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Monday, August 24, 2009

OSTEOPOROSIS: Metabolic Cause and Effects on Metabolism

Last I wrote about how our bone development takes place and how does bone resorption or calcium loss from bone occur. Today I will explain exact physiology of the Silent Killer due to harm almost all of us regardless of gender, age or community bias.
So we know that the process will take place post 35 years of age when the bone turnover begins i.e. bone - calcium deposition and bone - calcium resorption. We also know that the determining factor in whether the calcium deposition to calcium resorption is high or low will give the final bone density and structure stability. In a normal metabolic state the body will balance this ration of bone turnover; its the imbalance that kicks in the osteoporotic state. How is this imbalance in metablism caused? Lets find out.
For the bone to lose its hard earned calcium over 35 years of its life it better get a valid reason to give it away. Our body is much smarter and better in taking calculated risks than the brightest of us are. If the blood calcium level or serum calcium level falls to an alarming low level the body sends out through the brain a hormonal signal to the 'Parathyroid Gland' situated next to the thyroid gland to release 'Parathyroid Hormone' and the same signal is directed towards the skin to release 1,25 - D Cholecalciferol or Vitamin D after being activated by solar radiation. Parathyroid Hormone (PTH) will act upon the bone calcium deposition and stimulate the bone calcium resorption to release more calcium in the calcium deffecient blood, similarly it will also have effect to stop calcium loss through urine and facilitate calcium reuptake by the kidney. Vit D will have direct impact on calcium absorption from the instestinal tract into the blood to increase the calcium levels in the body. This is actually homeostasis that the body performs when in sudden imbalance or persitent imbalance. If this was just a one time situation the bone turnover wouldn't change majorly but when this occurance becomes habitual to the body the bones face a constant high resorption and low deposition rate leading to very low bone mineral density. The lower the bone mineral density the more porous the bones become as we last learned about the meshwork of protein being left behind making it soft.
Obvious question to the mind is how does this affect the rest of the metabolism? Well, to balance one mineral other minerals are also respectively adjusted or balanced. If there is an imbalance in calcium in the body there is going to be an imbalance in phosphorous too and so is flourine and the other minerals. Calcium is utmost essential for the normal beating of the cardiac muscle which can also go into harm if not balanced. There are other factors that take precedence like oxalic acid which form crystals with calcium. If calcium is low in the body as compared to oxalic acid it can be even reduced by formation of calcium oxalate crystals which may cause kidney stones or even joint dysfunction. Hormonal imbalance due to sudden PTH release or even a constant one changes the body's hormonal metabolism.
Once the bones are porous due to constant resorption, major joint fractures or long bone fractures are most likely to disable the person onto a bed forever causing lifestyle changing occurance. Imobility is the worst enemy of anybody and because of fraility there is no other option. There is no external infection, no cancer like disease, no major organ disorder, or major surgery to make you imobile and yet there is one and only one mineral imbalance or hormonal imbalance that has lead people like you and me to lay in their bed awaiting bone recovery. But unlike other debilatating disorders bone density can go through reversible effects, so you can work towards recovering back your bone mineral density by sheer hardwork.
There is a lot more to discover about this disorder so watch out for the next post, untill then...
Wish you wellness,
Neha Wasnik
R.D

Tuesday, August 18, 2009

OSTEOPOROSIS - From where does this silent killer creep in?

First of all I apologise for this long over due sabatical from the blog. I was working on bringing you something very close to my heart and I have now compiled a series of article topics which will be including my friend's request to write on menstrual body pain and also about fitness for sit at home people who just don't want to go to the gym.
So about this series of blog articles I am going to write everyday will be on Women's Health (of all ages). Before al my male readers turn away let me tell you some of the things I unravel to you is applicable to today's man too. If you are close to any female kind and I hardly doubt if you're not then this series is for you.
Osteoporosis has long been considered as a bone disorder of the elderly. Frankly not everyone knows what it factually is. All they can tell you is something to do with the bone and perhaps as far as a fracture in women. Well people guess what times have changed and we are solely responsible for it. In 2005 my mother was experiencing excruciating pain in one of her hip joint, she just neglected for a while thinking it was fatigue. It got to a point where she couldn't sit down or bend to pick things up from the floor. Needless to say she almost faced immobility, as I clearly recall that day when I came home from my health club to find my Mom struggling to get up from the bed. She then (somehow) got an MRI, Bone Density test, Serum calcium, Vit D, hormonal tests done. We found she wasn't osteoporotic, yet. She was osteopenic, which only meant that it will be sometime soon when she would be categorically under OSTEOPOROTIC status. That day when she found out she knew what I meant when I told her deliberatly deafened ears to start working out and stop comfort food as an excuse to feeling exhausted. In one year's time she not only lost 30 Lbs of dead weight but reversed her bone deterioration, of course with diet and apt exercise module along with Vit D supplementation. You have to really coax her today to give up one day of workout. So the question still remains what is it that we do to end up being susceptible to osteoporosis and that apart why do medical sciences tag it a 'SILENT KILLER'? I can understand your dilemma coupled with curiosity, but osteoporosis does more harm to our body than just bone frailty. This is what I will write about in this series.
To understand the pathophysiology (its effects) of osteoporosis we need to understand what is our bone structure made of. Simply it is nothing but a meshwork of protein molecules which have mineral fixations into it making it look like a wholesome sturdy structure. Protein forms the major support for the actual bone, while minerals like calcium, phosphorous, give it its sturdy tough body. Without the adequate mineral deposition in the protein meshwork the bone is just a croche of protein with big holes in it. Remember how you grow taller upto certain age and then just stop growing no matter how tall you want to be? Thats called growth of the epiphysis simply explained when we're young as in really small babies our bones aren't completely formed to what they are now. There are spaces between the firm bone structure that awaits development so we grow taller into adulthood. This process takes place along with the growth hormone by constant mineral deposition in the protein structure of the bone. At some point the growth hormone release is inhibited and the bone growth eventually stops. Our bones go through a process called as absorption and this continues upto the age of 35. After 35 however bones go through a turnover process i.e. absorption and resorption. The bone turnover determines the actual net bone density, which only translates into whether your bone is absorbing more calcium or giving away more calcium. This turnover is initiated by the overall process called ageing. Secondary to natural stimulus for bone resorption are factors that accelerate bone calcium resorption like obesity (too much weight on the ones), calcium defeciency(not enough calcium in the blood), Vit D defeciency, thyroid hormone abnormality, malnutrition overall, oestrogen imbalance. if you manage to do all the above mentioned activities you'll be succesfull in depleting your bones from calcium thus inviting with warm arms a permanent guest called OSTEOPOROSIS to your humble body. What osteoporosis will do after it starts developing is frailty in your physical self. Frailty leads to accidents, or immobilisation like in the case of my mom. Frailty of the bones also means your nervous plexi which were protected by adequate bone space is now facing muscular pressure as the body structure is weak and cannot hold major muscles in their original way. If the nerves are pressed there is neural damage symptomatic as dysfuntional part of the body the nerves are supplying brain impulses to. Now you can multiply all this into why this silent unwanted guest is a killer, a silent killer. Watch out for more on this topic as I unravel more about Osteoporosis and general health.

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