Disorders: Premature Osteoporosis

Osteoporosis can be defined as an ailment characterized with cases of minimal bone mass as well as micro-architectural deterioration of its tissue causing an increased fragility of the bones. Hence, there is observed a subsequent fracture incidence. As such, the condition makes the bones more breakable as well as delicate due to tissue loss and naturally because of the hormonal changes. It may result from the deficiency of Vitamin D as well as calcium (Sanson, 2011). The World Health Organization is focused on bone mineral density measurement, hence permitting treatment before the incident of fracture takes place.

Individuals who are suffering from the disorder experience back and neck pain, and sometimes neck ache. Moreover, they have a weak bone structure that is associated with a risk of bones breaking. The causes may include poor dieting, extreme exercises, low estrogen level, and minimal levels of calcium and phosphorous. The treatment may comprise of both medications and preventive measures that may be combined or applied separately.

Etiology of Mandy’s Premature Osteoporosis

Osteoporosis may result from several causes that have an impact on the health condition of an individual. In the case of Mandy, the disorder has not yet fully developed though there are real signs of its possible occurrence. As such, several causes that could lead to the disease could be observed. First, excessive physical exercises could contribute to the aggravation of the osteoporosis condition. Aerobics is considered an important aspect of the peak bone mass development especially during childhood as well as adolescent years (Pizzorno, 2013). However, it may as well become a threat to achieving the same if proper approaches and precautions are not taken.

Most of the times, physiques leading to the stoppage of menstrual periods facilitate a possibility of the osteoporosis development. Irregular menstrual cycles lead to a situation where estrogen is present at minimal levels in the female body. The decreased levels of the hormone are considered to be a contributing factor to the weakening of a woman’s peak bone mass. That contributes to the emergence or acceleration of osteoporosis.

Secondly, poor dieting may threaten the health of a person due to the possibility of nutrients deficiency. Just like in the case of excessive aerobics, unhealthy diet could cause imbalance in hormone levels making them lower than usual. This would include estrogen, eventually contributing to reduced bone density. During the adolescent period, like in the case of Mandy, the skeleton development accelerates. Hence, eating disorders could severely lower the prospects of achieving peak bone mass, thus leading to osteoporosis among young women like Mandy.

At its early stages, osteoporosis symptoms may not be present. Nevertheless, as the ailment progresses certain signs of its possible presence begins to show up. For instance, individuals suffering from the condition will start to experience bone or muscle pain particularly along their lower back, hips or around the neck. The pain ordinarily begins in a gradual manner before an abrupt aggravation of the condition. Although the pain may not spread to other areas, it gets worse when more weight becomes exerted on the aching body part. Other signs include a decrease in height due to fractured compressions of the spine, as well as stooped posture (McCormick, 2009).

Again, a fragile bone structure could as well spell doom for the individuals due to fracturing. Such flimsy breaking may occur while doing simple activities like striding off a curb, or during severe coughing or sneezing. In normal circumstances, this would not be likely to happen for people who do not suffer from osteoporosis. As such, Mandy’s fall during skating could lead to cracking of the bones particularly on the hip or any other part of the leg. The most severe fracture complications have hit the body parts such as the hip and the spine.

Pathophysiology of the Disease # 1

Bone Mineralization

The process involves precipitation of crystal calcium phosphate by bone-forming cells, to produce the bone’s fibrous matrix. Proper regulations should be implemented to avoid too much or too little mineral that could result in health problems. The regulation relies on inorganic phosphate that impedes abnormal classification. The levels in which it occurs are controlled by a total of three molecules including nucleotide pyrophosphatase phosphodiesterase 1 (NPP 1). Its function entails the production of pyrophosphate exterior of the cells. Another molecule is ankylosis protein (ANK) that transports pyrophosphate from the interior of the cell to its surface, hence leading to extracellular pool of the inorganic compound. The third one is tissue-nonspecific alkaline phosphate (TNAP). Its functions include breaking down of the phosphate present on the extracellular surface, thus checking its levels.

Absence or shortage of any of the three molecules could cause severe health complications. For instance, in the case of TNAP, it would lead to high levels of calcium-regulating phosphate, and hence no calcification of soft bones. On the other hand, deficiency of both ANK and NPP1 contributes to extreme calcification. This leads to bone-like toughening of ligaments as well as tendons of the spine.

Why the Deficiency of Estrogen in Women Lead to Osteoporosis

Estrogen plays a vital role in the formation of bones, as well as in the regulation of the level of bone reabsorption that mainly rises during the puberty period. The key driver of its production is considered the estrogen hormone. It helps in the absorption and utilization of calcium. It is achieved by regulating the osteoclast apoptosis. In case of its deficiency, the amounts of osteoclasts increase as they live longer, causing an extra reabsorption of the bone than is required. Due to this fact, the bone formation accelerates, developing a high-turnover state causing bone loss, as well as trabecular plates perforation (Pizzorno, 2013). This leads to poor bone structure, hence contributing to the occurrence of osteoporosis.

Pathophysiology of the Disease # 2

Macroscopic Difference between Osteoporosis and Osteomalacia

Despite the two conditions having an impact on the strength and vitality of the bones, they have several differences, especially in terms of their causes and symptoms. First, Osteomalacia is considered to be bone demineralization leading to their softening. This has become the case due to the abnormal phosphorous and calcium amounts, getting supplied to the body (Longo et al., 2012). Considering that calcium is a critical element for the growth and strength bones, a condition lowering it leads to health problems. On the other hand, osteoporosis is the lowering of the density of bone mineral (Holick, 2007). The condition contributes to the formation of a delicate bone structure, hence leading to the ailment.

Secondly, Osteomalacia is common for both children and adults. In the case of children, the disorder has become known as rickets. In contrast, osteoporosis has become a common occurrence for women aged around 65 years or older. Thirdly, Osteomalacia symptoms include muscle weakness, bone aching, as well as fragile bones. On its part, osteoporosis symptoms include stooped posture, loss of height, bone fracture, as well as the back pain precipitated by collapsed vertebra. Thirdly, osteoporosis causes the decrease in the bone mass, which has a typical bone mineral ratio to matrices besides microarchitecture alteration. On the other hand, osteomalacia has a lot of matrices in relative amounts to the quantity of the bones (Kennel, Drake, & Hurley, 2010).

Treatment Options for Mandy’s Case

Mandy’s condition of osteoporosis would require an approach for undertaking both preventive measures and treatment. As for preventive measures, she should avoid activities that would lead to the increased risk of fracturing bones. This will ensure that the dangers she gets exposed to are minimized. Again, she should change her dietary habits for more favorable ones to reduce the risk of osteoporosis development. Her diet should include consumption of such products as dairy products that contain calcium and Vitamin D.

Other important foods in the diet comprise of fish, canned salmon, and sardines, as well as mackerel and tuna. Moreover, Mandy should also limit the physical activity. Although aerobics is considered as important for keeping fit, doing such exercises in an excessive manner is a threat to one’s health. Therefore, it is critical that she adheres to a schedule that will allow her to both exercise and have enough time to relax her muscles and bones (McCormick, 2009). This will help to avoid the aggravation of the disorder and return the situation back to normal.

On the other hand, several treatment aspects may also ensure that Mandy gets cured from her ailment including the use of anabolic drugs, as well as antiresorptive medication. Each of the approaches will be appropriate in this respect. For instance, the antiresorptive prescription includes such medicines as calcitonin, the estrogen agonist, bisphosphonates, as well as denosumab. The medication allows avoiding bone loss during the breakdown stage of remodeling cycle, lowering its rate while maintaining the same pace of formation (Sanson, 2011). This eventually leads to an increased density of bones, hence strengthening the bone structure and reducing their fragileness. With the lowered possible bone breaking, the rate of osteoporosis can also be reduced.

On its part, the anabolic treatment may entail a type of parathyroid hormone known as teriparatide. It raises the bone formation rate thus helping to improve their structure. It will help to rebuild the bones, apart from minimizing bone breakage risks. As such, the two medication processes could be applied hand-in-hand. While one of them will concentrate on the formation of new bones in Mandy’s case, the other one will strengthen the already existing bone structure (McCormick, 2009). Despite that, she should also ensure that she adheres to the set preventive measures so as not to worsen her condition and recuperate at the minimum time possible.

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