OSTEOPOROSIS
By Emma Butler of
The National Osteoporosis Society
Osteoporosis is
a fragile bone condition that affects one in three women and one
in twelve men over the age of 50 in the UK. For people with Osteoporosis,
their skeleton can become so weak that just the simplest knock or
fall could result in a broken bone – sometimes causing pain
and disability.
Who is at risk?
We are all potentially
at risk of Osteoporosis because of the bone loss that occurs as
we get older – particularly as we are now living longer as
a population.
Women:
Women are more at risk of developing Osteoporosis than men. They
have smaller bones, which are less dense. They also experience the
menopause, which greatly accelerates bone loss for several years.
At the menopause (normally around the age of 50), the ovaries stop
producing the female hormone, oestrogen – which is essential
to bone health. It is this lack of oestrogen which causes the increase
in bone loss. Younger women can similarly be at risk of Osteoporosis
if they have low circulating levels of oestrogen. Over-exercising
and eating disorders, such as anorexia nervosa, can also upset the
normal hormonal balance and lead to bone loss.
Men:
Men generally have bigger, denser bones than women and do not undergo
the rapid bone loss associated with the female menopause. Osteoporosis
in men is often the result of another health problem. Low levels
of the male hormone testosterone can lead to Osteoporosis, due to
a problem with the testes themselves – or the pituitary gland,
which controls hormone levels. There may be no obvious signs or
symptoms, but some men do find they need to shave less regularly,
have a low sex drive and feel excessively tired. In nearly half
of all men with Osteoporosis the cause is unknown (called Idiopathic
Osteoporosis) and further research is needed to establish why excessive
bone loss occurs.
Am I at risk?
There are many factors
which can increase your risk of Osteoporosis.
For women:
A lack of oestrogen, caused by
– an early menopause (before the age of 45)
– an early hysterectomy (before the age of 45), especially
if both ovaries are removed (oophorectomy)
For men:
– Low levels of the male hormone testosterone (hypogonadism)
For men and
women:
– long-term use of corticosteroid tablets (for conditions such
as asthma)
– maternal history of hip fracture
– malabsorption, inflammatory bowel disease (Chrohn’s
disease or ulcerative colitis) and gastric surgery
– long-term immobility
– heavy drinking
– smoking
– low body weight
If you think you
have one or more of these risk factors, you are at increased risk
of developing Osteoporosis. You need to discuss your risk with your
doctor and find out how to prevent and treat the disease. Alternatively,
call the NOS helpline on 0845 4500230 for further information.
Warning Signs
If you have already
broken a bone after a minor bump or fall you may already have Osteoporosis.
Other warning signs include height loss and kyphosis (curvature
of the spine). If you have one of these warning signs, you may want
to discuss your risk of Osteoporosis with your doctor.
Do I have Osteoporosis?
Because you cannot
see your bones getting thinner, you will probably be quite unaware
of any problems with your bone health. Osteoporosis is a silent
disease. For most people, the first sign that something is wrong
can be when they break a bone, often in the wrist or spine after
a minor incident – although not all fractures are due to Osteoporosis.
Can I be tested for Osteoporosis?
A bone density scan,
called a Duel Energy X-ray Absorptiometry (DXA) scan, can be used
to measure the density of bones and compare this to normal range.
This test is currently the most accurate and reliable means of assessing
the strength of your bones and your risk of fracture. A bone density
scan can diagnose Osteoporosis, assess risk of fracture and monitor
the effects of treatment. However, bone density scans are only recommended
for people who are at a high risk of Osteoporosis – and so
you should discuss your medical history with your doctor, who will
decide whether or not to refer you for a bone scan.
The good news is
that Osteoporosis can be treated and there are now a wide range
of treatments available to people with the disease.
Can I prevent Osteoporosis?
There are lifestyle
measures that we can all put into place to reduce the risk of developing
Osteoporosis. Taking care of our bones from a very early age is
the best way to prevent Osteoporosis – but there are things
that can be done to benefit bone health at any age.
Follow a ‘bone-friendly’
diet
Healthy bones need
a well-balanced diet, incorporating minerals and vitamins from different
food groups, including bread, potatoes, pasta and cereals; fruit
and vegetables; milk and dairy products; meat, fish, eggs, pulses,
nuts and seeds.
Calcium is especially
important in the diet because it is the most abundant mineral in
our bones and helps to give them strength and rigidity. The most
readily available sources of calcium are milk and dairy products
such as cheese and yoghurt. Don’t worry if you are watching
your weight, as low-fat varieties usually contain just as much calcium
as their full-fat counterparts. If you do not like or are unable
to eat dairy products, you should be able to get enough calcium
from non-dairy sources – but it might take a bit more planning.
Non-dairy products such as green leafy vegetables, baked beans,
bony fish and dried fruit all contain useful quantities of calcium.
Take regular exercise
Like muscles and
other parts of the body, bones suffer if they are not used. They
need regular weight-bearing exercise, which puts force through the
bone, stimulating growth and, therefore, strength. Weight-bearing
exercise means any exercise in which you are supporting the weight
of your own body. Good bone-building exercises include running,
skipping, aerobics, tennis and weight-training. Even a brisk walk
can be of some benefit.
However, as we get
older some forms of high-impact exercise may no longer be suitable,
and they are not recommended for people who already have Osteoporosis.
In this situation though, other forms of exercise, although not
directly beneficial to bone are still vitally important – as
they can strengthen muscles, improve balance and co-ordination and
reduce the risk of having a fall.
Exercises such as
swimming, Tai Chi and regular walking can all be beneficial for
overall health and reducing the risk of a fall, which may result
in a broken bone.
What else can I do?
If
you are a smoker – give up! Smoking has a toxic effect on bone
in men and women. It can cause women to have an earlier menopause
and may increase the risk of hip fracture in later life. Not smoking
will benefit bone and general health.
Watch what you drink!
Drinking too much alcohol is damaging to bone turnover. Limit your
alcohol intake to a maximum of 3-4 units per day for men and 2-3
units for women. These limits are not targets to drink up to
and having alcohol free days is advisable.
How the National Osteoporosis
Society can help you
The National Osteoporosis
Society (NOS) is the only national charity dedicated to fighting
this fragile bone disease. We offer support to people with Osteoporosis,
their families and carers – through a range of detailed information
booklets, a national telephone helpline and a network of regional
support groups. We also provide information and support to healthcare
professionals.
For more information
about the NOS, Osteoporosis, or to find out how you can become a
member of the charity, please contact the NOS on 01761 471771 or
the NOS helpline on 0845 4500230. You can visit the NOS website
at www.nos.org.uk
or email info@nos.org.uk
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