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  • A
    • Arthritis

      Actually, “arthritis” is not a single disease; it is an informal way of referring to joint pain or joint disease. There are more than 100 different types of arthritis and related conditions, including osteoarthritis and rheumatoid arthritis. People of all ages, sexes and races can and do have arthritis, and it is the leading cause of disability in America. More than 50 million adults and 300,000 children have some type of arthritis. It is most common among women and occurs more frequently as people get older.

      Source: Arthritis Foundation

    • Athletic Energy Deficit (AED)

      Athletic Energy Deficit (AED) is a gap in energy. AED results when sustained activity (energy output) is not balanced with a proportional increase in nutrition (energy input). AED often develops when there is pressure to change eating habits, particularly in some sports where a low body weight is encouraged.

    • Atrial Fibrillation (a-fib)

      Atrial fibrillation or flutter is a common type of abnormal heartbeat. The heart rhythm is fast and most often irregular.

      When working well, the 4 chambers of the heart contract (squeeze) in an organized way.

      Electrical signals direct your heart to pump the right amount of blood for your body’s needs. 

      In atrial fibrillation, the electrical impulse of the heart is not regular.  Parts of the heart cannot contract in an organized pattern. As a result, the heart cannot pump enough blood to meet the body’s needs.

      These problems can affect both men and women. They become more common with increasing age.

      Source: National Library of Medicine

  • B
    • Bisphosphonates

      Bisphosphonates are a group of medications that work by slowing down the cells that break down bone. They are the most commonly prescribed medication for people with osteoporosis and are often the first treatment option considered by your doctor.

    • Body composition (Whole Body)

      The division of soft tissue (as opposed to bone tissue) into fat and lean tissue.

    • Bone mineral content (BMC)

      A measurement of bone mineral found in a specific area. BMC is measured in grams (g).

    • Bone mineral density (BMD)

      BMD is measured in grams per centimeter squared (g/cm2). BMD is derived using BMC divided by area, where BMC is measured in grams (g) and area is measured in centimeters squared (cm2).

    • Breast feeding

      Infants who are breastfed only may develop vitamin D deficiency. Human breast milk does not supply the proper amount of vitamin D. This can be a particular problem for darker-skinned children in winter months. This is because there are lower levels of sunlight during these months.

      Source: National Library of Medicine

  • C
    • Calcium

      Calcium is the most plentiful mineral found in the human body. The teeth and bones contain the most calcium. Nerve cells, body tissues, blood, and other body fluids contain the rest of the calcium.

      Calcium is one of the most important minerals for the human body. It helps form and maintain healthy teeth and bones. A proper level of calcium in the body over a lifetime can help prevent osteoporosis.

      Calcium helps your body with:

      • Building strong bones and teeth
      • Clotting blood
      • Sending and receiving nerve signals
      • Squeezing and relaxing muscles
      • Releasing hormones and other chemicals
      • Keeping a normal heartbeat

      Source: National Library of Medicine

    • Cortical bone

      Dense, hard bone with microscopic spaces. It is typically found in the long bones (i.e. femur, tibia) and in the outer region of the vertebrae.

  • D
    • Diabetes—Tyoe 1

      Type 1 diabetes is a lifelong (chronic) disease in which there is a high level of sugar (glucose) in the blood.

      It can occur at any age, but is most often diagnosed in children, adolescents, or young adults.

      Insulin is a hormone produced in the pancreas by special cells, called beta cells. It is needed to move blood sugar (glucose) into cells. Inside the cells, glucose is stored and later used for energy. With type 1 diabetes, beta cells produce little or no insulin.

      Without enough insulin, glucose builds up in the bloodstream instead of going into the cells. This buildup of glucose in the blood is called hyperglycemia. The body is unable to use the glucose for energy. This leads to the symptoms of type 1 diabetes.

      The exact cause of type 1 diabetes is unknown. Most likely, it is an autoimmune disorder. This is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue. 

      Source: National Library of Medicine

    • Diabetes—Type 2

      Type 2 diabetes is a lifelong (chronic) disease in which there is a high level of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes.

      When you have type 2 diabetes, your fat, liver, and muscle cells do not respond correctly to insulin. This is called insulin resistance. As a result, blood sugar does not get into these cells to be stored for energy.

      When sugar cannot enter cells, a high level of sugar builds up in the blood. This is called hyperglycemia. The body is unable to use the glucose for energy. This leads to the symptoms of type 2 diabetes.

      Type 2 diabetes usually develops slowly over time. Most people with the disease are overweight or obese when they are diagnosed. Increased fat makes it harder for your body to use insulin the correct way.

      It can also develop in people who are not overweight or obese. This is more common in older adults.

      Family history and genes play a role in type 2 diabetes. Low activity level, poor diet, and excess body weight around the waist increase your chance of getting the disease.

      Source: National Library of Medicine

    • Dual-energy x-ray absorptiometry (DXA)

      A quantitative imaging technique that uses a radiation source to measure bone mineral density. 

  • F
    • Femur scan

      A scan that measures three regions of interest: the femoral neck, Ward’s triangle, and the greater trochanter. This can be confusing because the “femoral neck” is sometimes thought to be in the neck, rather than the hip.

  • G
    • GERD

      Gastroesophageal reflux disease (GERD). This is a condition where food or liquid moves up from the stomach into the esophagus (the tube from the mouth to the stomach).

      Source: National Library of Medicine

    • Graves disease

      Graves disease is an autoimmune disorder that leads to an overactive thyroid gland (hyperthyroidism). An autoimmune disorder is a condition that occurs when the immune system mistakenly attacks healthy tissue.

      Source: National Library of Medicine

  • H
    • H2 blockers

      H2 blockers are medicines that work by reducing the amount of stomach acid secreted by glands in the lining of your stomach.

      H2 blockers are used to:

      • Relieve symptoms of acid reflux, or gastroesophageal reflux disease (GERD). This is a condition where food or liquid moves up from the stomach into the esophagus (the tube from the mouth to the stomach).
      • Treat a peptic or stomach ulcer.

      There are different names and brands of H2 blockers. Side effects may vary from drug to drug.

      • Cimetidine (Tagamet)
      • Famotidine (Pepcid)
      • Nizatidine (Axid)

      Note: (11/12/19) The FDA has asked manufacturers to voluntarily recall ranitidine (including Zantac) because these medicines may contain low levels of a a probable human carcinogen.

      Source: National Library of Medicine

    • Hashimoto’s thyroiditis (chronic thyroiditis)

      Hashimoto disease—chronic thyroiditis—is caused by a reaction of the immune system against the thyroid gland. It often results in reduced thyroid function (hypothyroidism).

      Source: National Library of Medicine

    • Hypercalcemia

      Hypercalcemia is a condition in which the calcium level in your blood is above normal. Too much calcium in your blood can weaken your bones, create kidney stones, and interfere with how your heart and brain work.

      Source: Mayo Clinic

  • I
    • Ipriflavone

      A synthetic isoflavone with anabolic compounds created to enhance bone density and muscle strength. In the research studies conducted to date the results were no better than the subjects taking calcium and vitamin D consistently.

  • K
    • Kidney stone

      A kidney stone is a hard object that is made from chemicals in the urine. The stone-forming chemicals are calcium, oxalate, urate, cystine, xanthine, and phosphate. Possible causes include drinking too little water, exercise (too much or too little), obesity, weight loss surgery, or eating food with too much salt or sugar (fructose). Infections and family history might be important in some people. 

      Source: National Kidney Foundation

    • Kyphoplasty

      Kyphoplasty is used to treat painful compression fractures in the spine. In a compression fracture, all or part of a spine bone collapses.

      The procedure is also called balloon kyphoplasty.

      It is done in a hospital or outpatient clinic.

      Source: National Library of Medicine

    • Kyphosis

      Kyphosis is a curving of the spine that causes a bowing or rounding of the back. This leads to a hunchback or slouching posture.

      Kyphosis can occur at any age, although it is rare at birth.

      In adults, kyphosis can be caused by:

      • Degenerative diseases of the spine (such as arthritis or disk degeneration)
      • Fractures caused by osteoporosis (osteoporotic compression fractures)
      • Injury (trauma)
      • Slipping of one vertebra forward on another (spondylolisthesis)

      Other causes of kyphosis include: 

      • Certain hormone (endocrine) diseases
      • Connective tissue disorders
      • Infection (such as tuberculosis)
      • Muscular dystrophy (group of inherited disorders that cause muscle weakness and loss of muscle tissue)
      • Neurofibromatosis (disorder in which nerve tissue tumors form)
      • Paget disease (disorder that involves abnormal bone destruction and regrowth)
      • Polio
      • Scoliosis (curving of the spine often looks like a C or S)
      • Spina bifida (birth defect in which the backbone and spinal canal don’t close before birth)
      • Tumors

      Source: National Library of Medicine

  • M
    • Magnesium

      Magnesium is an essential mineral for human nutrition.

      Magnesium is needed for more than 300 biochemical reactions in the body. It helps to maintain normal nerve and muscle function, supports a healthy immune system, keeps the heart beat steady, and helps bones remain strong. It also helps regulate blood glucose levels and aid in the production of energy and protein.

      There is ongoing research into the role of magnesium in preventing and managing disorders such as high blood pressure, heart disease, and diabetes. However, taking magnesium supplements is not currently recommended.

      Diets high in protein, calcium, or vitamin D will increase the need for magnesium.

      Source: National Library of Medicine

    • Malabsorption

      Malabsorption involves problems with the body’s ability to take in nutrients from food.

      Many diseases can cause malabsorption. Most often, malabsorption involves problems absorbing certain sugars, fats, proteins, or vitamins. It can also involve an overall problem with absorbing food.

      Problems or damage to the small intestine that may lead to problems absorbing important nutrients. These include:

      • Celiac disease
      • Crohn disease
      • Surgery that removes all or part of the small intestine

      Enzymes produced by the pancreas help absorb fats and other nutrients. A decrease of these enzymes makes it harder to absorb fats and certain nutrients.

      Some of the other causes of malabsorption include:

      • Certain medicines (tetracycline, some antacids, some medicines used to treat obesity, colchicine, acarbose, phenytoin, cholestyramine)
      • Gastrectomy and surgical treatments for obesity
      • Chronic liver disease
      • Cow’s milk protein intolerance
      • Soy milk protein intolerance

      Source: National Library of Medicine

    • Menopause

      Menopause is the time in a woman’s life when her periods (menstruation) stop. Most often, it is a natural, normal body change that most often occurs between ages 45 to 55. After menopause, a woman can no longer become pregnant.

      During menopause, a woman’s ovaries stop releasing eggs. The body produces less of the female hormones estrogen and progesterone. Lower levels of these hormones cause menopause symptoms.

      Periods occur less often and eventually stop. Sometimes this happens suddenly. But most of the time, periods slowly stop over time.

      Menopause is complete when you have not had a period for 1 year. This is called postmenopause. Surgical menopause takes place when surgical treatments cause a drop in estrogen. This can happen if both of your ovaries are removed.

      Menopause can also sometimes be caused by drugs used for chemotherapy or hormone therapy (HT) for breast cancer.

      Source: National Library of Medicine

  • N
    • Normal bone density

      Bone density that falls is the “T” score range -1 and higher.

  • O
    • Osteoarthritis

      Sometimes called degenerative joint disease or degenerative arthritis, osteoarthritis (OA) is the most common chronic condition of the joints, affecting approximately 27 million Americans. OA can affect any joint, but it occurs most often in knees, hips, lower back and neck, small joints of the fingers and the bases of the thumb and big toe.
      Source: Arthritis Foundation

    • Osteoblasts

      A cell from which bone develops, a bone-forming cell

    • Osteoclasts

      A large multinuclear cell associated with absorption and removal of bone: responsible for bone resorption

    • Osteonecrosis

      Osteonecrosis is broadly defined as necrosis of bone due to obstruction of blood supply. Osteonecrosis of the jaw (ONJ) is an oral lesion involving exposed mandibular or maxillary bone, which usually manifests with pain and purulent discharge, although it may be asymptomatic; ONJ typically occurs following tooth extractions or other dentoalveolar surgeries, but in some cases, it can occur spontaneously.

      Source: American Dental Association

    • Osteopenia

      A condition where bone mineral density is lower than normal however not yet as low as osteoporosis and falls in the “T score range of -1.1 to -2.4

    • Osteoporosis

      Osteoporosis is a systemic skeletal disease characterized by low bone mass and micro architectural deterioration of bone tissues, with a consequent increase in bone fragility and susceptibility to fracture.

    • Oxidative stress

      Oxidative stress, defined as a disturbance in the balance between the production of reactive oxygen species (free radicals) and antioxidant defenses.

  • P
    • PARS stress fracture

      The PARS stress fracture (spondylolysis) usually occurs in the lower back (lumbar spine) and results from repetitive hyperextension (bending backwards) and rotation activities. This fracture is often considered an “overuse injury.”

    • Paget disease

      Paget disease is a disorder that involves abnormal bone destruction and regrowth. This results in deformity of the affected bones.

      The cause of Paget disease is unknown. It may be due to genetic factors, but also could be due to a viral infection early in life.

      In people with Paget disease, there is an abnormal breakdown of bone tissue in specific areas. This is followed by abnormal bone formation. The new area of bone is larger, but weaker. The new bone is also filled with new blood vessels.

      The affected bone may only be in one or two areas of the skeleton, or in many different bones in the body. It more often involves bones of the arms, collarbones, legs, pelvis, spine, and skull.

      Source: National Library of Medicine

    • Phosphorus

      Phosphorus is a mineral that makes up 1% of a person’s total body weight. It is the second most abundant mineral in the body. It is present in every cell of the body. Most of the phosphorus in the body is found in the bones and teeth.

      The main function of phosphorus is in the formation of bones and teeth.

      It plays an important role in how the body uses carbohydrates and fats. It is also needed for the body to make protein for the growth, maintenance, and repair of cells and tissues. Phosphorus also helps the body make ATP, a molecule the body uses to store energy.

      Phosphorus works with the B vitamins. It also helps with the following: kidney function; muscle contractions; normal heartbeat; nerve signaling.

      Source: National Library of Medicine

    • Proton-pump inhibitors (PPIs)

      Proton-pump inhibitors (PPIs) are a group of drugs whose main action is a pronounced and long-lasting reduction of stomach acidproduction. 

      This group of drugs followed and largely superseded another group of medications with similar effects, but a different mode of action, called H2-receptor antagonists.

      PPIs include:

      • dexlansoprazole (Dexilant, Kapidex)
      • esomeprazole (Nexium®)
      • lansoprazole (Prevacid®)
      • omeprazole (Prilosec®, Zegerid)
      • pantoprazole (Protonix)
      • rabeprazole (Aciphex®)
  • R
    • RANKL Inhibitor

      A RANKL Inhibitor slows down the natural rate your bones are broken down. It works by blocking a protein and suppressing the cells that break down bone.

    • Recommended Dietary Allowance (RDA)

      Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy individuals; often used to plan nutritionally adequate diets for individuals.

    • Resorption (bone resorption)

      Bone resorption is the process by which osteoclasts break down the tissue in bones and release the minerals, resulting in a transfer of calcium from bone tissue to the blood.

    • Rheumatoid Arthritis (RA)

      Rheumatoid arthritis (RA) is an autoimmune disease in which the body’s immune system – which normally protects its health by attacking foreign substances like bacteria and viruses – mistakenly attacks the joints. This creates inflammation that causes the tissue that lines the inside of joints (the synovium) to thicken, resulting in swelling and pain in and around the joints. The synovium makes a fluid that lubricates joints and helps them move smoothly.

      Source: Arthritis Foundation

    • Rickets

      Rickets is a disorder caused by a lack of vitamin D, calcium, or phosphate. It leads to softening and weakening of the bones.

      Vitamin D helps the body control calcium and phosphate levels. If the blood levels of these minerals become too low, the body may produce hormones that cause calcium and phosphate to be released from the bones. This leads to weak and soft bones.

      You may not get enough vitamin D from your diet if you:

      • Are lactose intolerant (have trouble digesting milk products)
      • DO NOT drink milk products
      • Follow a vegetarian diet

      Disorders that reduce the digestion or absorption of fats will make it more difficult for vitamin D to be absorbed into the body.

      Source: National Library of Medicine

  • S
    • SERM

      Selective Estrogen Receptor Modulators mimic the effect the hormone estrogen has on your bone. It helps to keep your bones strong. 

    • Sclerostin Monoclonal antibodies

      Sclerostin Monoclonal antibodies are designed to work by inhibiting the activity of sclerostin, which simultaneously results in increased bone formation and to a lesser extent decreased bone break down.

    • Spine scan

      A scan that includes the vertebrae of the lumbar spine in its region of interest. We use lumbar 1-4.

    • Statins

      Statin drugs lower LDL cholesterol by slowing down the liver’s production of cholesterol. They also increase the liver’s ability to remove LDL cholesterol that is already in the blood.

      Source: Centers for Disease Control & Prevention

    • Stress fracture

      A stress fracture is a small crack in a bone, or severe bruising within a bone. Most stress fractures are caused by overuse and repetitive activity, and are common in runners and athletes who participate in running sports, such as soccer and basketball.

      Bone is in a constant state of turnover—a process called remodeling. New bone develops and replaces older bone. If an athlete’s activity is too great, the breakdown of older bone occurs rapidly — it outpaces the body’s ability to repair and replace it. As a result, the bone weakens and becomes vulnerable to stress fractures.

      Source: American Academy of Orthopedic Surgeons

    • Strontium

      An element that heavier than calcium and frequently found in supplements citing increased bone density. The bone density appears falsely  increased because the stronitium enters the bone and replaces the lighter weight calcium. There is concern that excess strontium in the bones may make them brittle.  Strontium is not approved by the  FDA.

  • T
    • T-score

      The difference between the patient’s BMD and the mean young adult value of the reference population, divided by the reference standard deviation (SD). A T-score of –2 means the patient is 2 SDs below the reference population.

    • TSH test

      A TSH test measures the amount of thyroid stimulating hormone (TSH) in your blood. TSH is produced by the pituitary gland. It prompts the thyroid gland to make and release thyroid hormones into the blood.

      Source: National Library of Medicine

    • Thyroid-stimulating Hormone (TSH)

      TSH is produced by the pituitary gland. It prompts the thyroid gland to make and release thyroid hormones into the blood.

      Source: National Library of Medicine

    • Tolerable Upper Intake Level (UL)

      Tolerable Upper Intake Level (UL): Maximum daily intake unlikely to cause adverse health effects.

    • Trabecular bone

      Porous bone composed of an intricate, latticed network of fibrous, calcified mineral. It is typically found at points of compression, such as lumbar vertebrae, femoral head, etc.

  • V
    • Vitamin A

      Vitamin A is a fat-soluble vitamin that is stored in the liver.

      Two types of vitamin A are found in the diet: Preformed vitamin A, found in animal products such as meat, fish, poultry, and dairy foods; and Provitamin A found in plant-based foods such as fruits and vegetables. The most common type of pro-vitamin A is beta-carotene.

      Vitamin A helps form and maintain healthy teeth, skeletal and soft tissue, mucus membranes, and skin. It is also known as retinol because it produces the pigments in the retina of the eye.

      Source: National Library of Medicine

    • Vitamin D

      Vitamin D is a fat-soluble vitamin. Fat-soluble vitamins are stored in the body’s fatty tissue.

      Vitamin D helps the body absorb calcium. Calcium and phosphate are two minerals that you must have for normal bone formation.

      In childhood, your body uses these minerals to produce bones. If you do not get enough calcium, or if your body does not absorb enough calcium from your diet, bone production and bone tissues may suffer.

      Vitamin D deficiency can lead to osteoporosis in adults or rickets in children.

      Source: National Library of Medicine

    • Vitamin K

      Vitamin K is a fat-soluble vitamin.

      Vitamin K is known as the clotting vitamin, because without it blood would not clot. Some studies suggest that it helps maintain strong bones in the older adults.

      Source: National Library of Medicine

  • Z
    • Z-score

      The difference between the patient’s BMD and the mean age-matched value of the reference population, divided by the reference standard deviation (SD). A Z-score of –2 means the patient is 2 SDs below the reference population (age and gender matched).

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