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Osteoporosis

Osteoporosis is a condition that affects bone strength (the word osteoporosis literally means "porous bones"). Bone is made of tough, elastic fibres (collagen fibres) and gritty, hard material (minerals). It is a living tissue and contains cells that make, mould and take back up (resorb) bone. Initially, as you grow, bone forms faster than it is resorbed. But, as you get older, this reverses. As a result, from about the age of 35, you start to lose a certain amount of bone material overall. Your bones become less dense and less strong. The amount of bone loss can vary. If you have a lot of bone density loss, then you have 'thinning' of the bones (osteoporosis). If you have osteoporosis, your bones can break more easily than normal, especially if you have an accident such as a fall. If you have a milder degree of bone loss, this is known as osteopenia.

Causes and risk factors

The exact cause of osteoporosis is not clear. The major risk factors associated with an increase in the incidence of osteoporosis include:

  • Age and gender: After the age of 35 years, the body gradually loses bone mass. Hence, the greater the age, the higher the risk for osteoporosis. Moreover, women are four times more prone to osteoporosis when compared to men. Thus older women over 50 are at a higher risk for osteoporosis
  • Family history and ethnicity: Caucasians, Hispanics and Asians are at an increased risk to developing osteoporosis. This risk is further increased by a small, thin body frame and a family history of fractures. Hence heredity plays an important role in the development of osteoporosis
  • Endocrine disorders: Endocrine disorders such as hyperparathyroidism and thyroid problems increase the risk of osteoporosis by adversely affecting the process of bone formation
  • Medications: Hormone replacement therapy for prostate cancer or breast cancer, long term corticosteroid therapy (more than 3 months) and some anti-epileptic drugs increase the risk for osteoporosis
  • Nutrition and lifestyle: A sedentary lifestyle, smoking, excessive alcohol intake and poor nutrition with a calcium deficient diet make an individual highly prone to develop osteoporosis
  • Eating disorders: These may lead to a deficiency of essential nutrients required for healthy bone and thereby increase the risk for osteoporosis

Diagnosis

At present, there is no national screening programme in Australia for osteoporosis. However, if you have a risk factor, your GP or other health professional may ask questions to see how many other risk factors for osteoporosis (listed above) apply to you. If you are found to be at increased risk, or your risk is uncertain, you may be referred for a DEXA scan. DEXA stands for dual-energy X-ray absorptiometry. It is a scan that uses special X-ray machines to check your bone density. A DEXA scan can confirm osteoporosis.

Treatment

Treatment of osteoporosis aims to strengthen the existing bones and stopping the disease progression. Medications such as calcium and vitamin D supplements, oestrogen for post-menopausal women, testosterone for men, parathyroid hormone shots and bisphosphonates can be prescribed to patients.

Simple lifestyle changes such as a healthy, well balanced diet rich in protein, calcium and vitamin D, regular exercise such as walking and jogging, along with abstinence from smoking and alcohol improve overall bone health and prevent the development of osteoporosis. In patients with osteoporosis these lifestyle changes may delay the progression of the disease.

Consult your doctor for clarification of any of your queries on osteoporosis.

  • Queen's University Belfast
  • University of New South Wales
  • University of Syndey
  • Kings College London