Osteoporosis is a condition in which the bones become fragile and brittle, leading to a higher risk of fractures (breaks or cracks) than normal bone. Osteoporosis occurs when bones lose minerals such as calcium, and the body cannot replace these minerals fast enough to keep the bones healthy. As a result, bones become thinner and less dense. Osteoporosis is almost as common as high blood pressure, and is more common than high cholesterol. Any bone can be affected by osteoporosis, but the most common sites are bones in the hip, spine, wrist, ribs, pelvis and upper arm. Osteoporosis has no signs or symptoms usually until a fracture occurs - this is why osteoporosis is often called a silent disease. Fractures due to osteoporosis are known as osteoporotic fractures. These can lead to changes in posture (eg. developing a stoop or Dowager's hump in your back), muscle weakness, loss of height and deformity of the area affected. Fractures can lead to long-term pain and disability, loss of independence, and may even contribute to premature death.
What is osteoporosis
- Osteoporosis is a condition where the bones become fragile and brittle fracturing more easily than normal bones. Even minor falls can cause serious fractures. The incidence of osteoporosis increases with age as from 45 years
- Osteoporosis is diagnosed by combining information gathered from a person's medical history with a physical examination that includes specific tests for the disease. One of the most important tests for osteoporosis is known as a bone mineral density scan. This measures the density of the bones and shows if any areas are thinner than others or not as strong as they should be
- There is no cure for osteoporosis, but it is treatable with drugs that reduces your chances of getting a fracture by increasing your bone density and helping prevent the progression of osteoporosis.
Causes of Osteoporosis
- Are past menopause, when the level of oestrogen falls. This is particularly so if you had an early menopause (before the age of 45), or had your uterus removed (hysterectomy) before your menopause.
- Have had a bone fracture after a previous fall or bump.
- Have a strong family history of osteoporosis.
- Have had long periods of dieting, especially if you suffered anorexia nervosa or bulimia. In these situations, the level of oestrogen is often low for long periods of time and combined with a poor diet, can affect the bones.
- Have done excessive exercise, such as regular marathon running. Excessive exercise in some women causes a low level of oestrogen and their monthly periods may stop. However, moderate exercise is good (see below).
- Have used, or are using, a steroid medicine (such as prednisolone) for three months or more. One side-effect of steroids is bone loss.
- Have had irregular menstrual periods for whatever reason.
- Smoke or drink a lot of alcohol.
- Do not receive adequate calcium or vitamin D.
- Never performed regular exercises, or have led a sedentary lifestyle.
- Have, or had, certain medical conditions which can affect the bones. For example, an overactive thyroid, Cushing's disease and any condition that causes poor mobility.
Symptoms of Osteoporosis
Prevention and treatment
2. Food and Diet:
- Drinking a pint of milk a day
- Eating 60 g (2 oz) hard cheese such as Cheddar or Edam, or one pot of yoghurt (125 g), or 60 g of sardines.
3. Smoking and Drinking:
4. Hormone Replacement Therapy (HRT):
1. Medication to prevent and treat bone loss
- The Bisphosphonates are a group of medicines which include ibandronate, alendronate, risedronate and etidronate. These are the most commonly used medicines to treat osteoporosis. They work on the bone-making cells. They can help to restore some lost bone and help prevent further bone loss. Research studies have shown that the risk of bone fracture is reduced by taking one of these medicines.
- Calcitonin, Raloxifene and Strontium Ranelate are medicines that are used only if a bisphosphonate is not deemed suitable. They too are supported by research evidence that shows they can help reduce the risk of bone fractures.
- Hormone Replacement Therapy is an option if other treatments are unsuitable.
- Parathyroid hormones are being used as a new treatment for osteoporosis. Its role is not yet fully established but it may become more widely used in the future.
2. Calcium/Magnesium and vitamin D tablets.
4. Preventing falls
- Check your home for hazards such as uneven rugs, trailing wires, slippery floors, etc.
- Regular weight bearing exercise may help prevent falls (as described above).
- Is your vision and/or hearing good? Do you need prescription glasses or a hearing aid?
- Do you take medicines that make you drowsy? Can they be changed?
Tips for management of osteoporosis
1. First draft by Infonet October 2011
2. Review and update Dr Alice Ojwang-Ndong January 2012
Information Source Links
- Phylis A. Balch, and James F Balch, Prescription fro Nutritional healing, 3rd Edition.
- Drugs for postmenopausal osteoporosis (2008). Treatment Guidelines From The Medical Letter, 6(74): 67-74.
- Woo S-B, et al. (2006). Systematic review: Bisphosphonates and osteonecrosis of the jaw. Annals of Internal Medicine, 144(10): 753-761.
- Jackson RD, et al. (2006). Calcium plus vitamin D supplementation and the risk of fractures. New England Journal of Medicine, 354(7): 669?683.