the supplement.
All of that said, some people report good results with natural treatments. Learn more about the natural treatment options available, as well as the risks associated with them.


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Osteoporosis - How To Treat It Effectively With Homeopathy?

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The bones and muscles tend to get worn with age and other conditions. Osteoporosis is a condition described by a reduction in bone thickness. Bones tend to become weak and fragile in this condition. The most common consequence of osteoporosis is fractures. Osteoporosis does not cause signs or side effects until it has reached an advanced state. Certain signs and symptoms of osteoporosis include:

Back pain

Loss of growth after some time

A stooped stance

Crack of the vertebra, wrist, hip or other bone

Homeopathy has been a very beneficial modus operandi in the campaign against Osteoporosis. Homeopathic remedies will not reverse existing bone loss, but can help control pain, will slow down or stop further bone loss, can promote stability and healing.

Homeopathic remedies will allow the essential minerals and nutrients to be absorbed more efficiently, thus, further preventing bone fractures, or accelerating healing of any existing fractures by strengthening the bones.

Homeopathic constitutional approach takes into account a patient’s characteristic symptoms, their overall physical and mental condition and understands the way a person’s body reacts to Osteoporosis.

The purpose of Homeopathic approach is to vitalize the body’s natural healing and self-repair ability to create the highest state of health and well-being.

The aim and objective of Homoeopathic management can be achieved by:

Dietary intake of intake of calcium required by body.

Correction of intake of calcium apart forms food to regulate the daily requirement of calcium.

Correction of intestinal absorption of calcium.

Correction of assimilation of calcium channels in body by constitutional approach.

Exercise, in the form of light exercises and/or meditation.

Therapeutic correction in case the above criteria fail or partially improve the patient.

Various homeopathic prescriptions are accessible to cure bone loss and keep up bone mass. They tend to get rid of the condition from its roots and prevent it from happening in the future. These include:

Symphytum Officinale: It is the best homeopathic solution for treating fractures in osteoporosis. This homeopathic cure helps in joining the cracked bone proficiently. Fractures, where patients complain of a prickling pain in the fractured area, can be significantly soothed by giving this regular homeopathic treatment. This common homeopathic medicine can likewise help in decreasing irritability of the fracture.

Ruta Graveolens: It is yet another very effective homeopathic cure used for the treatment of fractures in osteoporosis. Whenever a bone gets broken, the ligaments and tendons of bones that surround it additionally get harmed. It is in this circle where homeopathic medicine Ruta Graveolans demonstrates its great impact. This regular solution helps in mending torn ligaments and tendons.

Hypericum Perforatum: It is yet another helpful natural homeopathic solution that can be used with certainty for the excruciating pain in the back because of crushed nerves in the middle of harmed vertebral bones.

Calcarea Phosphorica: Calcarea phosphorica is a very effective medication used in homeopathic treatment of the curvature of the spine and flow of blood in patients of osteoporosis. It is mostly given to those patients who have a weak spine and delicate bones, which cause the curvature and stop the flow of blood.

Phosphorus: Phosphorus can also give the best results in curing the curvature and flow of blood in patients of osteoporosis. If blazing sensation in spine remains along with the curvature, this treatment is the most effective. This regular homeopathic cure is also valuable for pain and weakness in the spine.

Calcarea Fluorica: It is a brilliant solution for osteoporosis patients who complain of pain in the back, which is more painful while resting and better when walking or doing some physical exercise.

Syphilinum and Fluoric Acid: These are homeopathic prescriptions that can be used as a part of homeopathic treatment of osteoporosis where the pain occurs in the long bones and is more painful during the night.

Sulfur: It is used for those patients of osteoporosis who have an arch in the spine and walk and sit in a stooping position.

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Yoga - Know Which Asanas Can Help With Osteoporosis!

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Along with curing anger and stress, yoga is also beneficial in treating osteoporosis, either by itself or in combination with different medicines. Osteoporosis is an illness described by weak and diminishing bones that can result in cracks and fractures in the bones. Some of the postures that can be helpful in treating osteoporosis are as follows:

Utthita trikonasana: Uttihita trikonasana is an expanded triangle posture which is helpful in curing many diseases. Along with diminishing the side effects of osteoporosis, it additionally avoids soreness, increases strength and gets rid of spinal pain. Begin this posture by standing straight with your legs separated by four feet. Then, extend the arms to the ground with the palm facing downwards. Slide the left leg across the right side of your body. You need to slide it behind the left leg. Now extend your right leg towards the left side of your body. This will leave you in a sitting position. Where your right leg is placed on top of your left leg, make sure both your knees are on top of each other. Now straighten your body to an upright position.

Ardha chandrasana: This asana is also called as the half-moon posture. This posture comes under hatha yoga and is beneficial for various medical issues, for example, osteoporosis, menstrual issues, exhaustion, sciatica and stomach-related cramps. You can practice this pose to get rid of osteoporosis and appreciate a sound body.

Padangusthasana: This stance delicately stretches and strengthens persistently tight hamstrings.

Adho mukha svanasana: It is one of yoga's most commonly practiced postures. Adho mukha svanasana offers a definitive wholesome, reviving stretch.

Utthita hasta padangustasana: In this pose, keeping up the balance while standing on one foot strengthens your endurance capabilities.

Utthita parsvakonasana: Discover the flexibility in your sides of the body from your heel to your fingertips with an extended side angle pose.

Utthita trikonasana: It is a broadened triangle posture and is important as a standing posture in many styles of yoga.

Ardha chandrasana: Make proper balance with your leg and the lower part of your leg as you look for strength and flexibility into this adjusting posture.

Parivrtta parsvakonasana: This revolved side angle pose, a variation of utthita parsvakonasana requires a considerable measure of adaptability to bend flexibly and balance on the back heel.

Uttanasana: Uttanasana will awaken your hamstrings and will help you to calm your brain.

Urdhva dhanurasana: Urdhva dhanurasana can help in strengthening your arms, legs, abdomen and spine all at once.

Virabhadrasana: Named after a wild warrior, an incarnation of Shiva, this adaptation of a warrior pose increases the stamina.

Yoga is one of the most secure measures and medicines for osteoporosis. It is something that anyone of any age can do at any place. The advantages are numerous and dangers are few if done properly.

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How To Improve Bone Health And Prevent Osteoporosis?

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Bones are similar to a porous framework which is filled with minerals that make it hard and strong. With age, there is gradual degradation and the mineralized portion is lost, thereby leading to thinning of the bone. The word osteoporosis literally translates to porous bones, which is due to the gradual demineralisation. In addition to the natural ageing process, there are other diseases that can accelerate the demineralization process.

Women are more prone to demineralisation, and after the age of 40, they should take extra precaution to slow down the onset of the condition. The following are some ways to improve bone health and halt osteoporosis in the long run-

Diet: Ensure that your diet has sufficient amounts of vitamin D and calcium. Though calcium is the essential mineral for bone formation, vitamin D is required for the absorption of calcium, and therefore both these elements play a vital role in maintaining the quality of the bones in our body. Most people require about 1,000 mg of calcium and about 500 units of vitamin D for optimal bone health. This requirement goes up slightly in postmenopausal women.

Sun Exposure: In most people, exposure to the sun allows the body to make vitamin D, but careful sun protection prevents this from happening. Also, with age, the body’s ability to form intrinsic vitamin D also declines. The body, therefore, relies on supplements. Most dairy products are good sources of calcium. In addition, spinach, salmon, turnips, and broccoli are some calcium-rich foods. Supplements of calcium carbonate or calcium citrate can be taken if your diet is lacking in calcium. Vitamin D also should be included in the supplementation. The treatment for osteoporosis is incomplete without these two supplements.

Exercise With Weights: The constructive tension that exercise puts on the body helps in bone building, whatever the age may be, which prevents the onset of osteoporosis. Any exercise which improves muscle mass strengthens the bones, and puts stress on the bones is advisable. Since the fractured area due to osteoporosis mainly includes the spine, lower back exercises, yoga, tai chi, and abdominal exercises all work wonders. Pick any of these and do them for 30 minutes three times a week.

Quit Smoking: Continuing to smoke while taking osteoporosis medications is completely useless. Nicotine negates all the effects which defeat the purpose of taking the medication and is as good as taking no medication at all. So if you want the bone thinning to stop, stop smoking.

Alcohol Consumption: While a drink or two per week is permissible, more than this can harm the bones significantly.

Constant Health Watch: Talk to your doctor about how other routine medications (if any) can affect your bone health. Also, identify how frequently you should check your bone mineral density and stick to the schedule.

Dr. Nitin Desai
Dr. Nitin Desai
BAMS, Ayurveda Panchakarma, 22 yrs, Pune
Dr. Pramod Bharambe
Dr. Pramod Bharambe
DHMS, Family Physician Homeopath, 30 yrs, Pune
Dr. Yogesh  Gangurde
Dr. Yogesh Gangurde
BHMS, Family Physician, 10 yrs, Pune
Dr. Snehal Deshmukh
Dr. Snehal Deshmukh
BDS, Dentist, 3 yrs, Pune
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