Osteoporosis is a disorder of bone where reduced Bone Mineral Density makes the bones fragile

Osteoporosis is a silent disease that causes thinning and weakening of bones

There is decrease in Bone Mineral Density making the bones weak and brittle

Risk Factors of Osteoporosis

• AGE  and SEX – as age advances chances of osteoporosis increases, Bone Mineral density reached its peak at around 30 yrs of age. Then after certain years it gradually starts depleting due to depleting levels of Growth hormone and later more pronounced after 48 in women and after 60 in men, its attributed to depletion of oestrogen in females and depletion of testosterone in males. its more common and severe in females as oestrogen depletion in females affects more compared to effect of testosterone depletion in males.
• Genetics and Familial Predesposition
• Habitat  – in region or lifestyle with lesser exposure to sunlight.
• Vitamin D deficiency
• Parathyroid Dysfunctions
• Thyroid Dysfunctions
• Kidney diseases
• Diabetes Mellitus
• Acromegaly
• Certain rheumatological conditions
• Parkinson’s Disease
• Sedentary lifestyle lack of exercise and physical activity
• Excessive tobacco smoking
• High Protein diet
• High intake of phosphoric acid, usually its through areated soft drinks
• Prolonged increased exposure to Cadmium.
• Malabsorption and Malnutrition

Pathophysiology of Osteoporosis

(this part is under construction)

Bone constitutes major portion of Human Skeleton

There Are Over 206 bones in skeleton primarily it consists 270 bones at birth later they fuse together during development

Bones Differs in various size shapes and structures

Bones not only performs the functions of protection protection and support to the body but also helps in storage of minerals lipids and nutritients

Tissue that constitute bone are of two types that gives strength and rigidity to bones viz:

1. Cortical bone – Cortical Bone forms the outer layer of most of the bones. It is stiffest and hardest. It helps in supporting and protecting the soft tissues of body and gives shape to the body. It Consists of Osteons that in turn consists of Haversion Canal that allows the blood vessels and nerves to travel through them.
2. Cancellous Bone – It occur at the end of the Long Bones. It is less stiff and weaker compered to the Cortical Bone. They Consists of Red Bone Marrow that produce Blood Cells

The Bone tissue exibits following type of cells:

• Osteoblast
• Osteoclast
• Osteocyte

They help in Synthesization, Bone Resorption as well as Maintainence and repair of bones

Osteoporosis most commonly occurs due to the imbalance in bone resorption and bone formation and insufficient mass

Low Bone Density occurs when osteoclast degrads bone matrix faster than osteoblasts.

Role of Parathyroid Gland in Calcium Metabolism and Osteoporosis

•Hyperparathyroidism-Hyperparathyroidism can be defined as a condition when one or more of the parathyroid glands become hyperactivie and increases in size.
This leads to increased PTH levels in blood
Parathyroid Hormone Vitamin D and Calcium Metabolism –
•Parathyroid hormone is secreted by parathyroid glands.
•PTH along with vit D helps in regulation of calcium level in human body.
•PTH is secreted through negative feedback mechanism of the body when the serum calcium levels are decreased.
•Vit D regulates intestinal absorption of calcium.
•Calcitrol the active form of vit D regulates calcium metabolism.
•Vit D3 is produced from 7-dehydrocholestrol when the skin is exposed to Ultraviolet rays
•Vit D3(Cholecalciferol) is then carried to liver via blood where it undergoes two hydroxylation process.
•First it goes under hydroxylation in liver forming Calcidol 25(OH) and then in kidneys forming Calcidol(1,25 dihyrdroxy vit D).
•The decreased serum calcium level stimulates PTH secretion.
•As Bones are the major store house of calcium,the secreted PTH corrects calcium level by mobilizing calcium from bone through destruction of bones by osteoclasts.
•This leads to osteoporosis where there is weakening of bone decreasing it’s density.

Signs and Symptoms of Osteoporosis

• Osteoporosis itself may stay silent and show no symptom untill bone becomes weak and break down.
• Acute and chronic pain in bones and muscles.
• May precipitate or trigger osteoarthritis
• Deformities and anomalies to carry out normal daily activities.
• Stooped posture, loss of height, collapse (loss of consciousness).
• Fractures are most dangerous aspect of osteoporosis. Fractures most commonly occurs in spine, hip, rib, shoulder, wrist.

Diagnosis of Osteoporosis

The normal Bone Density is within +/-1 SD(+1 or-1)(Standard Deviation) in young adults.

The Score Between -1 and -2.5 is indication of low bone mass.

The score of -2.5 or lower indicates osteoporosis.

• X rays to an extent helps in detecting reduced Bone Mass also in detecting the complications of osteoporosis like fractures.
• CT Scan and MRI helps in detecting complications of reduced bone mass, preosteoporosis or follow up examination.
• Dual Energy X ray Absorptiometry(DEXA) is mostly used for evaluating Bone Mineral Density and its grading for diagnosis of Osteoporosis.
• Quantitave Ultrasound is a non-invasive method of estimating bone density and risk of bone fracture.
• Certain Biomarkers are also useful in detecting bone degradation.

Homoeopathic Medicines for Osteoporosis

• CALCAREA PHOSPHORICA 

  It affects the nutrition of bones and glands indicated in it Homoeopathic form when bones becomes soft brittle and thin, promotes ossification of bones in non union of fractures, pain and burning along the sutures, shifting pain, malassimilation.

• CALCAREA CARBONICA

  Improper assimilation of calcium gives rise to defective nutrition of bones glands and skin. Swelling of the joints especially knee weakness and trembling of limbs.

• SYMPHYTUM OFFICINALE 

  injuries to cartilage, periosteum, comminuted fractures, non union of fractures, deficient callus, arthralgia of knees, carries of vertebrae.

• RUTA GRAVEOLENS 

  Sore tendons, injured or bruised bones, formation of deposit or nodes in periosteum and tendons, ill effects of bruise, fractured bones, brittle paralytic rigidity of injured or affected part.

• FLOURICUM ACIDUM

  This remedy should be thought of when osteoporosis secondary to some chronic metabolic digestive or autommune condition or post chronic debilitating deep seated  infections  produces slow deeply destructive effects carries of long bones ulceration varicose veins bedsores calcareous degeneration tissues are puffy indurated and fistulus.

• Ammonium Muriaticum 

  A good remedy to combat secondary effects and complications of osteoporosis especially those due to nerve compression due to degenerative changes of spine as a complication of osteoporosis. Patient has tension and tightness as if muscles or tendons are too short neuralgic pain in stumpsof amputed limbs sciatica pain in heels.

 

VITAMIN D DEFICIENCY HYPOVITAMINOSIS D