Osteoporosis

Q: What is osteoporosis?

A: Osteoporosis is a medical condition characterised by weakened bones that are more susceptible to fractures and breaks. Bones become porous and brittle, leading to a decrease in bone density and mass. This condition is often associated with aging, particularly in postmenopausal women, but it can affect people of any age and gender.

The human skeleton is constantly undergoing a process of bone remodelling, where old bone is broken down and replaced by new bone tissue. In osteoporosis, the balance between bone formation and bone resorption is disrupted, resulting in a net loss of bone density.

Q: What are the risk factors for osteoporosis?

A: Risk factors for osteoporosis include:

• Age: the risk of osteoporosis increases with age.
• Gender: women, especially after menopause, are more prone to osteoporosis due to hormonal changes.
• Family history: a family history of osteoporosis may increase the risk.
• Body weight: low body weight or a small frame may increase the risk.
• Hormonal changes: conditions that affect hormone levels, such as menopause or certain medical treatments, can contribute.
• Nutrition: inadequate intake of calcium and vitamin D can affect bone health.
• Physical activity: lack of exercise or long periods of inactivity can contribute to bone loss.
• Certain medications and medical conditions: some medications and health conditions may increase the risk of osteoporosis.

Osteoporosis often progresses without symptoms until a fracture occurs. Common sites for fractures in people with osteoporosis include the hip, spine, and wrist.

Prevention and management strategies include a diet rich in calcium and vitamin D, regular weight-bearing exercise, and medications prescribed by healthcare professionals. Hormone replacement therapy may also be considered in postmenopausal women. It’s important for individuals at risk of osteoporosis to discuss prevention and treatment options with their healthcare providers

Q: How is osteoporosis diagnosed?

A: While osteoporosis is primarily diagnosed through bone density testing, there are some blood tests that can provide additional information about bone health and potential causes of bone loss. These blood tests may include:

Calcium and Phosphorus Levels

• Calcium: low calcium levels in the blood may indicate a potential issue with bone health.
• Phosphorus: abnormal phosphorus levels can also be associated with bone disorders.

Vitamin D levels

• Vitamin D plays a crucial role in calcium absorption and bone health. Low levels of vitamin D can contribute to bone loss.

Alkaline Phosphatase (ALP)

• Elevated levels of ALP may be indicative of increased bone turnover, which can occur in conditions like osteoporosis.

Parathyroid Hormone (PTH)

• PTH regulates calcium and phosphorus levels in the blood. Abnormal levels may suggest a problem with calcium metabolism.

Full Blood Count (FBC)

• FBC can help identify other conditions that might affect bone health, such as anaemia.

It’s important to note that while these blood tests can provide supportive information, the gold standard for diagnosing osteoporosis is a bone density test, called a DEXA or DXA scan. This test measures bone mineral density and helps assess fracture risk.

Q: What are the treatment options for osteoporosis?

A: The treatment options for osteoporosis aim to strengthen bones, reduce the risk of fractures, and manage underlying factors contributing to bone loss. It’s important to note that the choice of treatment depends on individual factors, such as the severity of osteoporosis, overall health, and potential side effects. Here are common treatment approaches:

Lifestyle Modifications

• Diet: Ensuring an adequate intake of calcium and vitamin D is crucial for bone health. Dairy products, leafy green vegetables, fortified foods, and supplements may be recommended.
• Exercise: Weight-bearing exercises, such as walking, jogging, and resistance training, help maintain bone density and strength.

Medications

• Infusions of certain medication: These drugs are commonly prescribed to slow down bone resorption and reduce the risk of fractures.
• Hormone Replacement Therapy (HRT): Oestrogen replacement therapy may be considered, especially for postmenopausal women, to help maintain bone density. However, the use of HRT is carefully weighed against potential risks and benefits.
• Selective Oestrogen Receptor Modulators (SERMs): Medications may mimic oestrogen’s positive effects on bone density without some of the associated risks.
• Injections: This medication inhibits bone resorption and may be prescribed for postmenopausal women at high risk of fractures.

Calcium and Vitamin D Supplements

• In addition to dietary sources, supplements may be recommended to ensure an adequate intake of calcium and vitamin D.

Fall Prevention

• Strategies to prevent falls can be crucial in reducing the risk of fractures, especially in elderly individuals. This may include home modifications, balance exercises, and other safety measures.

Regular Monitoring

• Bone density testing may be conducted periodically to assess treatment effectiveness and make adjustments if needed.

If you are diagnosed with osteoporosis, it is important to work closely with your consultant to determine the most appropriate treatment plan for your individual circumstances.