Osteoporosis

Osteoporosis is a major health problem that affects about one fourth of women over the age of 60. Persons with osteoporosis suffer from a loss in bone mass and bone strength. Their bones become weak and brittle which makes them more prone to fracture. Any bone can be affected by osteoporosis, but the hips, wrists and spine are the most common sites. Peak bone mass is reached between the ages of 25 and 35 years. After 35, bone mass is stable until, in women, it starts to drop with menopause. This drop occurs more slowly in males. About one in two women over the age of 65 will develop fractures due to osteoporosis.
The actual causes of osteoporosis are unknown. Certain risk factors, however, increase the likelihood of developing osteoporosis:

-Being female - women are four times more likely to develop osteoporosis than men. The reasons are:
*Their bones are generally thinner and lighter.
*They live longer than men.
*They have rapid bone loss at menopause due to a sharp decline of estrogen. The risk increases for women who have:
-Natural menopause before age 40; a hysterectomy which includes removal of both ovaries with no hormone replacement therapy (HRT); a lack of/or irregular menstrual flow.
-Having a thin, small framed body.
-Race - Caucasians and Asians are at a higher risk than African Americans.
-Having red or blond hair or freckles may also increase the risk.
-Lack of physical activity especially activities such as walking, running, tennis and other weight-bearing exercises.
-Lack of calcium and vitamin D - adequate intake of these nutrients throughout life helps to insure that calcium deficiency does not contribute to a weakening of bone mass.
-Heredity - the risk increases if there is a history of osteoporosis and/or bone fractures in your family.
-Cigarette smoking.
-Alcohol - regularly consuming alcoholic beverages, even as little as two to three ounces per day, may damage bones. Heavy drinkers often have poor nutrition and may be more prone to fractures from their predisposition to falls.
-Taking certain medicines such as corticosteroids (anti-inflammatory drugs used to treat a variety of conditions such as asthma, arthritis, lupus, etc.) and aluminum containing antacids like Rolaids or Di-Gel.
-Some anti-seizure drugs and inappropriate overuse of thyroid hormones may also increase the risk.
-Other disorders such as hyperthyroidism, hyperparathyroidism, certain forms of bone cancer, anorexia nervosa, scoliosis and gastrointestinal disease can also increase the risk.


Signs and Symptoms
Osteoporosis is a silent disease because it can progress without any noticeable signs or symptoms. The first sign is usually when a bone fracture occurs. Symptoms include:

+Osteoporosis, continued
+A gradual loss of height.
+A rounding of the shoulders.
+Gum inflammation and loosening of the teeth.
+Acute lower backache.
+Swelling of a wrist after a minor fall or injury.

Treatment and Care
Osteoporosis can only be prevented. Reversing the disease is rarely possible.

Medical tests, such as the dual-energy X-ray absorptiometry (DEXA) and densitometry, can measure bone mass in various sites of the body. They are safe and painless. These tests can help doctors decide if and what kind of treatment is needed.

Depression

One-fourth of women have a major bout with depression sometime during their life. They may not even know it as depression, but seek help for other ailments such as insomnia or extreme fatigue.
Depression is a condition marked by sadness, hopelessness, pessimism and a loss of interest in life. It can strike at any age and is common to all racial and ethnic groups. In general, depression is noted twice as often in women than in men. There may be many reasons for this:

*Hormonal changes women undergo:
-Premenstrually.
-During menopause.
-During and especially following childbirth or when a woman stops breast-feeding.
-When taking medicines that contain hormones such as the pill.
-With health conditions that affect a woman's hormones such as some ovarian cysts, endometriosis, etc.
*Women tend to express their feelings more openly than men which makes it more likely they will seek treatment for depression.
*In both men and women, depression can result from:
Brain chemical abnormalities.
*The death or loss of a loved one.
*Life changes such as a divorce, job loss or moving to another location.
*Financial problems.
*Taking certain medicines such as some for high blood pressure.
*Alcohol or drug abuse.
*Major nutrient deficiencies.
*Illnesses (acute or chronic) - the depression can either be a symptom or a consequence of the illness or both.
Examples include lupus and multiple sclerosis which are more common in women than in men.
Lack of natural, unfiltered sunlight between late fall and spring, known as Seasonal Affective Disorder (SAD).


Whatever the cause, depression can be treated. Treatment can include medication, psychotherapy and other things that are specific to the cause of the depression. For example, if a certain pill used for birth control results in depression, a different pill or another birth control method can be tried. The exposure to bright lights similar to sunlight can treat depression caused by SAD.


If you suffer from depression, see your doctor. Keep track of when and how often you feel depressed and any other physical and/or emotional symptoms you have. Report these to your doctor. He or she can determine the correct diagnosis.

Breast Cancer & Breast Self-Exam

Breast cancer is the most common form of cancer among women, accounting for 30% of cancers women get. Each year, there are approximately 180,000 new cases of breast cancer and 45,000 deaths from it. Only lung cancer causes more cancer deaths among women. The chance of breast cancer increases dramatically with age. The National Cancer Institute (NCI) has given the following statistics for a woman's chances of developing breast cancer:

By Age Chances
25 1 in 19,608
30 1 in 2,525
35 1 in 622
40 1 in 217
45 1 in 93
50 1 in 50
55 1 in 33
60 1 in 24
65 1 in 17
70 1 in 14
75 1 in 11
80 1 in 10
85 1 in 9
Lifetime 1 in 8

Men can also develop breast cancer, but it is very unusual. About 300 men die each year from the disease.

Breast cancer results from malignant tumors which invade and destroy normal tissue. When these tumors break away and spread to other parts of the body, it is called metastasis. Breast cancers can spread to the lymph nodes, lungs, liver, bone and brain.

The risk of breast cancer increases above the normal risk with these factors:

*Having had cancer in one breast increases the risk for cancer in the other breast.
*Never giving birth or giving birth after age 30.
*Early onset of menstruation (before age 12).
*Late menopause (after age 55).
*Family history of breast cancer, especially for mothers, daughters and sisters of women with breast cancer prior to menopause.
*Exposure to radiation.
*Diet high in fat.
*Obesity.
*Diabetes.
*Recent trauma.

Detection
Recommendations for mammograms vary among government and health organizations. Some favor screening before age 50. All suggest a mammogram every year or at least every two years after age of 50. Any woman who notices a lump in her breast should see her doctor as soon as possible. Tests can be done to tell if cancerous cells are present.


Treatment
There are a variety of treatments for breast cancer. The main treatment is surgery. The removal of the cancerous area is most often recommended along with taking a sample of the lymph nodes in the armpit to see if the cancer has spread there.
Other treatments are radiation therapy, chemotherapy and hormonal therapy. It is important to find out the type of cancer cell that is involved. If the cancer is a type which spreads quickly, a more extensive surgical treatment may be chosen.

Eating Disorders (Anorexia & Bulimia)

An eating disorder may be defined, in a sense, as self-abuse. It can be just as harmful to your health as substance abuse involving alcohol or drugs. Two of these disorders, anorexia and bulimia, result from the fear of overeating and gaining weight.

They share other common traits, as well, that reflect the mental/physical health of the sufferer:

*Depression.
*Low self-esteem, poor body image.
*Self-destructive outlook, self-punishment for some imaginary wrong.
*Disturbed family relationships.
*Abnormal pre-occupation with food and feeling out of control.
*Increased rate of illness due to low weight, frequent weight gain/loss and/or poor nutrition.


In addition, anorexia and bulimia have factors specific to each:

*Anorexia Nervosa sufferers tend to:
-Be female, pre-teen or teenage.
-Grow up in over-achieving families who establish unusually high expectations for their children.
-Place exaggerated emphasis on body image and perfection.
-parents who are very busy and involved in their own lives. The anorexic may feel the need to be perfect to gain their parents’ attention.
-Have marked physical effects - loss of head hair, stoppage of ovulation/menstruation, slowed heart rate, low blood pressure, cold intolerance.
-Have depression more extreme than in bulimia patients.
Develop osteoporosis later in life due to lack of calcium and decreased production of estrogen if menstruation stops. Excessive exercise can contribute to this as well.
-Have severe damage to heart and vital organs if weight drops sufficiently.
-Approximately 1% of American females have anorexia.

*Bulimia sufferers:
-Can be overweight, underweight or normal weight.
-Are mostly female, older teen or young adult.
-Are characterized by binge eating and then vomiting (purging) and/or taking laxatives and/or water pills (diuretics) to undo the binge.
-Have severe health problems that arise from binge-purge cycle of eating. These include stomach lining tears, ruptures, irregular heartbeat, kidney damage from low potassium levels, damage to tooth enamel from acids produced in vomiting and menstrual stoppage.
-Repress anger from inability to express emotions in an assertive way. They fear upsetting important people in their lives.

Approximately 2% of college students and 1% of U.S. women overall have bulimia. Bulimia can follow anorexia and vice versa.

There is no one cause for these eating disorders. Many factors contribute to them:

**A possible genetic predisposition.
**Metabolic and biochemical problems or abnormalities.
**Societal pressure to be thin.
**Personal or family pressures.

Treatment for anorexia and/or bulimia includes:

--Medical diagnosis and care, the earlier the better.
--Psychotherapy, individual, family or and/or group.
--Behavior therapy.
--Medication. Antidepressant medicine is sometimes used.
--Nutrition therapy, including vitamin and mineral supplements.
--Hospitalization, if necessary, especially in anorexia, if weight has dropped about 25% or more below normal weight and/or has affected vital functions.

Exercises for Heavy Menstrual Flow Anemia

Women who are anemic or have a problem with heavy menstrual bleeding tend to be very tired; they often find that moderate to brisk exercise is difficult for them because they lack stamina and endurance. The fatigue problem tends to resolve as the anemia and bleeding are corrected nutritionally. In the meantime, women with these conditions may completely stop their regular exercise program in an attempt to avoid feeling tired.
However, complete avoidance of exercise is not healthy, for it reduces oxygenation and circulation to vital organs, such as the brain and heart, as well as all the cells of the body. Gentle exercise such as deep breathing exercises, progressive muscle relaxation, range-of-motion exercises to keep the joints mobile, and slow relaxed walking promote good oxygenation and circulation and can even help to increase energy. The key is to exercise in a gentle, slow fashion.

I have included in this chapter several general fitness and flexibility exercises you can use to promote health and well-being. You may want to combine them with gentle aerobic exercise like walking. You can also combine them with the yoga stretches and acupressure points described in Chapters 10 and 11.

Exercise Techniques

Exercise 1: Deep Breathing
Deep, slow abdominal breathing is very important for your health and vitality. It expands your lungs and allows you to bring adequate oxygen, the fuel for metabolic activity, to all the tissues of your body. Rapid, shallow breathing decreases your oxygen supply and keeps you devitalized. Deep breathing helps to relax the entire body and strengthens the muscles in the chest and abdomen. Women with heavy menstrual bleeding and anemia have reduced hemoglobin and red blood cell counts, so less oxygen is available than under normal conditions.
*Lie flat on your back with your knees pulled up. Keep your feet slightly apart. Try to breathe in and out through your nose.
*Inhale deeply. As you breath in, allow your stomach to relax so that the air flows into your abdomen. Your stomach should balloon out as you breathe in. Visualize your lungs filling up with air so that your chest swells out.
*Imagine that the air you breathe is filling your body with energy.
*Exhale deeply. As you breathe out, let your stomach and chest collapse. Imagine the air being pushed out, first from your abdomen and then from your lungs.

Exercise 2: Progressive Muscle Relaxation

Women who are anemic may have muscles that are tense and tight because of inadequate oxygenation and blood flow. Lactic acid tends to accumulate in these muscles, and muscle tension can become a chronic problem. Movement effectively breaks up this pattern of chronically tight muscles. Unfortunately, women with anemia tend to become less active as their fatigue worsens. While strenuous exercise may be too difficult for a woman with anemia, it is still very important to keep the muscles loose and limber. Besides feeling more relaxed, supple muscles have a beneficial effect on mood and induce a sense of peace and calm. The following exercise will aid in releasing muscle tension.
*Lie in a comfortable position. Allow your arms to rest limply, palms down, on the surface next to you. Practice your deep abdominal breathing as you do this exercise.
*Clench your hands into fists and hold them tightly, for 15 seconds. As you do this, relax the rest of your body. Then let your hands relax.

*Now, tense and relax the following parts of your body in this order: face, shoulders, back, stomach, pelvis, legs, feet, and toes. Hold each part tensed for 15 seconds and then relax your body for 30 seconds before going on to the next part.
*Visualize the tense part contracting, becoming tighter and tighter. On relaxing, see the energy flowing into the entire body like a gentle wave, making all the muscles soft and pliable.
*Finish the exercise by shaking your hands. Imagine the remaining tension flowing out of your fingertips.

Exercise 3: Joint Flexibility

It is very important that women with heavy menstrual bleeding and anemia maintain full range of motion and flexibility in all the joints of the body to reduce the tendency of muscle tension. The following exercise helps to stretch and release tension in the muscles around the joints. This exercise is similar to the "range-of-motion" sequence that physicians may use when testing a patient for joint limitations such as arthritis produces. The exercises are also thought to stimulate the acupuncture meridians as based on the work of Motoyama, a Japanese researcher. In his book, Theories of the Chakras: Bridge to Higher Consciousness, Motoyama discusses the importance of these exercises in opening the acupuncture meridians.

Sit on the floor with your legs stretched out in front. Place your hands at your sides.

*Toes: Slowly flex and extend the toes without moving your feet or ankles. Repeat 10 times.

*Ankles: Slowly flex and extend the ankle joints. Repeat 10 times. Separate your legs slightly, then rotate your ankles in each direction 10 times. Be sure to keep your heels on the floor.

*Knees: Still resting in the sitting position, bend the right leg at the knee, bringing the heel near the right buttock. Then lift the right leg off the floor, straightening the right knee. Repeat 10 times. Then do the same exercise with the left leg.

Hold the thigh near the chest with both hands. Rotate your lower leg in a circular motion about the knee 10 times clockwise and then 10 times counterclockwise. Repeat with the left leg.

*Hips: Bend the right leg so that you can place your right foot on the left thigh. Hold the right knee with the right hand and hold the right ankle with the left hand. Then gently move the right knee up and down with the right hand. Repeat with the left leg.

While you are sitting in the same position, rotate the right knee clockwise 10 times and then counterclockwise 10 times. This improves the flexibility of the hip joints. Repeat on the left side.

While sitting, bring the soles of the feet together, bringing the heels close to the body. Using your hands, gently push the knees to the floor and then let them come up again. Repeat 10 times.

*Fingers: Sit on the floor with your legs stretched out in front of you. Lift your arms up to shoulder height, keeping them straight. Open your hands wide. Flex the fingers, closing them over the thumbs to make a fist. Repeat 10 times.

Female hair loss

A couple of readers wrote in with further comments on the possible link between thyroxin and sudden hair loss. One reader was doubtful that the drug is the cause as she had been taking thyroxin for over 6 years and has not had any hair loss, while another suggested that long term use of thyroxin could lead to high levels of the reverse T3 hormone, which in turn causes hair to fall out. Whether thyroxine is the cause of this distressing problem, it is always important to remember that you should not suddenly withdraw from taking any prescribed medication without first seeking professional advice.

Healthy Bones

Osteoporosis is a clinical condition which is characterized by a high susceptibility to bone fracture. It is due to excessive bone loss and decreased bone density. The "disease" occurs most commonly in post-menopausal women because of reduced levels of the hormone estrogen, although some consider lifestyle, diet and exercise to be important factors affecting the disease as well. After menopause, 25% of white-skinned, Asian and brown-skinned women develop serious osteoporosis. Here are some easy-to-follow guidelines on maintaining healthy bones for both men and women:

Exercise
Exercise is the single most important thing one can do to preserve and increase one's bone mass. It is clear from research that the best kind of exercise for strong bones is weight bearing in nature. Activities such as running and brisk walking are ideal. But don't forget "fun" exercise like dancing, rope jumping, hiking, tennis and volleyball. Each of these activities is useful in strengthening the bones. I usually recommend 45 minutes of weight bearing exercise, three times each week. In addition, walk 20 to 30 minutes, three times a week. And remember, you are never too young or too old to begin an exercise routine. If you have any questions about how much exercise you should start with, consult your physician.

DietAs far as your bones are concerned, what you shouldn't eat is as important as what you should eat. Sugar is a big culprit, and as recommended in any healthy diet, it should be reduced. In addition, using too much table salt in the diet can actually cause calcium to be excreted through the urine. One study revealed that adding a teaspoon of salt to the diet of young women increased the amount of calcium lost in the urine -- enough to diminish bone mass by 1.5% per year. It is important to include moderate amounts of animal protein and make certain that one includes two vegetable servings with any protein meal. And, of course, you should also include calcium-rich foods such as green, leafy vegetables and moderate amounts of dairy products in your diet.

Caffeine, Nicotene and Alcohol
Caffeine will also cause calcium to be excreted in the urine. One study has demonstrated that three cups of coffee will secrete 45 milligrams of calcium into the urine. Cigarette smoke has been shown to curtail estrogen activity, and anything that interferes with estrogen is very likely to increase one's chances of osteoporosis. Women who smoke are clearly at high risk for osteoporosis. And alcohol should be reduced or eliminated. Chronic alcoholics are notorious candidates for poor bone density since research indicates that most osteoporosis in middle age men is associated with alcoholism.

Nutritional Supplements
Both calcium and magnesium are clinically used in the prevention and management of osteoporosis. These nutrients can be so effective that the Harvard Health Letter considers recent research (showing that calcium with vitamin D prevents hip fractures in the elderly) to be one of the top ten medical advances of 1993. In a recent clinical study, it was found that calcium supplementation alone significantly retarded the degree of bone loss and improved calcium balance in recently post-menopausal women. In a study comparing the incidence of several types of fractures in women ages 50 to 84, it was found that those with a calcium intake of 1000 mg a day or greater were less likely to suffer from bone fractures. And some additional data indicates that magnesium is also valuable in the treatment and prevention of osteoporosis. In one study, supplemention using 500 mg of calcium and 600 mg of magnesium had a significant effect on reversing post-menopausal bone loss.