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Osteoporosis

What is osteoporosis

Bone is a living and growing tissue that changes throughout our lifespan. When our body loses too much bone or makes too little bone, osteoporosis will occur. Osteoporosis is defined as a condition where the bones become weak and brittle –  making them fragile and more likely to break. It develops slowly over several years and is often diagnosed when a minor fall or sudden impact causes a bone fracture.

Osteoporosis is also known as ‘porous bone’. When a bone structure is viewed under a microscope, a healthy bone looks like a honeycomb. In contrast with an osteoporotic bone, the holes and spaces in the honeycomb are much larger than the healthy bone. Bone density starts to decrease after 35 years of age and occurs more rapidly in women as compared to men. This is especially so after menopause due to the lack of estrogen.

Approximately, 1 in 2 women and 1 in 5 men over the age of 50 in UK have osteoporosis. Although osteoporosis usually affects the entire skeleton, the most common fractures are in the wrist, hip, and spine. Each year, there are over   70,000 hip, 50,000 wrist, and 40,000 spinal fractures reported due to osteoporosis.

Risk factor

The bone mass and density depend heavily on nutrition and one’s lifestyle, but, genetics dominate the peak of bone density and the size of the body. Studies show that more than one gene (approximately 30 genes) determine the lower bone mass. People who have a family history of osteoporosis may have a lower peak bone mass.

Aging – When we are young, the formation of new bone is faster than losing bone. Most people reach their peak bone mass in their 20s. As we get older, the greater the risk of having osteoporosis because bone loss is faster than bone renewal.

Women are more likely to develop osteoporosis when they are at the stage of peri-menopause and menopause. During this stage, estrogen levels are low, thus mineral absorption into their bones is reduced. Men with reduced testosterone levels due to prostate cancer are also at high risk of developing osteoporosis.

Dietary factors like low calcium intake, eating disorders, and vitamin D deficiency may also lead to osteoporosis. Having a disease like dementia, Parkinson, sclerosis, and gastrointestinal surgery which reduces the size of stomach and intestine will limit the absorption levels of nutrients including calcium. This will create calcium deficiency which is a major cause of osteoporosis.

Your living environment ( especially lack of exposure to sunlight) and lifestyle can also be some of the risk factors causing osteoporosis. Too much alcohol and/or tobacco use may also increase your risk of osteoporosis or osteopenia (early stage osteoporosis). People who spend a lot of time sitting have a higher risk than those who are more active. Doing any weight-bearing exercise and activities that promote a  good posture are beneficial for healthy bones and joints.

Long-term use of steroids like prednisolone and other medications may interfere with the bone rebuilding process. Osteoporosis has also been associated with medications used for these conditions or disease such as:

  • Autoimmune disease – Lupus, spondylitis, rheumatoid arthritis
  • Cancer – breast and prostate cancer
  • Neurological – stroke, Parkinson, spinal injuries
  • Blood disorder – leukaemia, lymphoma, thalassemia, myeloma
  • Endocrine – Hyperthyroidism, menopause, low levels of testosterone and estrogen
  • Digestive and gastrointestinal disorder – celiac disease, inflammatory bowel disease, gastric reflux
  • Organ transplant

Sign and symptoms

Preventing osteoporosis

The goal of managing osteoporosis is to prevent bone fractures by reducing bone loss, or, preferably increasing bone density and strength. It is difficult to completely rebuild bone that has been weakened by osteoporosis. Therefore, prevention is always better than cure. The following are some of the available treatment for osteoporosis  and prevention measures for optimal bone health:

  • Lifestyle changes – quit smoking, reduce alcohol consumption and exercise regularly. Weight-bearing exercises like walking must be incorporated into the daily routine. For those who are over 40, with heart disease, obesity, diabetes, and high blood pressure, exercise should be prescribed and monitored by physicians. Extreme exercise like marathon may not be suitable for this group of patients.
  • Medication that stops bone loss and increases bone strength – Fosamax, Actonel and Evista are some of the common medications prescribed by medical health practitioners
  • Taking calcium-rich food or supplement – According to the National Institute of Health Consensus Conference on Osteoporosis, the total daily intake of calcium should not exceed 2000 mg/day. It was recommended that everyone should take calcium supplements especially growing kids, pregnant women, nursing mothers, and pre-and post-menopausal women. Besides that, it is advisable to consume calcium-rich food in our daily diets such as broccoli, spinach, pumpkin seeds, avocado, brussels sprouts, yoghurt, milk, and sesame seeds.

  • Get enough vitamin D – Vitamin D plays an important role in protecting bones and absorption of calcium. Children and adults need vitamin D to build and keep the bones strong and healthy. According to the Institute of Medicines, the safe upper limit of vitamin D is 4000 IU per day for most adults. Generally, most people will take 400 – 1000 IU of vitamin D daily. There are 3 ways to get vitamin D which is from sunlight, food, and supplements. If you aren’t getting enough of vitamin D from sunlight and food, you may consider a vitamin D supplement. There are 2 types of vitamin D supplements which are vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Both types are good for bone health.

 

Sources:

  • London Osteoporosis: https://www.londonosteoporosisclinic.com
  • Mayo Clinic: http://www.mayoclinic.org
  • PADMAD articles: http://articles.padmad.org
  • NHS: http://www.nhs.uk
  • National Osteoporosis Foundation: https://www.nof.org
  • Medicine Net: http://www.medicinenet.com
  • Global Healing centre: https://www.globalhealingcenter.com