What is Osteoporosis?
is a condition characterized by substantial bone loss. When the extent of
bone loss reaches a critical point fractures may occur as a result of very
minor stress. Osteoporosis affects the entire skeleton, but fractures
occur most notably in the vertebrae, hips and wrists. The bones become so
weak that normal workloads overcome their capacity. A simple fall can
result in a broken hip. Spinal vertebrae can collapse and in extreme cases
cause a "dowager's hump."
Calcium is the most common mineral in the
human body. About 99% of the calcium in the body is found in bones and
teeth, while the other 1% is found in the blood and soft tissue. Calcium
levels in the blood and fluid surrounding the cells (extracellular fluid)
must be maintained within a very narrow concentration range for normal
physiological functioning. The physiological functions of calcium are so
vital to survival that the body will demineralize bone to maintain normal
blood calcium levels when calcium intake is inadequate. Thus, adequate
dietary calcium is a critical factor in maintaining a healthy skeleton.
Vitamin D is a fat-soluble vitamin that
exists in many forms. The form utilized primarily by humans is vitamin D3
(cholecalciferol). Animals (including humans) can convert cholesterol to
7-dehydrocholesterol, which is a precursor of vitamin D3.
Exposure to the ultraviolet light in sunlight (UVB radiation) converts
7-dehydrocholesterol in the skin to vitamin D3. In fact, adequate
exposure to sunlight can eliminate the requirement for vitamin D in the
diet, making it only "conditionally essential." Vitamin D3
is not itself biologically active, but must be modified by the body to have
any physiologic effects.
Risk factors for vitamin D deficiency
Infants who have
little or no sun exposure, and do not consume vitamin D-fortified formula
are at increased risk, especially those born just before winter in
northern or southern latitudes.
Elderly individuals with minimal sun exposure:
elderly have reduced capacity to synthesize vitamin D in response to
sunlight exposure, and are more likely to stay indoors or use sunscreen
for the prevention of skin cancer.
Dark skin: Those of African
or Indian descent with darkly pigmented skin living in northern or
southern latitudes synthesize less vitamin D on exposure to sunlight than
those with light skin .
Covering all exposed skin when outside:
Osteomalacia has been documented in Arab women who cover all of their skin
at all times when going outside, for religious or cultural reasons.
Fat malabsorption syndromes:
Cystic fibrosis and cholestatic liver disease impair the absorption of
dietary vitamin D.
Inflammatory bowel disease:
inflammatory bowel disease such as Crohn's disease appear to be at
increased risk of vitamin D deficiency, especially those who have had part
of the smal intestine removed (small bowel resection).
Kidney failure: Severe kidney disease can impair
the conversion of calcidiol to the biologically active form of vitamin D,
Genetic disease: A rare genetic disease affects
the activity of the 1-hydroxylase enzyme in the kidneys that converts
calcidiol to its active form, calcitriol.
Seizure disorders (epilepsy):
with anticonvulsant medications, such as phenytoin, can affect hepatic
(liver) metabolism of vitamin D
Calcium 600 + Vitamin D
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