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Osteoporosis - Details

osteoporose1 The adult skeleton is characterised by the dynamic equilibrium between bone degradation by continual so0called osteoclasts, and bone formation by so-called osteoblasts. If the bone degradation dominates, this can lead to osteoporosis.

The bones of an adult skeleton consist of a highly dense compact cortical zone surrounding a porous sponge-like scaffold-structured bone area.

Osteoporosis is a disease, in which the bone substance, bone density and the microstructure of the bone tissue are disturbed, leading to increased bone fragility. The highest fine density is reached about 10 years after the completion of growth and then decreases again between the fortieth and fiftieth year, to be reduced approximately by half by the eightieth birthday. The maximum bone density is lower in women than in men and lower in white people than in black people. An accelerated bone loss occurs in women of all ethnic groups over a period of about 10 years with the menopause.

There are different types of osteoporosis, such as the post-climacteric osteoporoses, senile osteoporosis, osteoporosis through cortisone treatment, but also the local osteoporosis from the preservation of a body part.

In the postmenopausal osteoporosis, a particular reduction in the proportion of spongy bone occurs after the menopause, so that parts of the skeleton are affected, such as the vertebral bodies, which have a high proportion of spongy bone and therefore tend to fracture.

osteoporose2

The senile osteoporosis occurs in men and women around the seventieth birthday. At this point, both spongy bone regions and the dense cortical zones are affected, so that even compact structured bone regions such as the femoral neck can easily break: the femoral neck fracture is one of the most serious complications of osteoporosis and attracts not only a significant impairment of quality of life, but is also associated with a high mortality rate.

To successfully prevent such complications, it is necessary to diagnose a decrease in bone density as early as possible.

In our practice, we offer patients affected by certain risk factors (peripheral fracture after inadequate trauma after the menopause, radiologically secure osteoporotic vertebral fracture, body mass index < 20 or unintentional weight loss of more than 10% in recent years, high risk of falling at home - with at least two falls in the last six months, high risk of secondary osteoporosis - after long-term use of cortisone) a harmless radiation screening using ultrasound measurement on the heel.

Should this result in a borderline or low bone density value; a measurement in connection with dual X-Ray absorptiometry (DXA) is performed.

osteoporose3 If there is a slightly reduced bone mass (osteopenia), a treatment will be initiated with exercise, additional administration of calcium and vitamin D3 and other dietary measures: The mineral calcium is responsible for the strength of our bones, the daily demand is 1000mg (1500 mg after menopause).

The most important sources of calcium are milk and dairy products like yogurt, buttermilk or cheese. However, green vegetables like kale, fennel, broccoli and leeks are also considered rich in calcium. One should look for the calcium values when buying mineral water. Vitamin C and lactose stimulate calcium absorption in the body, as well as vitamin D3, which is abundant in fish (salt water fish are preferred to fresh water fish). In human skin, vital D3 is formed in sunlight, so it is recommended to spend enough time outside.

Training and exercise should always be practiced, as this will stimulate the bone structure.

In the presence of osteoporosis, a drug therapy with a once-weekly administration of bisphosphonate (e.g. Fosamax, Fosavance, Alendronate) will be initiated for the health of the bones. Here, we focus on the guidelines of the World Health Organisation (WHO).

From a socio-economic perspective, the osteoporosis puts an increasing burden on our health care system and must be considered as a very important health-economic factor.

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