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It is said that as many as 8 out of 10 women in their 50s and older in Korea have osteopenia and osteoporosis. The problem is that not only are the signs of osteoporosis hard to notice, but 9 out of 10 people go untreated because of the perception that bone weakness is normal with age.
If you don't take good care of your bone health, it's hard to live a happy and independent old age. As we age, we expect the aging process to progress gradually, but when our bones become weaker, our physical condition can change rapidly.
In addition, fractures caused by osteoporosis can lead to death beyond just broken bones. In fact, according to statistics in Korea, 3~4 out of 10 femur fracture patients died within 1 year. The fracture itself can be surgical. However, if you suffer a fracture and become weak and bedridden, you will be exposed to aspiration pneumonia or blood clots. When a clump of blood goes to the head or heart, it's a very scary situation.
Let's find out the definitions of osteopenia and osteoporosis. The absolute symptom of osteoporosis is, first of all, a fracture. But if it's only a fracture, you can't take action until it's broken. Therefore, a census was taken to define the criteria for osteoporosis. We take the average bone density of healthy young people between the ages of 20~29 or 20~39, and then those who measure below -2.5 based on the mean value are more likely to break bones. Because this criterion is relative, different mean scores on different machines can result in different bone density scores for the same person.
Osteopenia is a value between -1.0~-2.5, which is between osteoporosis and normal, and it can be considered as a pre-osteoporosis stage.
Women go through menopause around the age of 50. During menopause, female hormones decrease drastically. The problem is that female hormones also work to protect the bones. As this protector disappears, the bone left behind is more susceptible to osteoporosis.
Young premenopausal women are also at risk. Muscle mass and bone density are generally closely related, and when comparing men and women of the same size, men have stronger bones. It's partly due to the influence of male hormones, but it's also because the muscles are a little bigger. However, women in Korea try to maintain an excessively thin body at a time when their bones are in the prime of denseness, which has a negative effect on their bones.
So, should men really be relieved? Men are much safer because they don't have menopause, but this is no exception because they lose muscle from their 30s. In fact, according to Korean statistics, 1 out of every 10 men suffer from osteopenia and osteoporosis.
Cancer has a significant negative effect on the bones. Not only are cancer medications bad for bone health, but cancer itself loves bones. The bone marrow contains so many nutrients that the longer you have cancer, the worse it will be on your bones. In particular, patients with breast or uterine cancer should be more careful because female hormones decrease during the treatment process.
Osteoporosis caused by cancer treatment is almost identical in treatment to regular osteoporosis. However, if you take care of it from the beginning of treatment, you can more easily prevent bone loss.
Did I mention that different measurement machines can give different bone density scores? Let's imagine that among bone densitometry machine companies, Company A used young adults aged 20~29 as the standard, while Company B used young adults aged 20~39 as the standard. The reference points for the two machines may be slightly different.
In general, the measuring machines used in large hospitals use the global standard, but the entry-level machines set the standard arbitrarily, so there may be differences in the numbers. Therefore, if it is too low, it is recommended to use a large hospital, and when measuring changes in bone density, it is recommended to use the same machine in the same hospital for follow-up examination.
Basically, it is recommended to have a bone density test around the age of 50. If there are other reasons, such as a fracture signal or receiving anti-inflammatory treatment, it is okay to receive it.
Osteoporosis testing is done through x-rays. However, the resolution is not that high, so the amount of radiation is much lower than that of a regular X-ray examination. To use an analogy, it's about the amount of injections that take a plane to and from the United States. It is safe for the human body even if you take the test. However, in Korea, it is an official salary once a year, so you do not need to receive it more often than that unless your bone density has dropped drastically due to steroid treatment.
Among bone density tests, CT scans are tests that increase the amount of X-rays and allow them to penetrate. This is not a common method because it is only taken in certain cases.
The cortical bones that surround our vertebrae gradually thicken as we age. So, when there is a vascular calcification in front of the spine, the bone density is higher than the true value because it is mistaken for a mineral when the X-rays are passed. At this time, a CT scan can be used to measure the cavernous bone specifically, but the standard is different from that of a general examination because the value is much lower.
Patients with osteopenia who are younger are often prescribed calcium supplements or vitamin D.
Some people are concerned about calcium calcification when they take calcium supplements. It is true that excessive calcium intake can promote calcification. By the way, this data is based on Western countries with a high daily intake of dairy products, and calcium preparations are helpful for people in our country whose average calcium intake does not exceed 0.5 grams per day. Therefore, calcium supplementation seems to need to be understood depending on whether I am a person who is usually calcium deficient or not.
The same goes for vitamin D. Vitamin D is a fat-soluble vitamin that accumulates in fat cells for a long time. In Korea, there are four distinct seasons, and foods high in vitamin D are limited, so the average intake is not that high, so there is no need to worry too much. Vitamin D supplementation of 400~600IU is not a major problem, and people with osteoporosis or osteopenia usually take a dose of about 1,000IU. Here, when the preparation of 2,000~5,000IU is insufficient, you can adjust the dose according to your condition, such as taking it for a month or two.
Foods high in caffeine and salt are bad for bone health. Caffeine and salt have a diuretic effect, and when they pass through the urine, they can drag calcium with them. Contrary to popular belief, bone broth is one of the foods that is not good for bone health. Not only is it high in calories, but the phosphoric acid dissolved in bone broth eats up calcium, which likewise causes bone porridge.
Foods that are good for bone health include dairy products and greenish-yellow vegetables. However, green and yellow vegetables require a significant amount of calcium intake, so dairy products are more efficient. Foods such as cheese, fish, anchovies, and sauteed mushrooms are also good for bone health, but you should consider the increased salinity during the cooking process.
Medications prescribed to treat osteoporosis include bone resorption inhibitors, osteogenesis stimulants, and supplements such as calcium and vitamin D.
Even though bone density is equally high, osteogenesis stimulants and bone resorption inhibitors have different mechanisms of action. Bone resorption inhibitors inhibit the destructive cells that make holes in the bones, and osteogenesis stimulants are drugs that fill the holes in the bones. For this reason, depending on the order in which the medicine is used, the effect may be maximized or a little may be lost. It is recommended to use the most effective drugs first, followed by other drugs sequentially.
Osteoporosis, like diabetes and high blood pressure, requires lifelong treatment. You can have a washout period along the way, but there is no end to the treatment.
Because osteoporosis is a systemic problem, all bones, including teeth, become weaker. However, the speed of progression varies from part to site, and the jaw bone, which usually performs masticatory exercises, tends to weaken relatively slowly. The test measures three places: the spine, the femur, and the wrist bones.
Where fractures are most likely to occur depends on age. Around the age of 45~55 after menopause, people often break their wrist bones while putting their hands on the floor when falling. From the age of 50~65, the spine begins to feel pressure, and at the age of 70~90, the femur and sacrum are often broken while slumping.
Steroids are anti-inflammatory drugs that are used in the medical profession in all disciplines. Steroid injections can have side effects such as diabetes, high blood pressure, and osteoporosis, but they should be taken when necessary. Transplant patients and patients with autoimmune diseases need long-term steroid treatment to sustain their lives. You shouldn't be reluctant to get one or two steroid injections because of a disc or allergic disease. On the contrary, if you are unable to exercise due to a disc, the adverse effect on your bones is greater.
If you have a premature birth, breastfeeding can cause your bones to deteriorate. If you have a late first birth, long-term breastfeeding is not recommended.
There have been cases where osteonecrosis has occurred as a result of combining implant treatment with osteoporosis treatment. Among osteopenic inhibitors, bisphosphonates with a long half-life were left in the jaw bone, and all the metabolism of the bone was suppressed, causing inflammation in the extracted space.
However, this situation does not happen very often. If you're diabetic, on steroid therapy, or if you've been taking bisphosphonates for more than 4 years. There is no problem if you only stop the treatment for about 4 months, two months before and after the implant treatment.
There is no interaction between osteoporosis drugs, thyroid drugs, and hyperlipidemia drugs. However, it is important that thyroid medications are absorbed correctly, so it is not recommended to take them with food or other medicines. You have to take it on an empty stomach before meals. On the other hand, among osteoporosis medications, Dicamax is calcium carbonate, which must be consumed with meals. That's why thyroid medication is taken before meals, and Dicamax is taken separately after meals.
There is no significant difference between hyperlipidemia drugs before and after meals. You can take it with Dicamax.
Basil Plus is a female hormone analogue. Female hormones have benefits against osteoporosis but are associated with the risk of breast cancer, and Basil Plus can act as an anti-hormone to the breasts while providing the same protective action on the bones as female hormones. Due to the low number of side effects, it is considered a good option for women who have had breast cancer or are in the premenopausal period. However, the effect is weak, and there are cases where you should not use it, so you need to be careful.
Basically, osteoporosis is not accompanied by changes in calcium. However, the reason for measuring calcium levels is to diagnose hypercalcemia. In this case, secondary osteoporosis is caused by a problem with the parathyroid gland, and treatment other than the usual osteoporosis treatment should be used.
There is no difference in calcification depending on calcium, but there are differences in absorption and dosage. Among calcium citrate and calcium carbonate, calcium carbonate has a higher calcium content, and calcium carbonate requires stomach acid to be absorbed, so if you have undergone gastrectomy or need to take it on an empty stomach, you should take calcium citrate.
The sound made by the hip joint is not associated with osteoporosis. It's a joint and cartilage problem, so you have to go to an orthopedic surgeon.
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