Is it true that people in North Dakota are more likely to develop osteoporosis?

Osteoporosis weakens bones and increases the risk of broken bones. People in northern climates not just North Dakota have higher incidences of osteoporosis.

The theory is that people living in these climates have vitamin D deficiency because the majority of vitamin D levels in our bodies comes from skin exposure to sufficient sunlight. Long winters with restricted sunlight inhibit our ability to absorb vitamin D, which plays a major role in bone strength and growth. Eating a healthy diet that includes plenty of foods containing vitamin D and staying physically active can do a lot to prevent development of osteoporosis.

Who is most likely to develop osteoporosis?

Almost 80 percent of bone density is determined by heredity and 20 percent by lifestyle so anyone who has a family member with osteoporosis is at higher risk. It occurs most frequently in postmenopausal women because estrogen, which blocks or slows bone loss, diminishes during menopause.

While osteoporosis is often thought of as a womans disease, 25 percent of men over 50 also will be diagnosed. Others at greater risk include individuals with chronic gastrointestinal and thyroid diseases, eating disorders, transplants, and users of certain long-term prescription medications. If you smoke, abuse alcohol, live a sedentary lifestyle and/or consume a diet low in nutrition and vitamin D, your chances of developing osteoporosis also increase.

How would I know if I have osteoporosis?

Many people are never diagnosed until they break a bone because osteoporosis is a silent disease. If you are a woman 65 or older or a man 70 or older, your primary care doctor will likely recommend a bone mineral density test. A BMD is a safe, painless X-ray that measures the density of your bones.

Your primary care doctor also may recommend a BMD at a younger age if you have risk factors or have already had a broken bone.

Why is it important to have a BMD?

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Questions and answers about osteoporosis

Dr. ZORBA PASTER | family physician, Dean Health madison.com | | Posted: Wednesday, March 21, 2012 7:00 am

A friend of mine from New York recently called and asked about screening for osteoporosis. She’s 70, jogs five times a week, goes to the gym regularly, and dances on weekends. She’s at a normal weight and has never smoked. She eats yogurt, some cheese, and every day takes a calcium tablet with Vitamin D.

She’s no slouch she exercises right and eats well. And she has no family history of osteoporosis. Her mom is 95 and still going strong. When she was 65, her doctor correctly recommended a screening densitometry exam, an X-ray-like test to see how strong your bones are.

Hers was slightly low, the medical term for this is mild osteopenia. She was not happy. She’s doing everything she can to stay well, yet her bones weren’t perfect (and she’s a perfectionist).

It’s now five years after the first test and her doctor wants her to repeat it to see if she’s sliding into the more serious problem of osteoporosis. She’s a stickler when it comes to unnecessary tests, especially when it comes to X-rays. She asked me what to do.

Most of you know that osteoporosis is a “softening” of the bones. Less calcium in your bones means you’re more likely to break one. When this occurs in the spine you have that “bent over” look. When it occurs in the hip it means surgery. And for too many, these breaks mean a lifetime of pain and disability.

Now back to my friend’s question. She had mild osteopenia, which we could relabel as “pre-osteoporosis.” Osteopenia carries a minimal risk of fractures, but osteoporosis ups your chances tremendously. A recent study from the New England Journal of Medicine addressed this.

Researchers took 5,000 women 65 and older and looked at their bone density. Those with a normal bone density or osteopenia were followed for 15 years looking to see who progressed to osteoporosis. Why was this important? Because women with osteoporosis should be offered medications that may help strengthen their bones. And because smart testing, in medicine, means knowing how often to retest.

The trial, which went on for 15 years, found that women with normal bone density had less than a 10 percent chance of developing osteoporosis. That’s reassuring. It means that if the bone density test you get at 65, when it’s recommended, is normal, your risk of developing osteoporosis is really small.

What about the osteopenia group? If it was minimal osteopenia, then they had the same risk as the normal group their risk of going on to osteoporosis was minimal. But if they were in the moderate to severe osteopenia group, they needed to be tested within a few years. That group was the one that went on to develop osteoporosis.

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Dr. Zorba Paster: When should one get screened for osteoporosis?

Newswise Reducing a patients treatment time and simplifying the treatment can increase patient acceptance and reduce the risk of complications. For dental implants, this means moving away from the traditional two-stage surgical approach toward a one-stage procedure. The success of this concept when combined with another complicationthat of patients receiving drug therapy for osteoporosiswas studied to determine the best method of treatment in this situation.

The current issue of the Journal of Oral Implantology reports on adult patients, all taking oral biphosphonates for osteoporotic disease, who received fixed full-arch dental prostheses supported by six implants. Immediate loading procedures were performed, installing the implants in a one-stage surgery.

Osteoporosis is a well-known disease that weakens bone and increases the risk of fracture, particularly among postmenopausal women. Biphosphonates, an inhibitor of bone resorption, are widely used as a drug therapy for those with osteoporosis. Prolonged used of biphosphonates, however, can lead to a painful refractory bone exposure in the jaws, known as biphosphonate-induced osteonecrosis of the jaw (BONJ).

This condition usually develops after dental treatment, indicating that oral surgery and implants placed into the jaw bone can precipitate BONJ. Although the process is not fully understood, it appears that prolonged use of biphosphonates may suppress the bones repair function, interfering with healing after implants.

In the current study, a total of 54 implants were installed for nine osteoporotic patients, 45 to 68 years old, eight of them female. All had been taking oral biphosphonates for less than three years; a significant increase in risk of developing BONJ is associated with more than three years of biphosphonate therapy.

Immediate occlusal loading procedures were used, which require that motion at the bone-implant interface be kept below a certain threshold during healing. This study demonstrated a 100 percent success rate, with all patients rehabilitated with a full-arch prosthesis supported by implants. Two years of follow-up found no adverse events of infection, tissue swelling, or lesions, showing this to be a viable one-stage treatment.

Full text of the article, Immediate Loading in Mandible Full-Arch: Pilot Study in Patients With Osteoporosis in Biphosphonate Therapy , Journal of Oral Implantology, Vol. 38, No. 1, 2012, is available at http://www.joionline.org/

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About Journal of Oral Implantology The Journal of Oral Implantology is the official publication of the American Academy of Implant Dentistry and of the American Academy of Implant Prosthodontics. It is dedicated to providing valuable information to general dentists, oral surgeons, prosthodontists, periodontists, scientists, clinicians, laboratory owners and technicians, manufacturers, and educators. The JOI distinguishes itself as the first and oldest journal in the world devoted exclusively to implant dentistry. For more information about the journal or society, please visit: http://www.aaid-implant.org/index.html/

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Successful Dental Implants for Patients Taking Biphosphonates for Osteoporosis

Osteoporosis and osteopenia (low bone density) currently affects an estimated 55 percent of the population over the age of 50 in the United States.

As of 2010, it was estimated that more than 52 million Americans were affected by the condition, a statistic that is thought to climb to 61 million people by 2020.

Osteoporosis is a disease characterized by an imbalance in bone turnover. I often liken the physiology of osteoporosis to a bank account that has developed a debt. Over the course of a month, it is normal for there to be movement of cash in and out of your account – you deposit your pay check, but also pay bills. At the end of the month, ideally the balance is positive; however, if you spend more than your income, you can develop a deficit.

This situation is analogous to osteoporosis. Your bones are constantly being broken down and rebuilt; however, in osteoporosis there is an imbalance between building new bone and bone loss resulting in thinner fragile bones that are more vulnerable to fractures.

Key to treating the disease is prevention and identification of high-risk patients before fractures occur. The United States Preventive Services Task Force recommends screening for osteoporosis in all women ages 65 and older with a dual-energy X-ray absorptiometry (DXA scan). Last summer, the task force broadened the recommendations to include screening of high- risk women as early as 50 years of age.

The DXA scan is an X-ray that traditionally looks at the bone density of the wrist, hip and spine, in order to determine bone density.

Preventing osteoporosis Many risk factors for osteoporosis have been studied and well-established. Unfortunately, some of these are out of our control. For instance, having a history of hip fracture in your family puts yourself at an increased risk, as does being white, female or older. Other risk factor can be modified to decrease the likelihood of developing osteoporosis. For more than 20 years, research has demonstrated a strong connection between smoking and ones risk of fractures secondary to thin bones.

The number of cigarettes you smoke is correlated to decreased bone density. Additionally, smokers who develop a fracture, take longer to heal from the injury. Smoking not only affects the bones of the individuals, but research has shown that second-hand smoke during youth and early adulthood may increase the risk of developing osteoporosis later in life. It is possible to reverse the effects of smoking by quitting.

Despite the strong relationship with increasing age and osteoporosis, it should not be considered a normal part of the aging process and there are steps one can take to prevent the disease. The key is to start building your bones while you are young. Bones strength peaks in ones 20s, making it essential to build strong bones while young.

A study published last month in the Journal of Bone and Mineral Research demonstrated that physical activity early in life results in stronger bones. The report followed 833 young Swedish men, aged 19 to 24, for 5 years. The authors investigated the effects of physical activity on bone density, finding a strong relationship between routine exercise and peak bone strength.

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What you need to know about bone health

The word osteoporosis literally means “porous bones.” It is silent disease which causes loss of bone mass over time leading to bone fractures. Osteoporosis is a common bone disease that affects both men and women, usually as they age.

Facts about osteoporosis:

Osteoporosis is diagnosed with a simple test called a bone density test which is done by a dual energy X-ray absorptiometry (DXA) machine that measures bone mineral density (BMD) in different parts of your body, such as your spine or your hips, to determine if you have osteoporosis. The test is quick and painless.

The results are interpreted as follows: A score between 1 and -1 indicates healthy bones, score between -1 and -2.5, indicates osteopenia, score between -2.5 or lower indicates osteoporosis.

The risk of fractures generally is lower in people with osteopenia when compared with those with osteoporosis.

After reviewing the results of your medical history, physical examination, vitamin D levels and bone density test, you and your healthcare provider can develop a plan to help protect your bones.

The most common first step in treatment of osteoporosis is adequate intake of calcium and vitamin D. Current recommendations from the National Osteoporosis Foundation are as follows: adults under age 50 need a total of 1,000 milligrams of calcium from all sources and 400 to 800 international units (IU) of vitamin D every day. Adults age 50 and older need at total of 1,200 milligrams of calcium from all sources and 800 to 1,000 IU of vitamin D every day.

A number of medications are also used for the prevention and treatment of osteoporosis. Alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva) and zoledronic acid (Reclast) are all FDA”‘approved for the prevention and treatment of osteoporosis in postmenopausal women. Alendronate, risedronate, and zoledronic acid are also approved for the treatment of osteoporosis in men and for the prevention and treatment of glucocorticoid-induced osteoporosis in both men and women. These medications help to slow down bone loss and have been shown to decrease the risk of fractures.

You can play your part in reducing your risk of osteoporosis.

Dr. Mazhar Jakhro specializes in family medicine. Board certified, Dr. Jakhro is in practice at Southcoast Primary Care in Dartmouth. He is accepting new patients and can be reached at 508-995-6381.

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Dr. Mazhar Jakhro: A look at osteoporosis

THURSDAY, Feb. 16 (HealthDay News) — Although a growing number of Americans now struggle with heart failure, experts say new treatments have dramatically improved both quality of life and life expectancy for these patients.

“The present environment for heart failure is substantially improved, and the future holds promises that will truly remove the term 'failure' from the description of this illness,” said Dr. Gregg Fonarow, director of the Ahmanson-UCLA Cardiomyopathy Center in Los Angeles and co-director of the Preventive Cardiology Program at UCLA's David Geffen School of Medicine.

Dr. Clyde Yancy, past president of the American Heart Association and chief of cardiology at Northwestern Memorial Hospital in Chicago, seconded that notion, pointing to what he sees as “the edge of a new dawn” in which advances in treatment will enable clinicians to “take the heft, the drama and the 'failure' out of heart failure.”

To raise public awareness, the American Heart Association has deemed this week National Heart Failure Awareness Week.

A little understood medical condition, the symptoms of heart failure include extreme fatigue, weakness and/or shortness of breath, as years of poor nutrition, inactivity, high blood pressure, high cholesterol, excessive weight and related health complications, such as diabetes, take a cumulative toll on an ever-weakening heart.

In turn, the heart muscle strains, and ultimately fails, to carry out its continuous duty of pumping blood (and the oxygen it carries) throughout the body. This makes everyday acts such as walking or climbing stairs a major effort for patients. Heart failure is now estimated to affect 6 million men and women in the United States.

“Anybody in the population over the age of 40 has a 20 percent chance of developing heart failure, regardless of your medical history,” Yancy said. “Which means, in short, that all of us are at risk. And of course those with a history of heart disease have an even higher risk.”

However, Yancy noted, “just a few years ago we had nothing we could say that was particularly encouraging. It wasn't a disease for which there was much hope or optimism. But that has totally turned around now.”

Why?

Fonarow credits the shift to a decade of drug and medical device innovation. On the one hand, there is the advent of whole new classes of medications — such as ACE inhibitors, beta blockers and aldosterone antagonists — that help lower the risk for developing heart failure, while expanding treatment options when it does strike.

And, Yancy added, “We also know that cardiac rehabilitation — namely an exercise regimen — can also help. Years ago, we told patients to just take it easy. But, now we know that an active vigorous lifestyle is actually a better way to go.”

At the same time, Fonarow pointed to the rise of small, affordable and effective implantable electrical devices that have helped physicians better control the sort of electrical disturbances of the heart that can harm normal function.

“Even for the patient with far advanced disease, the utility of mechanical support — artificial heart pumping devices — has become remarkable,” Fonarow noted. “We can sustain patients for a time sufficiently long enough to not only allow for heart transplantation, but also to serve as definitive therapy and, even more provocatively, to support recovery of heart muscle function.”

The result: over the past decade heart failure hospitalizations have actually declined, while the risk of death has plummeted 65 percent to 80 percent, Fonarow said. “What was once a dismal and depressing diagnosis, with an over 50 percent five-year mortality rate, is now a clinical scenario for which optimism and new hope emerges.”

The future of heart failure treatment looks even brighter, said Yancy, given developments now under way that revolve around protein, gene and stem cell transplantation therapies designed to help patients recover more fully after a heart attack.

“It is a reality that will take some more time to be fully realized,” Yancy noted. “But it is assuredly coming down the road.”

That said, he admits that the status quo is not entirely rosy, given that U.S. hospitals now see roughly 500,000 new heart failure patients come through their doors each year.

The key to lowering that number: helping the public connect the dots between an unhealthy lifestyle and harm to the heart.

“For many people, heart failure is a fuzzy disease,” Yancy noted. “People commonly think about their risk for a dramatic event, like a heart attack. But heart failure needs to be on everyone's consciousness because it develops quietly over time, as the heart gets weighed down by burdens such as obesity, diabetes and smoking,” he explained.

“So, it's important to galvanize the public so that everyone knows that heart failure can be treated, but also prevented,” Yancy said. “Because even though we can't cure it, we do know how to handle it. So, we can't approach it as if it's an inevitability. Because it's not.”

More information

For more on a heart-healthy lifestyle, visit the American Heart Association.

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Treatment Advances Improve the Odds for Heart Failure Patients

In the postmenopause years, the risk for osteporosis is greater than ever.

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Osteoporosis in postmenopause

TORONTO – Health Canada is alerting Canadians that a class of drugs used for osteoporosis is linked to a slightly higher risk of a rare but serious thigh bone fracture known as an atypical femur fracture.

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Osteoporosis drugs linked to increase in rare thigh fractures: Health Canada

OTTAWA, ONTARIO– – Health Canada is updating Canadians with respect to its review of bisphosphonate drugs, used to treat osteoporosis, and the risk of a rare but serious type of thigh bone fracture known …

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Bisphosphonate Osteoporosis Drugs (Aclasta, Actonel, Didrocal, Fosamax, Fosavance): Small But Increased Risk of …

phoenixnutritionals.com (CLICK HERE) Those of us in the natural medicine and nutrition fields have been touting the use of natural calcium compounds to not only aid in the prevention of osteoporosis but also as a safe alternative to osteoporosis drugs. We have been warning women of the potential dangers of osteoporosis drugs for several decades.

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Dr Whiting on The Dangers of Osteoporosis Drugs – Video