Osteoporosis

What is osteoporosis?

Osteoporosis is a medical term for the thinning and weakening of the bones, it literally means 'porous bones'. If this deterioration in the bones goes untreated, our skeleton eventually becomes very fragile and some bones will be likely to break or fracture with a minor bump or fall.

The bones and osteoporosis

Bone is living tissue made largely of calcium and when we are young, our bones, like other parts of our body, are constantly being renewed - as old cells wear out they are replaced by healthy new ones. However, as we get older, more cells wear out than are being replaced and so the bone starts to lose its density (mass). The bones become weakened and when bones are weak they are more likely to fracture or break, they will also take longer to heal.

What are the symptoms of osteoporosis?

Unfortunately, because your bones are hidden and the thinning of the bones does not cause any symptoms, most people do not know that they are suffering from osteoporosis, until they have the unfortunate experience of breaking a hip or wrist due to a minor fall. Loss of bone in itself has no effect, on the body unless a fracture occurs. When the bones are significantly thinned (low in bone mass) even a simple cough or sneeze could cause a fracture of a rib. It is estimated that around 60,000 fractures occur every year in people aged 65 or over.

Other symptoms of osteoporosis can include:

• Height loss.
• Curving of the spine, also called Kyphosis. This can become so severe that the chin is forced on to the chest and can cause breathing problems.
• Unexplained back pain.

Am I at risk of osteoporosis?

Women are at greater risk of developing osteoporosis after the menopause. This is because the ovaries stop producing the female hormone oestrogen. Oestrogen is the sex hormone, which helps maintain calcium and other minerals in your bones to keep them healthy and strong, so when oestrogen levels fall the bones start to lose their density.

The severity of the condition can vary from person to person. However, there are a number of factors that may put some people more at risk of developing osteoporosis earlier or more severe than others, they are as follows:-

• Lack of exercise - exercise keeps bones strong.
• Smoking.
• Excessive alcohol intake.
• Steroid use for a long period of time (for conditions such as asthma).
• Poor diet, especially if you are lacking in calcium.
• Family history of osteoporosis.
• If you are of thin or slender build, especially those with anorexia.
• Women who have had an early menopause (usually before the age of 45) or had a hysterectomy.
• Women who have have low oestrogen levels.
• Men who have low levels of the male sex hormone, testosterone.

How is osteoporosis diagnosed?

Osteoporosis can be detected by carrying out a special bone scan called bone densitometry, on a machine known as a Dual X-Ray Absorptiometer (DXA.). This device will take special x-rays and measure the density of bones. This will help the doctor confirm a diagnosis of osteoporosis and assess the risk of fractures.

Occasionally a biopsy (small piece of bone) is taken from the hip to help analyse the severity of the problem.

If you think you may be suffering from osteoporosis, any questions or worries can be discussed with your G.P.

Can osteoporosis be treated?

As of yet there is no treatment which can restore bone to normal but there is treatment which can slow done the rate of bone thinning. Drugs called biphosphonates have been found to encourage calcium into the bones, reducing the rate of bone removal and increasing bone mass. There are a few different types of this drug available, your doctor will help you decide the treatment which is best for you.

The most common treatment for women, is with Hormone Replacement Therapy (H.R.T.). If taken over a long period of time H.R.T. can halt and prevent further bone loss. If you believe you are going through the menopause you should talk to your doctor to see if H.R.T. would be a suitable treatment for you. For more information on H.R.T. click here.

Testosterone can be given to treat men who are deficient in the male sex hormone. This can be in the form of implants or injections. It may also be given to men with severe osteoporosis but with normal testosterone levels to increase bone density.

Bones need calcium and vitamin D so doctors will often advice a high calcium diet and may even suggest additional calcium tablets. Calcium provides strength and rigidity to the bones and it is therefore important that children and teenagers have a calcium rich diet. Calcium is present in milk, cheese yoghurt, bread and sardines. If your diet is not giving you the right amount of calcium, supplements are available from most chemists and supermarkets. The recommended daily allowance (R.D.A.) for calcium intake is between 800-1000mg per day, or 1500mg once over the age of 45.

Vitamin D helps the body absorb calcium from foods and so is essential for healthy bones. The recommended daily intake of vitamin D is 5 micrograms, this increases during pregnancy and in men and women over 65 years of age. Vitamin D is found in oily fish, sardines, salmon and is also obtained from sunlight, so you should try to get out in the sun as much as you can. Elderly people are advised to get out in the sun for at least half an hour to an hour a day. In the wintertime you should eat plenty of oily fish or take a vitamin D supplement. You may require a larger dose than recommended if you are suffering with osteoporosis so speak to your doctor for advice.

In the event of a fracture you may need to take strong pain killers to relieve the pain.

How can I help myself?

You should take regular exercise, such as brisk walking, jogging, dancing, racquet sports and keep fit. Exercise can help push calcium back into the bones and keep them strong. You should try and take exercise three times a week for approximately half an hour. Be careful not to over exercise as you may end up doing more damage.

Two main health hazards for bone health are smoking and heavy drinking. If you want to help your bones and improve your general health try to give up cigarettes and reduce your alcohol intake.

If you suffer with osteoporosis avoid any heavy lifting and pay attention to anything that could cause you to fall, as it is usually a fall that causes fractures.