Osteoporosis
Osteopenia
It is diagnosed if T-score is between –1 and –2.5
Management
Start Caltrate 1 tab daily
Advice regarding falls prevention
Involve Occupational therapist
Osteoporosis
Non-modifiable Risk factors
Female sex
Age
Asian or Caucasian race
Family history of osteoporosis
Late menarche
Early menopauses <45 years
Modifiable risk factors
Smoking
Increased caffeine intake >4 cups/day
Increase alcohol intake > 2 standard drinks/day
Low vitamin D intake
Low calcium intake
Physical inactivity
Medical causes causing osteoporosis
Malabsorption – Coeliac disease
Eating disorder – Anorexia nervosa
Connective tissue disorder – Rheumatoid arthritis
Chronic organ failure – liver, lungs, kidney
Endocrine disorders (Cushing syndrome, diabetes mellitus, thyrotoxicosis, acromegaly, hypogonadism, and hyperparathyroidism )
Medications ( corticosteroids, anti-epileptic drugs, breast cancer hormone therapy, prostate cancer hormone therapy)
Diagnosis
Bone density scan
1 or >1 ———-Normal
–1 to -2.5 ——– Osteopenia
–2.5 or less —— Osteoporosis
Management
Adequate dietary intake of calcium – 1000-1300 mg /day – dairy food, cheese yoghurt
Brisk walking for 30 minutes 4-5 times/ week
Stop smoking
Cut down caffeine to less than 2 cups/day
Alcohol – cut down to less than 2 drinks/day
5-15 minutes of sunlight/day
Keep BMI >18
Falls prevention use of zimmer frame, walking stick, falls assessment, etc
Bisphosphonates – decreases bone absorption
Alendronate
Risedronate
Etidronate
Zoledronic acid
The main side effects are
- Oesophagitis
- Osteonecrosis of the jaw
Raloxifene (Selective estrogen receptor modulator)