Mount Carmel Health Partners Clinical Guidelines Osteoporosis

Table B: WHO Definition of Osteoporosis Based on BMD Classification BMD T-Score Normal Within 1 SD of the mean level for a young adult reference population At -1.0 and above Low Bone Mass (Osteopenia) Between 1.0 and 2.5 SD below that of the mean level for a young adult reference population Between -1.0 and -2.5 Osteoporosis 2.5 SD or more below that of the mean level for a young At or below -2.5 adult reference population Severe or Established Osteoporosis 2.5 SD or more below that of the mean level for a young At or below-2.5 with one or adult reference population more fractures Table C: Secondary Causes of Osteoporosis Acromegaly Epidermolysis bullosa Leukemia Amyloidosis Gastrectomy Lymphoma Ankylosing spondylitis Hemochromatosis Malabsorption syndrome Celiac disease Hemophilia Mastocytosis Chronic active hepatitis Hyperparathyroidism Multiple myeloma Chronic obstructive pulmonary disease Hyperprolactinemia Multiple sclerosis Congenital porphyria Hyperthyroidism Pernicious anemia Cushing's syndrome Hypogonadism Rheumatoid arthritis Diabetes mellitus Idiopathic scoliosis Sarcoidosis Eating disorders Inflammatory bowel disease Sickle cell anemia Endometriosis Thalassemia Table D: Risk Factors for Osteoporosis Non-Modifiable Potentially Modifiable Dietary — low body weight (< 127 lbs or BMI < 20) Inadequate calcium and/or vitamin D Excessive phosphate/protein Caucasian/European or Asian Ethnicity Increasing Age and Female Lifestyle — lack of weight-bearing exercise, sedentary Nulliparity Social — current tobacco use, > 2 alcoholic drinks/day Family History of Osteoporosis including kyphosis, previous fragility fractures, and low trauma fracture after 50 Medication — Long-term use of corticosteroids, excess thyroid hormone replacement, chronic heparin or anti-seizure medication use, chemotherapy, tamoxifen, lithium, radiation therapy Table E: Institutes of Medicine Recommended Allowances for Calcium and Vitamin D Calcium Vitamin D Age Recommended Dietary Allowance (mg/day) Recommended Dietary Allowance (intl. units/day) 9 to 18 1,300 600 19 to 50 1,000 600 51 to 70 1,200 600 71 and up 1,200 800 Osteoporosis - 3

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