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2012年9月16日 星期日

Natural Bone Health Basics: There's More to Bone Health Than Bone Density


When we think of bone health, the conventional thinking focuses on bone density and our DEXA-scan results being within a certain T-score range. But this concept of bone health is actually misleading. Yes, it's helpful to have sufficient mineralization and density in our bones, but a standardized T-score is based on the bone density of a 30-year old woman with a medium skeletal frame. What if you're a woman with a smaller frame? Where does that leave you in this context? What if you're a woman in her 50s, 60s or 70s?

The truth is: bone loss is natural. In fact, it's completely normal from around age 30 onwards. And in the six to ten years around menopause the rate of bone loss tends to increase. There's cause for concern when bone loss is markedly high or significantly progressive.

More importantly, the architecture of bone, the collagen matrix (a latticed protein matrix) of bone and its capacity for flexibility are much more significant factors in determining the overall health of our bones. It is quality, not quantity that matters most when it comes to our bones. Dense bones can be just as brittle as thinner bones. And thinner bones can have healthy architecture, stronger collagen matrix, and a greater capacity for flexibility, reducing our chance of experiencing fracture. After all, we want to avoid fracturing, no matter the density of our bones.

Despite the hype about susceptibility to fracture based on T-scores, more than 85% of women over 50 years of age will never experience a hip fracture, regardless of bone density. (Marcelle Pick, OB/GYN NP, Women to Women) Likewise, an examination of the effectiveness of bone density screening by the University of Leeds found that people with higher bone density go on to have 63% of all fractures. (Health Studies, School of Public Health, University of Leeds) Just ask your doctor what s/he sees on a regular basis among patients.

The hype around T-scores and the prescribing of medications based on these T-scores may be a diversion from the real questions that need to be asked and from the most basic and overall health-enhancing strategies that need to be taken for optimum bone health.

Many factors contribute to bone loss and it is important to consider these, taking into account your health history, current diet and lifestyle factors. And in light of that we will very likely lose some bone as we age, the questions to ask are: what are the true causes of bone loss? what are the best ways to minimize bone loss? what can I do to truly maintain or restore the health of my bones?

Stress, sedentary lifestyle, nutrient imbalances, compromised digestion, endocrine imbalances, commonly prescribed medications and environmental toxins can deplete our bone reserves and impact the integrity of our bones.

In most cases, a diet rich in alkalinizing foods, the right balance of protein, healthy essential fats, minerals and micro-nutrients along with the appropriate physical activity, sunlight and a few choice bone building supplements will successfully restore bone health. Underlying causes must be considered and addressed when appropriate.

Here are a few key requirements for healthy bones. Protein and vitamin C stimulate formation of collagen matrix. Vitamin D helps absorb calcium from the intestines into the blood. Magnesium increases calcium absorption from the blood into the bones. Vitamin K acts in the production of proteins in the bone and helps calcium crystallize in the bones. Healthy fats are required to absorb fat-soluble vitamins such as D and K. Phosphorus is essential for proper mineralization of bones and teeth.

The food you eat each day is the most essential and bio-available source for all of the constituents for healthy bones. Supportive supplements may be a wise choice as well. Add to this, slowing down and paying attention when eating plus overall stress reduction, and not only are you likely to improve the quality of your bones and overall health, but also the quality of your life!




Cheryl Berkowitz, CHHC, CHC is a Certified Holistic Health Counselor and Certified Health Coach based in Northampton, MA offering nutrition and lifestyle counseling to women of all ages. Cheryl provides nutritional healing support with a mindfulness-based approach, helping clients to improve and sustain good eating habits, shift underlying imbalances, reduce stress and overcome health issues to achieve vibrant health. Cheryl supports women with Natural Bone Health, to prevent and reverse osteopenia and osteoporosis, and she leads seasonal cleanse and weight loss programs. She teaches workshops and teleclasses nationally, and works one-on-one with women in the Pioneer Valley of Massachusetts and across the nation, in-person, by phone and Skype.

To find out more about Cheryl's approach, go to: http://www.cherylberkowitz.com/Natural_Bone_Health.html





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2012年9月14日 星期五

Screen For Bone Mineral Density Quickly and Easily During Routine Patient Examinations


Many individuals are at risk for osteoporosis. This includes all women over the age of sixty five, postmenopausal women, people with an overactive thyroid or those who take steroids, among others. Because this serious condition can lead to bone fractures and physical pain, it is best to screen everyone at risk and catch it early. Ordinarily, this would mean a trip to the hospital imaging center for the patient, because most private practices or smaller medical offices do not have the equipment needed for the testing. With digital imaging, this is finally changing. A new bone density machine is available, called the Metriscan, that allows physicians to perform bone mineral density tests quickly in office.

This bone density machine essentially functions as a bone densitometer. It gauges how much optical density is apparent in the bone when it is exposed to light. At a hospital, the name of the test that is often given to check for bone mineral density is a DEXA, or dual energy x-ray absorptiometry, test. It utilizes two x-ray beams focused at the patient's bone, and it can determine how much light is absorbed by the bone, and then use that information to come up with how dense the bones are.

Rather than having to go to the hospital for this test, a primary care physician can instead use this bone density equipment to test for bone mineral density right at the medical office. One of the best parts of this bone densitometer is that the actual test only takes one minute to perform, making it quick, easy and painless for everyone involved.

The bone machine simply scans the patient's hand. From this, the physician can determine his or her bone mineral density, and the amount of risk for developing osteoporosis that he or she faces. The bone densitometer is a small piece of bone density equipment, fitting on the top of a desktop. It works in a similar fashion to a scanner.

The information obtained by the density machine is used to compute T and Z scores, which relate to a level of deviation average for the person's age and sex, as well as the level of deviation when compared to the average for a healthy young adult of the same sex. This bone densitometer will compute these scores for you, and print out the test results for you as well.

People over sixty-five and at greater risk for osteoporosis may be eligible for Medicare coverage for bone density machine testing. The bone density equipment is very easy to use, making it simple to get your office up and running with in-house bone testing. The bone density machine causes no pain in the patient, and uses only low radiation levels.

Bone density equipment such as this makes it much easier to detect early on low bone density machine in your patients, and take steps to prevent it from becoming worse.




In this article Jonathon Blocker writes about bone density equipment.





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2012年9月12日 星期三

What is a Bone Density Test?


In the course of my daily work, I continue to get patients that have no idea what a Bone Mineral Density test (BMD) involves. Some think it is similar to a bone scan (which is a Nuclear Medicine test), or an MRI or a CT (CAT) scan. Others think it involves needles or drills to get a sample of bone to test! Ouch!

In fact, a BMD test (sometimes referred to as a DEXA, or DXA scan) is quite likely one of the easiest medical tests you will ever have. All it really involves is for the patient to lie on their back on a cushioned table top while being scanned. A typical exam involves the scanning of the Lumbar (or, lower) spine and one hip, usually the left, sometimes both. If one of these areas cannot be scanned for some reason, such as scoliosis (excessive curvature of the spine), or metal hip replacements or surgically placed metal rods or screws in the lower spine, then a forearm scan is performed.

A typical scan takes only a few minutes, after a relevant medical history along with the patient's weight and height are taken. As you can see, the arrangement is by no means claustrophobic and the radiation dose is so low that the technologist operating the machine is seated close nearby. Some facilities will require you change into a patient gown, removing any items with zippers, buttons, belts, etc. Others may ask you to come dressed in clothing without any metal objects on them and in this case you will not need to change and can be safely scanned in the clothes you are wearing. It will depend on the department's protocol as to what they require you to wear (or not wear).

After your scan is completed, the results are prepared by the technologist for the Radiologist (a medical doctor specializing in radiology interpretation) to report. It is the radiologist's report that the referring doctor receives. The technologist is trained to operate the machine efficiently as well as caring for the patient's needs. They cannot (and really should not) give patients any personal observations on what they see on a scan.

So as you can see, a BMD test is pretty simple after all and is nothing to be unduly concerned over. If you still have questions, feel free to ask your doctor, or contact the Radiology department before your scan.




James M. Fisher has been a Microsoft "Most Valuable Professional" since 2003. His website is http://www.WindowsTalk.org. He is also a Medical Radiation Technologist and works in Bone Density Testing, MRI and General Radiography.





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2012年9月2日 星期日

How Low Bone Density Is Associated With Low Back Pain and How Chiropractic Care Helps


Low bone density or osteopenia in medical term is a problem that commonly affects women, particularly in their middle ages and certainly after menopause. Its bone mineral density is lower than normal peak. It is estimated that 40% of all postmenopausal Caucasian women have low bone density and proportion of these women will go on to develop osteoporosis, with a high risk of bone fractures.

Bones constantly recycle themselves to maintain their strength. Old bone is absorbed by the cells in body called osteoclasts in a process known as resorption. New bone growth by cells called osteoblasts replenishes the old. The osteoblasts construct new bone material to maintain bone strength. Low bone density takes place when old bone is taken up than new bone deposited, resulting to thinning of bone or low bone density and in severe cases, may result to osteoporosis, a disease characterized by low bone mass and structural deterioration of bone tissue that leads to bone fragility and an increased fractures of hip, spine, and wrist.

The association between bone density and low back pain is quite intimate. The classic condition and cause of spinal pain associated with the loss of bone density is spinal compression fracture. All bones lose strength over time and the lumbar vertebrae, particularly in postmenopausal women, can be fractured or compressed from a fall or even from the stress of lifting or everyday activities. The bone strength decreases to a point where slight trauma and sometimes, no trauma whatsoever can result in a fracture.

A compression fracture is a complete bone break that disrupts the bone tissue and collapses the affected bone. Most commonly, the site where compression fractures occur can be found on the spinal vertebral body. Pain from a vertebral compression can be severe and it may show no symptoms and only be discovered when x-rays of the spine are done for other reasons. Over time symptoms such as back pain, loss of height, and kyphosis or stooped over posture may occur. A person may experience less pain during bed rest due to the fact that sitting and standing puts weight on the vertebra and can cause pain.

Studies have shown that the likelihood of incurring additional vertebral fractures is increased once an individual has already experienced one, even if that person does not have low bone density. Research also suggests that around 20% of older women who experience spinal fracture will experience another such fracture within a year.

The normal effects of aging in relation to decreased bone mass and decreased strength and elasticity of muscles and ligaments is unavoidable. However, such effects can be slowed by keeping the muscles that support your back strong and flexible by exercising regularly, using proper body mechanics in lifting and moving, maintaining proper body weight, maintaining a proper posture, avoiding smoking, and receiving regular chiropractic care.

Most cases of low back pain respond to chiropractic treatment. A chiropractor can accurately diagnose and effectively treat most types of low back pain. DEXA (dual-energy X-ray absorptiomery) scan is used in some cases to predict brittle bone conditions. A DEXA T-score of -1.1 to 2.4 indicates osteopenia while 2.5 or greater indicates osteoporosis. A DEXA scan can also help to identify if you are at risk, before it becomes a problem.

A newer bone imaging technology has been developed. FRAX is a computer-based algorithm that provides the 10-year probability of fractures in men and women on the basis of classic risk factors alone or by integration of classic risk factors with bone mineral density, which is measured by DEXA.

Proper diagnosis will help figure out whether a chiropractic adjustment would be beneficial as a part of back pain treatment. A lot of doctors regularly refer people with severe back pain to chiropractors. A patient can go directly to a chiropractor as referral from a doctor is not actually required. The key to such health concern is early identification and intervention. Receiving chiropractic treatment helps in the prevention of low back pain from low bone density.




Dr. Ross Carter D.C.
Chief Wellness Consultant
Discover Family Wellness Center

1860 Duluth Hwy
Suite 103
Lawrenceville, GA 30043
(770) 817-4445

Low back pain affects your quality of life. Chiropractor Lawrenceville GA offers back pain treatment. Visit www.gentledr.com now!





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2012年9月1日 星期六

Bone Density - How Important is It?


Bone density has not been talked about very much until the last 5-7 years. However, today startling facts have come to light. One in 2 women, and one in 4 men,over the age of 50, will break a bone due to osteoporosis. Pretty scarey when you see statistics like that.

So, what is Osteoporosis and is it really such a big deal? Osteoporosis is a progressive bone disease in which the density of the bone is decreased & the structural integrity of the bone is impaired, thus making the bone more brittle. The cortex, or outer portion of the bone, becomes thinner and more porous, thus making it more prone to fractures. This disease affects 75 million people in the United States, Europe, and Japan. It is known to cause at least 1.3 million fractures each year in the U.S. alone. Since the disease often shows no symptoms, many people do not know they have it until they actually break a bone.

Now, that we see how important bone density is to our health, just what can we do to protect our bone health or even improve it? You should start with a sit down visit to your physician. They will begin by taking a look at your diet and your lifestyle. A good healthy diet with adequate calcium and Vitamin D can help to keep your bones strong. Bones store extra calcium for basic body functions. However, when we don't get enough calcium our body robs our bones of this calcium and it makes our bones weaker. Talk honestly to your Doctor about your diet and possible calcium supplements. You should also think about increasing your activity level. Exercise, especially weight bearing exercise, is proven to increase your bone strength and bone density. It can also help your muscle strength which takes pressure off your bones. Another important fact; Smoking, excessive alcohol intake, and also phosophoric acid from carbonated beverages, have all been shown to decrease the calcium in your bones. There is a lot you can do to help protect your bones and your health the natural way.

Your Dr. will next recommend that you have a Bone Density Test. This a simple, painless procedure usually performed in the X Ray Department. It can help the Dr. diagnose osteoporosis in the earliest stages. The test is a major predictor of the strength of the bones and how they can withstand stresses. If your bone density is reduced by a significant amount then you are considered to have osteoporosis.

The most common test to measure Bone Density is called the DEXA Scan. It takes xrays using a minimal amount of radiation, of the lower spine, hips and perhaps the hands and wrists. This test compares your bone density levels to those of a healty young adult. Anything above a Minus 1 is considered normal bone density. For those within the -1 to -2.5, you are depleting your bone mass. Below the 2.5 level you are considered to have osteoporosis. Doctors recommend all women over the age of 60 to have a DEXA scan, and all men over 70. The disease is especially prevalent in this age group. Some younger patients with a family history of osteoporosis may need to followed closely and have a DEXA scan sooner.

For patients who are diagnosed with Osteoporosis there are many options for treatment. There are several medications on the market that have proven very effective in combating the disease. Also, there is more information than ever out there regarding better diets, different exercise methods, etc. All these things are vitally important in helping you to stay healthy and protect your bone density.




Elaine Mashburn
http://xrayinformation.blogspot.com
Elaine is a Registered Xray tech who has been working in the field for 32 years. You can find more information regarding DEXA scans and other Radiology information on her blog.





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2012年8月31日 星期五

The DXA Bone Density Test


The Bone Density test comes in many forms. You may have seen the small machines at Health Fairs or at your local pharmacy.

These devices measure bone density by ultrasound technology. It is inexpensive, portable and there is no radiation exposure. Several studies have shown it to be a good predictor of fracture risk. It is sometimes called Quantitative Ultrasound(QUS).

However, ultrasound is not recommended to monitor osteoporosis long term because of limited precision of the machine and the fact that bone mass at peripheral sites (e.g. heel) changes very slowly. If an ultrasound test reveals an abnormal result we suggest obtaining a confirmatory DXA scan of the hip and spine.

It is also possible to use Quantitative Computed Tomography (QCT) to measure bone density. It is used less often than DXA. It is more expensive, less reproducible and emits a higher radiation dose than DXA.

So let's talk a little about DXA. DXA is short for Dual X-Ray Absorptiometry. It is also known as DEXA, Bone Densitometry or the Bone Mineral Density (BMD) test/scan. It is really the 'gold standard' of bone density measurement techniques. DXA uses a very low radiation dose. The radiation is equivalent to the dose received when flying on an airplane from San Francisco to New York! So as you can see the exposure is minimal, but you should NOT undergo a scan if there is any chance of you being pregnant. DXA measures the BMD in one hip and in the lumbar spine. A few centers will measure both hips. Smaller, more mobile peripheral DXA devices are also used(pDXA). Talk to your physician about which Bone Density Test is available in your area.

So when you have had your scan you will be given a t-score. This is a statistical number that compares your bone density to that of a young adult. The more negative the t-score the worse your bone density. The lower the t-score the higher your risk of fracture. Take a look at this scale to see where your t-score lies.

The World Health Organisation classifies your t-score as follows:

T-SCORE better than -1.0 is NORMAL

T-SCORE from -1.0 to -2.5 is OSTEOPENIA

T-SCORE -2.5 or worse is OSTEOPOROSIS

On the day of the exam, eat normally, but don't take calcium supplements for at least 24 hours beforehand. Wear loose, comfortable clothing, avoiding garments that have zippers, belts, or buttons made of metal. Inform your physician if you recently had a barium examination or have been injected with a contrast material for a computed tomography (CT) scan or radioisotope scan; you may have to wait 10-14 days before undergoing a DEXA test. Women should always inform their physician or x-ray technologist if there is a possibility they are pregnant.

The results of a DEXA bone density exam are interpreted by a physician specially trained in Bone Densitometry.I am a Certified Clinical Densitometrist with the International Society for Clinical Densitometry (www.iscd.org). I send an interpretation of your results and a signed report to your primary care physician, who will work with you to develop a treatment plan. Usually available within a few days, your test results will be in the form of two scores:

T score -- This number shows the amount of bone you have compared to a young adult of the same gender with peak bone mass. A score above -1 is considered normal. A score between -1 and -2.5 is classified as osteopenia, the first stage of bone loss. A score below -2.5 is defined as osteoporosis. It is used to estimate your risk of developing a fracture.

Z score -- This number reflects the amount of bone you have compared to other people in your age group and of the same size and gender. If it is unusually high or low, it may indicate a need for further medical tests.

Despite its effectiveness as a method of measuring bone density, DEXA is of limited use in people with a spinal deformity or those who have had previous spinal surgery. The presence of vertebral compression fractures or osteoarthritis may interfere with the accuracy of the test. CT scans may be more useful in such instances. DEXA cannot predict who will experience a fracture, but can provide indications of relative risk.

Central DEXA devices are more sensitive than pDEXA devices, but they are also somewhat more expensive. The peripheral devices don't accurately follow changes in your bones during therapy. A test done on a peripheral location, such as your heel or wrist, may help predict the risk of fracture in your spine or hip. But because bone mass tends to vary from one location to the other, measuring the heel is not as accurate as measuring the spine or hip.




Adrian J Rawlinson MD

[http://www.osteoporosis-advisor.com]





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2012年8月23日 星期四

Protect Your Health With a Bone Density Scan


As the human body ages, various problems start to surface. Skin that was once taut and youthful becomes old and saggy. Joints that were once limber become stiff and arthritic. Problems with the skin and joints are among the most common worries of aging people, but what about bones?

Once a person hits middle age, it is time to get a bone density scan. These people usually shake their head in confusion when their doctor orders a bone density scan as part of a complete physical exam. Also known as DEXA, a bone density scan involves using x-ray technology in an advanced form to calculate the amount of minerals (specifically calcium) in the bones.

One of the most debilitating maladies that people face as they age is osteoporosis. This is a medical condition in which the bones lose so much calcium that they become brittle and break easily. Also, this condition causes people to hunch over. So, in order to diagnose this, as well as other medical problems, it is very important to have a bone density scan.

The procedure itself is painless. Basically the patient lays still while a very minor form of ionized radiation scans the body - paying particular attention to the hips and legs. The patient should wearing comfortable clothes (avoiding clothes with things like zippers) and no jewelry. If the patient is found to be wearing any of those things, their clothes will have to be removed entirely. The process will be performed, usually, as an outpatient procedure.




More information on bone density scan technology and a Newport Beach body scan center in California is just a click away.





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2012年8月22日 星期三

Bone Density Tests Without a Radiation Dose


Many people who want to know the status of their bone health don't want to undergo a DEXA test (bone density scan) for a number of reasons. One is the expense, but even more significant is that the DEXA test creates exposure to ionizing radiation. Even though it's reported to be a low dose, more and more people are becoming uncomfortable with being exposed to any more radiation than they absolutely have to be, especially after the Japan nuclear site leaks, which are spreading radiation across the planet on the prevailing winds.

And then, there's the uncertainty about what the DEXA scan results actually mean and whether or not the test results are accurate and therefore can be relied upon. Questions about accuracy is a pertinent concern, because if the test is conducted on a different machine than was used previously, scores can be higher or lower. Therefore the reading results are not directly reflecting the actual density of bones, but rather also include influences from equipment that measured them.

Then, there's the T score Z score issue. Many people question the validity of comparing an older woman's bone density score to the average bone density of a 35 year old woman, which is what the T score evaluates. Better, they say, to use the Z score, which compares bone density of the patient with that of others her own age. After all, you wouldn't expect to compare the vision of a 65 year old with that of a 35 year old - some decline is expected with age and is not in that case cause for aggressive treatment with medications.

These and other reasons are why many people want a different test. Do such things exist?

The short answer is, 'yes', some other tests do exist. That said, it's important to know that these other tests are going to give a different answer than a DEXA answers because each of these tests asks a different question.

A question answered by DEXA scan results is "how dense are my bones?" A DEXA scan result, when compared to a previous one on the same equipment, can also address, "Does it appear that I have gained or lost bone since my last scan?"

Two alternative tests answer different but relevant questions, which are:

"Does it appear that I am I breaking down bone right now, and

"If so, how much?"

To answer that question, by-products of bone breakdown can be measured in the urine. These tests have several advantages:

1. They have the possibility of uncovering a bone loss process in its earlier stages;

2. They carry no risk of exposure to x-rays or photons; and

3. They are far less expensive than DPA or DEXA.

Before interpreting the results, however, you should know that measurements can vary by up to 40 or even 50% from one day to the next - not because the tests are inaccurate, but because bone loss rates can vary that much from day to day, and even hour to hour!

One such test measures the level of calcium excretion in the urine. However, if the test shows a higher rate of calcium excretion, that still doesn't mean the calcium is being taken from the bone. For example, the body could be dumping calcium due to high protein intake where the body is attempting to get rid of some calcium to balance phosphorus ratios, and the high score has nothing to do with bone loss at all.

Also, a great deal depends on when in the course of the bone breakdown process the tests are taken: urinary calcium is increased in the initial phases of bone depletion, normal later, and low when the bone bank calcium deposits are drained.

Another urine test measures pryidinium crosslinks, which are metabolic products that show up in the urine when bone type I collagen is being broken down. Again, this is a test that takes a 'snapshot' of the bone loss process at the moment the test is taken.

Normal laboratory values for these test people are still being determined to discover normal levels for people of different ages.

Therefore, interpreting these results remains a matter of opinion.

Still, for a variety of reasons, such alternative test results can be valuable in attempting to discover status of the mineral density of your bones - and doing so without a radiation dose!




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