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Aerobic exercise: Type of activity intended to strengthen the heart, such as running, cycling, or brisk walking, by increasing your breathing and heart rate; helps the body to burn off fat and control cholesterol.

Alternative therapies: Therapies that are used in place of conventional Western medical therapies; includes massage, visualization, naturopathic medicine, and acupuncture, among others.

Alzheimer's disease: Degenerative brain disorder that gradually causes disorientation, confusion, and memory loss.

Amenorrhea: Absence of menstruation for 3 months or more.

Anabolic agent: Medication, steroid hormone, or substance intended to build bone; examples are Forteo (teriperatide) and testosterone.

Anorexia nervosa: A disorder characterized by fear of becoming obese, thinking the body is larger than it really is, severe weight loss, and an aversion to food. Once thought to only affect teenage girls, it is now recognized in women of all ages and rarely in men.

Antiresorptive agents: Medications and substances that decrease bone resorption (bone breakdown).

Biochemical marker: Substances found in blood and urine that can be tested to determine the rate of bone turnover.

Bioidentical: Refers to hormones manufactured in a laboratory, usually from wild yam or soy, which have the exact same chemical makeup as the hormones made in the body; also termed "natural" hormones.

Bisphosphonates: A group of antiresorptive agents, such as Fosamax,

Boniva, and Actonel, which slow the rate at which bone is broken down.

Body mass index (BMI): A measurement of body size that includes both height and weight. It is calculated by dividing your weight (in pounds) by your squared height (in inches), multiplied by 704.5.

Bone mass: The volume, density, or quantity of bone.

Bone mineral density (BMD) tests: Safe, painless, and noninvasive tests to evaluate bone mineral density.

Bone modeling: A process that takes place in childhood and adolescence in which new bone is developed at one site and old bone is destroyed at another site. For healthy bones during bone growth, the amount of new bone being formed should exceed the amount of old bone being broken down.

Bone remodeling: A process that occurs after peak bone mass is reached in early adulthood. Bone forming cells respond to the activity of the bone breakdown cells. When bone formation does not keep pace with bone breakdown, osteoporosis occurs.

Bone turnover: The process of breaking down bone and forming new bone in its place, a process that occurs throughout life. When bone is growing (during childhood through early adulthood) new formation exceeds breakdown; later in life breakdown exceeds formation.

Bulimia: An eating disorder that usually includes episodes of binge eating (eating very large amounts of food) and purging (forcing vomiting or diarrhea to get food out of the system).

Calcitonin: A hormone naturally secreted by the thyroid gland that makes the osteoclasts less active, allowing for more bone formation to take place.

Calcitriol: A hormone resulting from the conversion of vitamin D by liver and kidney enzymes to aid in balancing the activity of the osteoclasts and osteoblasts.

Calcium: A mineral necessary for the production and function of bone. It is removed from bone when blood levels of calcium become low; also vital for functioning of nerves and muscles. Calcium must be consumed daily and is found in many dairy products, certain vegetables, fortified products, and supplements.

Cartilage: Rubbery connective tissue that is found in joints and the outer ear.

Central bones: Bones that are found in the main or central areas of the body, such as the hips, vertebrae, and spine. These bones provide the best measures for determining bone mineral density.

Central testing: Usually DXA or QCT bone density tests of the hip, upper thigh, or spine.

Collagen: A protein substance used by osteoblasts to make new bone and keep teeth strong. Also found in connective tissue such as skin, tendons, and ligaments throughout the body.

Complementary therapies: Therapies that are used in addition to conventional, Western medical treatments or interventions.

Conjugated equine estrogen: The most common form of estrogen used in hormone therapy (HT), extracted from the urine of pregnant mares.

Contrast dye: A dye that is given orally or intravenously for the purposes of focusing certain types of imaging tests; should not be taken within 2 weeks before having a bone mineral density test.

Cortical bone: Hard outer shell of bone responsible for bone strength.

Cortisol: A steroid hormone secreted by the adrenal glands necessary for bone growth. Too much cortisol can cause bone loss.

Dementia: Condition marked by memory loss, lack of ability to attend to personal care, personality changes, impaired reasoning, and bouts of disorientation.

DHEA (dehydroepiandrosterone): A precursor to testosterone secreted by the adrenal glands and ovaries; in supplement form, made from steroid molecules extracted from wild yam, an herb.

Dialysis: Process by which impurities and toxic substances are removed from the body either by filtering blood through a machine or infusing fluids into the abdominal cavity that remove wastes; required for those who do not have adequately functioning kidneys.

Disability: A physical or mental impairment that causes inability to perform normal or routine activities.

Dowager's hump: see Kyphosis.

DXA (dual-energy x-ray absorptiometry): A test that measures bone mineral density in the hip, upper thigh, and spine. DXA tests use a particular form of x-ray imaging that is analyzed through a computer to give results in the terms of T-scores and Z-scores; gold standard for measuring bone loss and diagnosing osteoporosis.

Elemental calcium: The calcium that your body absorbs and uses.

Endocrinologist: Physician who specializes in the care of people with hormone disorders such as diabetes, thyroid problems, and osteoporosis.

Endometriosis: A painful condition characterized by the abnormal presence of endometrial (uterine lining) tissue outside the uterus, such as on the ovary, colon, or bladder.

Estrogen: Known as a female sex hormone although it is also found in men in small amounts; primarily secreted by the ovary in response to follicle stimulating hormone (FSH) and is also made in body tissues in both men and women. Estrogens used in hormone therapy (HT) can be manufactured using certain plants or from pregnant mare's urine.

Estrogen agonist/antagonist: Antiresorptive medications such as Evista that help to reduce bone loss by their positive estrogenic effects; formerly known as selective estrogen receptor modulators or SERMs.

Estrogen receptor positive cancer:

Type of cancer that is estrogen dependent or has receptors for estrogen.

Estrogen therapy (ET): Estrogen-containing products that are used in the treatment of perimenopausal and menopausal symptoms. Estrogen taken by itself for the treatment of menopausal symptoms is also called MHT (menopause hormone therapy).

Extension: Straightening a flexed limb.

Flexion: A bending motion of any joint.

Folate: A vitamin needed for new cell development; helps reduce levels of homocysteine, a substance associated with osteoporotic fractures, heart disease, and stroke; also reduces risks for breast and colon cancer; also called folic acid. A vitamin found in fruits, vegetables, and low-fat dairy products and lowers homocysteine levels; a substance associated with osteoporotic fractures.

Fracture: To break, splinter, or crack a bone.

Fragility fracture: Term used to describe a fracture that occurs with very little trauma or force and from a height that is usually not great enough to cause broken bones, usually indicating that the bone is weak. Also called an osteoporotic fracture.

Frozen bone: Speculated to be a potential concern in individuals taking combinations of osteoporosis medications. While the medications increase bone mass, the bone quality may not be as good, resulting in bone that is more brittle rather than stronger.

Glucocorticoid-induced osteoporosis: Osteoporosis caused by taking glucocorticoids (commonly called steroids), a class of medications taken for their anti-inflammatory effects on illnesses such as rheumatoid arthritis, asthma, lupus, and Crohn's disease.

Gluten intolerance: Allergy to wheat, which occurs in celiac disease. Can cause intestinal absorption problems.

Growth hormone: Hormone secreted by the pituitary gland and especially important for bone growth during puberty.

Gynecology clinician (GYN): A nurse practitioner, midwife, physician assistant, or physician who specializes in the practice of gynecology, the health care of women; often focused primarily on their reproductive organs.

Half-life: Time it takes the body to metabolize or inactivate half of the amount of a medication that was taken.

Hip protector: A protective pad worn over the hip.

Homocysteine: A substance associated with fractures due to osteoporosis as well as heart disease; can be reduced by eating a diet high in folic acid (e.g., green leafy vegetables and fruits) or by taking vitamins B6 and B.

Hot flashes: Sensations of heat, occurring during perimenopause and often well into postmenopause, that begin at the head and spread over the entire body; occurs with an increase in luteinizing hormone. Is not a health hazard, may be accompanied by sweating, and can cause significant discomfort or interfere with sleep.

Hypogonadism: Inadequate testicular or ovarian function most commonly causing low levels of testosterone.

Hysterectomy: Removal of the uterus.

Idiopathic ovarian insufficiency: The loss of ovarian function (and therefore fertility) in a woman under the age of 40, resulting in menopause. It is usually associated with other health conditions and can sometimes be temporary. Also called premature ovarian failure.

Induced menopause: Permanent menopause that is not natural; can be caused as a result of removal of the ovaries (surgical), chemotherapy, or radiation to the pelvis.

Injection: Given into the muscle, fat tissue, or vein using a needle with a syringe attached.

Insulin: A hormone secreted by the pancreas and important for the body's ability to use carbohydrates and sugar.

Isoflavone: A type of phytoestrogen found most notably in soy and red clover.

Kyphoplasty: A surgical procedure used to relieve pain of VCFs, which combines vertebroplasty and angioplasty by placing a balloon in the fractured vertebra and filling it with a cement-like substance.

Kyphosis: A deformity of the spine that develops when the front edges of the bones of the spine collapse due to osteoporosis and fractures; also called "dowager's hump."

Lactose intolerance: Occurs when the small intestine does not make enough lactase, the enzyme required to break down the lactose (milk sugar) in milk products before they enter the large intestine; can cause bloating, pain, gas, and diarrhea.

Leptin: A hormone found in fat cells that affects bone growth.

Ligaments: Tough bands that connect bones to each other.

Long bones: The larger bones of the legs (femur, tibia, fibula) and arms (humerus, ulna, radius).

Lysine: An amino acid that strengthens collagen in bone formation.

Magnesium: A mineral important for hardening of bone.

Menopause: The specific point in time occurring after 12 consecutive months without a menstrual period that does not have another identifiable cause such as illness or medications.

MHT (menopause hormone therapy): Hormone therapy (HT) was changed to MHT to distinguish it from other types of hormone therapy that are not given to alleviate the symptoms of menopause. See estrogen therapy.

Night sweats: Sweating that occurs at night resulting from hot flashes during perimenopause and postmenopause.

Obesity: Condition of being severely overweight based on body mass index greater than 30 and associated with many health problems; a leading cause of death in the United States.

Orthopedist: A physician who specializes in the treatment and surgery of bone and joint disorders.

Osteoarthritis: Inflammation and stiffness of the joints that usually occurs in older persons as a result of deterioration of the cartilage around the joints.

Osteoblasts: Cells that cause bone formation.

Osteocalcin: A protein that is part of the bone remodeling cycle.

Osteoclasts: Cells that cause bone breakdown.

Osteomalacia: A softening of bones caused by vitamin D deficiency because of diet or ailments that impair normal vitamin D absorption or use; causes bone pain, leg deformities, and fractures; sometimes called adult rickets.

Osteonecrosis of the jaw: Deterioration of jaw bone associated with tooth loss, local infection, and delayed healing; leads to death of local jaw bone tissue.

Osteopenia: A condition in which there is low bone mass or low bone density, but not to the same degree as osteoporosis. Osteopenia means bones (osteo) are lacking (penia). T-score is between —1.0 and —2.5.

Osteoporosis: The most common bone disease, in which bones become less dense, lose strength, and are more likely to break (fracture). Osteoporosis means bones (osteo) with holes (porosis). T-score is lower than —2.5.

Oversuppression: Occurs when bone turnover is suppressed to such a high extent that bone quality may be compromised; associated with "frozen bone."

Paget's disease: Causes large, deformed bones due to the excessive breakdown and formation of bone. Although totally unrelated to osteoporosis, it can occur with osteoporosis in the same bones.

Panoramic x-ray: A type of radiography, usually of teeth and surrounding bones such as the jawbone.

Parathyroid hormone (PTH): A hormone secreted by the parathyroid glands that assists in the regulation of calcium by promoting the absorption of calcium from the intestine and reducing the loss of calcium through urine excretion. Also the active ingredient in Forteo, a medication and anabolic agent used to treat osteoporosis.

pDXA (peripheral dual-energy x-ray absorptiometry): Uses the same technology as the DXA but measures bone density in the wrist, forearm, finger, or heel.

Peak bone mass: The highest amount of bone present in the human body, usually obtained by early adulthood.

Pedometer: A small gadget that measures the number of footsteps taken.

Periodontal disease: Disease of the gums, tissues, and bone supporting teeth.

Peripheral bone mineral density testing: Bone mineral density tests of the non-central bones, usually heel, wrist, forearm, or fingers.

Peripheral limbs: The outer areas of the body, including hands, forearms, wrists, lower leg, and feet.

Phosphorus: A mineral important for the formation of bone and teeth.

Phytoestrogens: Weak, estrogen-like substances that are in plants. Can be eaten in whole foods, such as soy, or extracted from red clover in the form of isoflavones and made into supplements.

Pilates: A type of activity for muscles that promotes strength and flexibility; developed by Joseph Pilates, this group of exercises can be done by yourself or in a class.

Placebo: An inactive substance that contains no medication or active ingredient; to be given to participants in a clinical trial to determine the effectiveness of a specific treatment or medication.

Plantar fasciitis: An inflammation of the connective tissue of the bottom of the foot, which can cause severe pain.

Postmenopause: The time following menopause during which estrogen loss is the major cause of osteoporosis in women past midlife.

pQCT (peripheral quantitative computed tomography): Type of radiography that uses the same technology as the QCT but measures bone density in the forearm or wrist; primarily used in research.

Premature menopause: Permanent (usually natural) menopause occurring in women younger than 40 years of age; also refers to women who have induced or surgical menopause.

Premature ovarian failure: The loss of ovarian function (and therefore fertility) in a woman under the age of 40, resulting in menopause. It is usually associated with other health conditions and can sometimes be temporary. Also called idiopathic ovarian insufficiency.

Prescription medication: An instruction from a health care professional who is licensed to provide written authorization of medications or devices to be issued by a pharmacy.

Primary osteoporosis: Type of osteoporosis related to age that affects women more severely and earlier than men.

QCT (quantitative computed tomography): Type of radiography that uses CT scan technology to measure the bone density in the spine.

QUS (quantitative ultrasound): Type of radiography that uses sound wave technology to test the bone density of the heel, wrist, tibia bone in the leg, and fingers.

RA (radiographic absorptiometry):

Conventional x-ray with software and scanning equipment used to measure bone density of the middle bones of the hand.

Radiogrammetry: Like radiographic absorptiometry, an imaging technique that uses conventional x-rays by comparing the bone density of the two bones in the hand.

Resistive exercise: Type of activity that pushes and pulls muscles to strengthen them; examples are swimming, biking, and weight-lifting.

Resorption: Process by the osteoclasts of breaking down bone.

Rheumatologist: Physician who specializes in the care of people with disorders related to joints, bones, tendons, and muscles. Unlike a surgeon, does not perform surgery on joints and bones.

Salpingo-oophorectomy: Removal of fallopian tube and ovary; bilateral means both fallopian tubes and both ovaries are removed.

Secondary osteoporosis: Osteoporosis at any age resulting from illnesses, conditions, or medications that cause bone loss.

Sedentary lifestyle: A way of living that involves little or no exercise.

Severe osteoporosis: A T-score lower than -2.5 plus the presence of one or more fragility fractures.

Sex hormones: A chemical substance formed in one organ or part of the body that can alter the function or structure of another organ, tissue, or various numbers of them; examples are estrogen, testosterone, and progesterone, which stimulate bone growth.

Standard deviation: A mathematical measure that indicates how far or how near something is to the mean (average).

Supplements: Additional doses of vitamins, minerals, or other dietary substances; usually taken to enhance diet to get the recommended amount for your age, gender, and medical conditions.

SXA (single energy x-ray absorptiometry): Type of radiograph where the bone mineral density test is done on the wrist or heel while the body part is submerged in water.

Tai chi: A form of exercise that combines meditation and flexibility training.

Testosterones: A steroid hormone formed by the testes in males and, to a far lesser degree, by the ovary and adrenal glands in women; responsible for male characteristics such as a deep voice and facial hair; is important for normal sexual development and function as well as normal bone development in both men and women.

Thyroid hormones: Secreted by the thyroid gland, these natural chemicals regulate the body's metabolism and help to control the rate of bone remodeling; too much can cause bone destruction.

Total hysterectomy: Although technically only refers to removal of the uterus, "total" is sometimes used to refer to removal of the uterus, ovaries, and fallopian tubes.

Trabecular bone: Connective spongy tissue of bone, particularly of the central and long bones. Provides strength and integrity, houses bone marrow, produces blood products, and provides the surface used for the exchange of calcium and phosphorus.

T-score: A positive or negative number representing the number of standard deviations that is calculated based on a comparison between your bone mineral density with that of healthy young adults. T-scores between -1.0 and -2.5 indicate osteopenia; T-scores lower than -2.5 indicate osteoporosis.

Vasomotor symptoms: Symptoms resulting from irregular functioning of the part of the brain that controls body heat, usually experienced as hot flashes and sweats that may or may not be followed by feeling cold or chilled.

Vertebrae: Individual bones of the spine. Fractures of these bones are the most common fractures in people with osteoporosis.

Vertebral compression fracture (VCF): A fracture of the body of a vertebra (spine bone) that collapses it and makes it thinner and weaker. Usually results from osteoporosis but can also result from complications of cancer or some injuries.

Vertebral fracture: See vertebral compression fracture.

Vertebroplasty: A nonsurgical procedure that involves injecting a cement-like substance into the fractured vertebra to stabilize it and relieve pain.

Vitamin: One of a group of organic substances, present in minute amounts in natural foodstuffs, that are essential to normal metabolism; insufficient amounts in the diet may cause deficiency diseases.

Vitamin A: Plays an essential role in growing healthy bones by helping to regulate osteoclast and osteoblast activities in bone modeling and remodeling; too much of it can actually damage your bones.

Vitamin Indirectly helps with bone development by lowering levels of homocysteine.

Vitamin C: Important for bone development because of its role in making collagen.

Vitamin D: Also known as calciferol, which is actually a hormone; a nutrient important for absorbing and regulating calcium and phosphorus levels. Sunlight, fortified products, or supplements are necessary in order to get the required amount of daily vitamin D.

Vitamin K: Aids in the production of osteocalcin; also important for the blood's ability to clot; helps to prevent calcium from being removed from bone. Insufficient vitamin K can lead to hip fractures.

Weight-bearing exercise: Type of activity that places weight on certain bones; necessary for bone growth; examples are walking, dancing, and stair-climbing.

Yoga: A group of breathing exercises and movements intended to improve flexibility and strength, and bring about tranquility.

Z-score: Matches your bone mineral density with individuals of the same age, gender, and ethnicity, but is more helpful in evaluating children and premenopausal women. Very low Z-scores may mean that you have secondary osteoporosis.


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