A patient with a bone mineral density T-score of -2.7 would be suffering from osteoporosis.
• Normal BMD, T-score -1 SD>
• Osteopenia, T-score between -1 & -2.5 SD><
• Osteoporosis, T-score -2.5 SD<
• Severe Osteoporosis, T-score -2.5 SD< with associated fractures.
Key hormones associated with bone formation in men/women are PTH (parathyroid hormone) produced by the parathyroid glands, and Calcitonin produced by C-cells. In children, HGH is important and is most involved in epiphyseal plate activity; in adolescents the sex hormones testosterone and oestrogen play an important role in bone growth, growth hormone (HGH) is modulated by the activity of the thyroid hormones, ensuring that the skeleton has proper proportions as it is growing.
Later in adolescence, the sex hormones testosterone and oestrogen induce epiphyseal plate closure in the long bones; an excess of growth hormone during this development phase can lead to gigantism, while a deficiency of HGH and/or the thyroid hormones would produce dwarfism.
Low blood levels of ionic calcium will stimulate the release of PTH; in turn stimulating osteoclasts to resorb bone and thus releasing more calcium to the blood. Osteoclasts will break down both old and new bone matrices, osteoid escapes assimilation due to its lack of calcium salts.
Rising levels of blood calcium will end the stimulus of PTH, declining levels of PTH will reverse these effects; causing the level of blood Ca2+ to fall, calcitonin only has a negligible effect on calcium homeostasis in humans. (Marieb & Hoehn, 2010, pp.185-86)
The major supplements used to help sufferers of osteoporosis are calcium and vitamin D, aim for at least 700mg of calcium from food/drink intake; when using calcium and vitamin D to help osteoporosis then a formulation prescribed by a doctor should be sought.
Most over the counter calcium/vitamin D supplements do not contain the correct amount and ratio of calcium/vitamin D, to help treat osteoporosis a formulation containing 1.2g of calcium and 800iu of vitamin D should be taken. (NHS , 2011)
Other good dietary sources of calcium are small fish (with bones – sardines/pilchards), low-fat dairy products and dark green leafy vegetables (broccoli/cabbage/okra) as are tofu (soya) and nuts. (NHS, 2011)
Good dietary sources of vitamin D include all oily fish, eggs; fortified spreads and liver. It is also important to get the appropriate amount of sunlight, as the UVB rays penetrate skin where they are converted into pre-vitamin D3 by cutaneous 7-dehydrocholesterol.
Aim for at least 5-30 minutes per day of UVB during the hours of 10am to 3pm, to the legs; face; back and arms for sufficient vitamin D production; cloud cover and darker skin tones will reduce the available UVB. (USA.Gov, 2011)
High impact sports, such as running; weight training; walking; aerobic exercise and squash are all good for increasing BMD, low impact sports such as swimming and cycling have no positive effect on BMD.
Exercise regimes should be undertaken at least twice per week, preferably three times p/w of 30 minutes or more, and of course should be supervised by a qualified individual. The level of intensity...