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Metabloic Bone Disease and Osteoporosis




Osteoporosis is a disease associated with soft, brittle and week bones which can result in fractures. Osteoporosis is due to high bone turn over with excessive bone resorption than bone formation leading to soft and week bones and fractures. Hip, spine and wrist are the usual sites for fractures in osteoporosis. It affects women more than men. Women after menopause are at higher risk for osteoporosis. Risk factors for osteoporosis include Female gender, Thin built (weight less than 127 pounds[58 Kg] ), Caucasian race, older age, smoking, Alcohol intake (more than 3 servings per day), use of steroids, family history of hip fracture, Previous fragility fracture (fracture after fall from standing height), hypogonadism and rheumatoid arthritis.

Osteoporosis can be prevented by adequate calcium and vitamin D intake and healthy living with exercise. Osteoporosis is a silent disease until it manifests by fracture. These fractures can be prevented by screening for osteoporosis with DXA scan. All women above age of 65 years old and most men over 70 years old should get an assessment of bone health by DXA scan. Furthermore men or women above age of 50 years with 2 or more risk factors for osteoporosis (soft bones) should get DXA scan to assess strength of bones. Treatment of osteoporosis includes work up for any reversible cause; modify risk factors for fall and fracture, adequate calcium and vitamin D supplementation along with pharmacologic agents. There are various pharmacologic agents available. Pharmacologic agents who slow down bone resoption include bisphosphonates (once weekly or once monthly oral pills, once every 3 months bonivia injections or once an year intravenous Reclast injection), evista (once daily pills) and prolia (Subcutaneous injections given once every 6 months ). Forteo is the only bone forming agent available, which is given once daily subcutaneous injection, for maximum of 2 years to enhance bone formation in sever osteoporosis.

Below you will find few links for patient education handouts and resources developed by national Societies in the field of osteoporosis and metabolic bone disease.

Patient education tool for exercise for bone health

Patient education tool for balance improvement

Patient education tool for fall prevention

Patient education tool for bone health in breast cancer

Patient Education tool for bone health in prostate cancer

Patient education tool for Paget's disease