Osteoporosis

Osteoporosis is a disorder in which the bones gradually become thinner and weaker until they get to the point where they break easily.  The skeletal disease of bone thinning and compromised bone strength, osteoporosis, continues to be a major public health issue as the population ages.osteoporosis

This disease is characterized by bone fragility and an increased susceptibility to fractures, especially of the spine and hip, although any bone can be affected.

Risk for osteoporosis has been reported in people of all ethnic backgrounds. An additional 34 million have reduced bone mass, called osteopenia, which puts them at higher risk for fractures later in life. The risk of fracture from osteoporosis increases with age.

Osteoporosis is greatly underdiagnosed and undertreated in Asia, even in the highest risk patients who have already fractured

India: Expert groups peg the number of osteoporosis patients at approximately 26 million with the numbers projected to increase to 36 million by 2013

Among Indian women aged 30-60 years from low income groups, BMD at all the skeletal sites were much lower than values reported from developed countries with a high prevalence of osteopenia (52%) Osteoporosis (29%) thought to be due to inadequate nutrition

Management:

Most of the conventional calcium supplements provide only Calcium and vitamin D.

But they are not able to provide other important nutrition like – EPA, DHA, folic acid, methylcobalamin and boron.

Conventional calcium supplements in many cases may not provide required nutrition for bones and may lead to osteoporosis.

Osteoarthritis

Sometimes called degenerative joint disease or degenerative arthritis, osteoarthritis (OA) is the most common chronic condition of the joints.

OA can affect any joint, but it occurs most often in knees, hips, lower back and neck, small joints of the fingers and the bases of the thumb and big toe.

In normal joints, a firm, rubbery material called cartilage covers the end of each bone. Cartilage provides a smooth, gliding surface for joint motion and acts as a cushion between the bones.  In OA, the cartilage breaks down, causing pain, swelling and problems moving the joint. As OA worsens over time, bones may break down and develop growths called spurs. Bits of bone or cartilage may chip off and float around in the joint. In the body, an inflammatory process occurs and cytokines (proteins) and enzymes develop that further damage the cartilage. In the final stages of OA, the cartilage wears away and bone rubs against bone leading to joint damage and more pain

Risk factors

Although OA occurs in people of all ages, osteoarthritis is most common in people older than 65. Common risk factors include increasing age, obesity, previous joint injury, overuse of the joint, weak thigh muscles, and genes.

Symptoms

Symptoms of osteoarthritis vary, depending on which joints are affected and how severely they are affected. These symptoms tend to build over time rather than show up suddenly. Some of the common symptoms include:

  • Sore or stiff joints – particularly the hips, knees, and lower back – after inactivity or overuse.
  • Limited range of motion or stiffness that goes away after movement
  • Clicking or cracking sound when a joint bends
  • Mild swelling around a joint
  • Pain that is worse after activity or toward the end of the day

Management

Osteoarthritis is a chronic (long-term) disease. There is no cure, but treatments are available to manage symptoms. Long-term management of the disease will include several factors:

  • Managing symptoms, such as pain, stiffness and swelling
  • Improving joint mobility and flexibility
  • Maintaining a healthy weight
  • Getting enough of exercise

Physical Activity: One of the most beneficial ways to manage OA is to get moving. While it may be hard to think of exercise when the joints hurt, moving is considered an important part of the treatment plan.

Pain and Anti-inflammatory Medications

  • These are pain relievers
  • Nonsteroidal anti-inflammatory drugs (NSAIDs). These are the most commonly used drugs to ease inflammation and related pain.

Natural and Alternative Therapies: Many people with OA use natural or alternative therapies to address symptoms and improve their overall well-being. These include nutritional supplements, acupuncture or acupressure, massage, relaxation techniques and hydrotherapy, among others.

Surgery: Joint surgery can repair or replace severely damaged joints, especially hips or knees. A doctor will refer an eligible patient to an orthopaedic surgeon to perform the procedure.

Vitamin D3 and Deficiency

Vitamin D3

Vitamin D is a fat-soluble vitamin that is naturally present in very few foods, added to others, and available as a dietary supplement.

It is also produced endogenously when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis.

Classical Functions

Mobilizes Ca from bones thereby initiating bone remodeling process at the same time promotes CaPo4 into rachitic and osteoporotic bones.Regulation of calcium homeostasis and bone mineralization.

Helps to regulate immune system.

Regulates cell differentiation and cell proliferation

Vitamin D deficiency is pandemic, yet it is the most under-diagnosed and under-treated nutritional deficiency in the world

 

Status Level of Vitamin D
Deficiency < 20 ng/ml
Insufficiency 20 – 29 ng/ml
Sufficiency ≥ 30 ng/ml
Desirable and Safe 30 – 100 ng/ml

Defining Vitamin D insufficiency/deficiency: 25-hydroxyvitamin D (25-OHD) levels—the best measure of vitamin D status in humans

VDD Burden

  • Diabetic patients – >80 %
  • PCOS – 67- 85%
  • Higher at risk for CVDs – 62 times
  • Increased risk of Anaemia – 64%
  • Pregnant women – 94%
  • Reduction in clinical pregnancy during IVF- by 20 %

Management:

Good exposure to Sunlight

Vitamin D3 Supplementations

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