The term osteoporosis means "porous bones." It is a gradual, progressive weakening of bone strength, which can cause health problems, lack of mobility and increase the risk of a fracture. It is a worrying condition because we cannot see our bones to assess how healthy and strong they are. The first symptom may be a fracture, typically of the hip, wrist or spine.
So, what can we do to ensure our bones are strong and healthy and reduce the risk of osteoporosis in later life?
There are 206 bones in the body and they provide support and protection and form the basis of our body shape. They consist of collagen (a protein), calcium phosphate and minerals. There are two types of bone: compact (the outer, protective layer) and cancellous (a spongy, internal mesh). Bones contain three types of cells – osteoblasts, which build and repair them, osteocytes, which carry nutrients and expel waste matter, and osteoblasts, which break down bone.
Bone is living tissue, which means it is constantly being broken down and renewed, a process called "bone turnover." Bones are strongest around age 30 and from the mid-30s the process of regeneration slows down. Oestrogen has a protective effect on bones; helping to keep them strong so when we reach menopause, the loss of oestrogen can quickly affect the strength of our bones.
Osteoporosis is often referred to as the silent disease as there may be no symptoms until you have a fracture. However, be aware of any joint pains or problems maintaining your posture when sitting or standing. Further symptoms include kyphosis (curvature of the spine), Dowager’s Hump and loss of height.
Dr Trisha Macnair, medical journalist and BBC Health Expert explains that the following factors can increase the risk of osteoporosis:
long-term use of corticosteroid (steroid) or blood thinning medications
smoking and heavy drinking
a low calcium diet
lack of regular exercise
a low body weight (having a BMI (body mass index) of 19 or less
amenorrhoea (absent periods for six months or more)
a medical condition which impacts on absorption, e.g. celiac disease
having an early menopause or hysterectomy (prior to 45)
problems with hormone-producing glands – e.g. hyperthyroidism or adrenal gland disorders.
The strength of your bones is down to genetics but the good news is that lifestyle has a big part to play. From childhood to your 30s, it is important to invest in your bone bank, says the National Osteoporosis Society (NOS). This will ensure strong and healthy bones later in life. Bones grow in length until around age 18 and become denser and stronger up until our mid 20s-30. You can keep them strong through regular exercise (resistance training and weight-bearing activities), eating a balanced diet high in calcium, and avoiding smoking, excessive caffeine and alcohol. A good supply of vitamin D helps the body absorb calcium and NOS recommends 20 minutes daily exposure to sunlight every day during the summer to ensure the body has enough vitamin D for winter.
There are various ways to test bone health and a DXA (Dual Energy X-ray Absorptiometry) scan is considered to be the gold standard test for assessing bone strength against the average. It will determine if you have osteoporosis or are at risk of developing it (a condition called osteopenia). It is a painless procedure which uses X-ray to determine the level of calcium and minerals in your bones.
NOS advises bone density testing if you are postmenopausal, over 65, have an associated medical condition or are taking certain medications as mentioned in risk factors. DXA scans are available on the NHS if you are considered to be at risk, and you can also have bone density scans done privately (using different technologies). Such tests may be covered by health insurance.
Treatment options depend on what level of osteoporosis you have and your GP will advise. Common treatment options include the following:
Calcium and vitamin D supplements can be useful alongside medical treatment. The International Osteoporosis Foundation recommends between 800-1300mg of calcium a day according to your age (700mg is a pint of milk). The NHS recommends that everyone over 65 takes a vitamin D supplement. Vitamin D is found in cod liver oil, oily fish, and egg yolks.
SERMs (Selective Estrogen Receptor Modulators) can help maintain bone density. Raloxifene is currently approved for osteoporosis treatment.
Bisphosphonates – non-hormonal drugs that prevent bone breakdown and encourage new bone formation. There are several types.
If you are postmenopausal and worried about osteoporosis speak to your doctor or healthcare provider about bone density testing. Osteoporosis may be a silent condition but it is preventable and treatable and there is much you can do now to reduce the risk of a fracture in later life. Consider your lifestyle and diet and make some changes to maximise your health and bone density.
So, what can we do to ensure our bones are strong and healthy and reduce the risk of osteoporosis in later life?
What are Bones?
There are 206 bones in the body and they provide support and protection and form the basis of our body shape. They consist of collagen (a protein), calcium phosphate and minerals. There are two types of bone: compact (the outer, protective layer) and cancellous (a spongy, internal mesh). Bones contain three types of cells – osteoblasts, which build and repair them, osteocytes, which carry nutrients and expel waste matter, and osteoblasts, which break down bone.
Bone is living tissue, which means it is constantly being broken down and renewed, a process called "bone turnover." Bones are strongest around age 30 and from the mid-30s the process of regeneration slows down. Oestrogen has a protective effect on bones; helping to keep them strong so when we reach menopause, the loss of oestrogen can quickly affect the strength of our bones.
Symptoms of Osteoporosis
Osteoporosis is often referred to as the silent disease as there may be no symptoms until you have a fracture. However, be aware of any joint pains or problems maintaining your posture when sitting or standing. Further symptoms include kyphosis (curvature of the spine), Dowager’s Hump and loss of height.
Osteoporosis Risk Factors
Dr Trisha Macnair, medical journalist and BBC Health Expert explains that the following factors can increase the risk of osteoporosis:
long-term use of corticosteroid (steroid) or blood thinning medications
smoking and heavy drinking
a low calcium diet
lack of regular exercise
a low body weight (having a BMI (body mass index) of 19 or less
amenorrhoea (absent periods for six months or more)
a medical condition which impacts on absorption, e.g. celiac disease
having an early menopause or hysterectomy (prior to 45)
problems with hormone-producing glands – e.g. hyperthyroidism or adrenal gland disorders.
Preventing Osteoporosis
The strength of your bones is down to genetics but the good news is that lifestyle has a big part to play. From childhood to your 30s, it is important to invest in your bone bank, says the National Osteoporosis Society (NOS). This will ensure strong and healthy bones later in life. Bones grow in length until around age 18 and become denser and stronger up until our mid 20s-30. You can keep them strong through regular exercise (resistance training and weight-bearing activities), eating a balanced diet high in calcium, and avoiding smoking, excessive caffeine and alcohol. A good supply of vitamin D helps the body absorb calcium and NOS recommends 20 minutes daily exposure to sunlight every day during the summer to ensure the body has enough vitamin D for winter.
Bone Density Testing
There are various ways to test bone health and a DXA (Dual Energy X-ray Absorptiometry) scan is considered to be the gold standard test for assessing bone strength against the average. It will determine if you have osteoporosis or are at risk of developing it (a condition called osteopenia). It is a painless procedure which uses X-ray to determine the level of calcium and minerals in your bones.
NOS advises bone density testing if you are postmenopausal, over 65, have an associated medical condition or are taking certain medications as mentioned in risk factors. DXA scans are available on the NHS if you are considered to be at risk, and you can also have bone density scans done privately (using different technologies). Such tests may be covered by health insurance.
Osteoporosis Treatment
Treatment options depend on what level of osteoporosis you have and your GP will advise. Common treatment options include the following:
Calcium and vitamin D supplements can be useful alongside medical treatment. The International Osteoporosis Foundation recommends between 800-1300mg of calcium a day according to your age (700mg is a pint of milk). The NHS recommends that everyone over 65 takes a vitamin D supplement. Vitamin D is found in cod liver oil, oily fish, and egg yolks.
SERMs (Selective Estrogen Receptor Modulators) can help maintain bone density. Raloxifene is currently approved for osteoporosis treatment.
Bisphosphonates – non-hormonal drugs that prevent bone breakdown and encourage new bone formation. There are several types.
If you are postmenopausal and worried about osteoporosis speak to your doctor or healthcare provider about bone density testing. Osteoporosis may be a silent condition but it is preventable and treatable and there is much you can do now to reduce the risk of a fracture in later life. Consider your lifestyle and diet and make some changes to maximise your health and bone density.
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