Under understand osteoporosis decrease in bone mineral density and disruption of its structure.
A bit of anatomy
Bone consists of a protein framework which skillfully woven mineral substance - calcium and phosphorus in the form gidroksiappatita and little magnesium, copper, silicon, fluorine, manganese.
It is a dynamic system that is constantlyupdated due to special cells: osteoclasts destroying old bone, and osteoblasts, synthesizing new. Full upgrade our skeleton is carried out in about 10 years.
Calcium - is a basic element of givinghardness and strength of the bones. Because of this, our skeleton is able to withstand not only the weight of his own body, but also a lot of stress on the tensile deformation, compression, for example, when moving heavy loads or falling. In osteoporosis imbalance between the destruction of old bone and synthesis of new, washed calcium, "support" becomes brittle.
Thus, the main risk of osteoporosis -it fractures that occur without a cause or a minor injury, such as falling from a height less than its growth. The most common fractures in osteoporosis - fracture of the radius in the "typical place" (wrist); hip, especially the femoral neck; vertebrae in the lumbar and thoracic spine. If the fracture of the radius is not so terrible condition, fractures of the spine or hip - lead to the loss of the ability to move independently in the long term, and in old age can be disastrous. they are very difficult to heal.
Who is at risk?
First of all, women after menopause.
On the structure and strength of bone big impactIt has the function of sexual glands, especially in women. Estrogens have a protective, tonic effect on the bone. With a decrease in their number (menopause) there is a progressive loss of minerals and change microarchitectonics skeleton, leading to increased fragility and risk of fractures. Extinction androgen in men function operates similarly, but to a lesser degree.
According to statistics, about 35% of women and 24% of men over age 50 have osteoporosis (called the primary).
The earlier menopause, the soonerIt starts to decrease bone strength. If the operation is the removal of appendages at a young age was carried out due to illness, osteoporosis will be developed with the youth.
The second most common group of reasonsosteoporosis (the so-called secondary) - presence of disease, leading to bone structure of a breach or require serious treatment to certain drugs. Here are some of these states:
- Hypogonadism (hypoplasia and / or reduced function of sexual glands).
- Syndrome and disease Cushing's (excessive production of its own steroid hormones).
- Hyperparathyroidism (increased parathyroid function).
- Connective tissue diseases: rheumatoid arthritis, systemic lupus erythematosus, etc. The disease itself often adversely affects bone strength, and in addition, such patients are often forced to take glucocorticoids, one of the side effects of which is osteoporosis.
- Chronic renal failure.
- Diseases of the blood (lymphomas, leukemia, multiple myeloma) and cytostatic therapy.
Still, most doctors and patientsdeal with the primary, "age" osteoporosis. However, it is developing it not at all. Why does one person have a tendency to fracture and the other will live to a ripe old age "whole"? How to determine whether it is necessary for you to take measures of protection and prevention?
Factors that trigger the development of osteoporosis
In principle, yes, but the changes on the radiographappear rather late when lost 20% of bone mass or more, i.e. for early diagnosis and prevention of this method is not very suitable. On the X-ray visible consequences of osteoporosis: changing the shape of the vertebrae, fractures, strains and fractures themselves.
Thus, to diagnose and monitor osteoporosis treatment efficacy necessary by specific methods.
Is osteoporosis manifests itself clinically, what some symptoms?
Unfortunately, the early symptoms of osteoporosis exist. Basically symptoms appear late when complications arise.
The pain is often accompanied by osteoporosis, it arises when the deformation of the vertebral bodies, reducing their height when the vertebrae and their processes begin poddavlivat nerve roots, and of course, fracture. In this case, so-called characteristicCompression fractures in the vertebra when appears the transverse line breaking under the weight of the weight of it pressed, sags, acquiring a wedge shape. Pain in this case can be quite stubborn. The spinal cord is usually not damaged.
When thus deformed morethe vertebrae, the height is reduced, mitigated the waist, the back becomes round, edges closer to the pelvic bones. In severe cases, forming a hump.
The pain is accompanied by neurological disorders: paresthesia, numbness of the skin, convulsions.
The most serious complication of osteoporosis - fracturehip. The femur along with the spine carries most of the load weight and, in addition, the movement is impossible without it. Older people should try to avoid such an injury, leading to disability.
Treatment and prevention of osteoporosis
First, all people should try to collect at a young age the maximum bone mass, so it was enough for active longevity. For this purpose it is necessary to avoid the risk factors for osteoporosis (see. Above).
However, proper nutrition, rational exercise, a healthy lifestyle are relevant at any age. It is not only preventive measures, but also the key to successful treatment of osteoporosis.
The daily need for calcium is 1000-1500 mg perday. Such an amount of it is contained in about 6 glasses of milk or dairy products (fermented baked milk, kefir), 1.5 kg of cottage cheese, 200 g of hard cheese. Calcium is also found in fish, nuts, cauliflower and sea kale, but it is less difficult to digest and is more difficult to digest from milk than from milk.
Not all people carry the milk in suchquantity or like cottage cheese. Therefore it is necessary to make up a deficiency of this important element of the reception of the drugs, particularly effective combination of calcium and vitamin D (calcium-D3 Nycomed, komplivit calcium-D3).
It should be borne in mind that a loved calcium gluconate very low digestibility, multivitamins are not suitable (the concentration there is too small for the prophylactic and therapeutic effect).
In addition, the treatment of osteoporosis musttaking and other means, directly retard bone destruction and improving its synthesis. Currently, there are quite a lot of the drugs, the different mechanism of action, cost, reception multiplicity. All are sufficiently safe and effective. What medicine is necessary for you, the doctor must decide!
Groups of drugs for the treatment of osteoporosis
- Alendronate (Fosamax, ostalon, osterepar, tevanat, foroza);
- Ibandronate (Bonviva, bondronat);
- risedronate (Actonel);
- zolendrovaya acid (blaztera);
- Strontium renelat (Bivalos).
- Calcitonin: synthetic salmon calcitonin (Miakaltsik, boar).
- Parathyroid hormone (forsteo).
- Denosumab (shed, eksdzhiva).
- Estrogenic substances (hormones do not!), Raloxifene (Evista).
They slow resorption (resorption) bones have lasting effect even after treatment discontinuation.
It increases bone formation and prevents its destruction.
It prevents bone resorption, has a good analgesic effect.
It stimulates bone formation.
It inhibits bone resorption.
In some cases the use of hormone replacement therapy (in young women with early, including surgical, menopause).
In numerous studies at home and abroadIt is shown that antiresorptive therapy significantly increases bone mineral density by 3-12% in different parts of the skeleton, which is accompanied by a decrease in the frequency of fractures by 37-49%. However, in order to achieve such a good result, it is necessary to carefully follow the doctor's recommendations on the dose, frequency, duration of admission. Self-dose reduction, taking every other day, etc. - reduces the effect of the drug to nothing. Our site recommends - tune in to long-term treatment. The result is your vitality, young posture, activity and longevity!