Osteoporosis

Holey Bones!

Written by Lucy Scannell
Pharmacist at Bennettswood

What is Osteoporosis?

Osteoporosis is a condition where bones become thinner and more fragile over time and more likely to break or in other words one develops “holey bones”! Osteoporosis affects more than 50% of women and 30% of men over the age of 60 years.

To build and maintain healthy bones the body needs calcium, minerals and Vitamin D to absorb calcium from food and incorporate it into the bones. Most people don’t realise they have osteoporosis until a something like a fracture happens because there are usually no signs or symptoms. The result can lead to chronic pain, problems with mobility and, more seriously, a possible lack of ability to live independently.

Assessing risk

Currently, the most reliable way to diagnose osteoporosis is to measure bone density with a dual-energy absorptiometry scan or DXA. A DXA scan is a short, painless scan that measures the density of your bones, usually at the hip and spine, and in some cases, the forearm.

Risk factors

There are many risk factors for osteoporosis, these include;

  • Post-menopausal
  • Family history
  • Lack of dietary calcium
  • Low Vitamin D levels
  • Cigarette smoking
  • Excessive alcohol and caffeine intake
  • Lack of physical activity
  • Long-term use of medication such as corticosteroids for rheumatoid arthritis and asthma
  • Aged 50 years and older
  • Being tall and thin
  • Weight disorders such as anorexia nervosa

Some conditions place people at a higher risk of osteoporosis. These conditions include:

  • Thyroid disease or an overactive thyroid gland
  • Rheumatoid arthritis
  • Chronic liver and kidney disease
  • Sufferers of Crohn’s, coeliac disease and other inflammatory bowel conditions.

Prevention of osteoporosis

The best advice is to make lifestyle changes as early as possible to avoid osteoporosis developing. There is no cure for osteoporosis, but medicines and lifestyle changes can help:

  • Stop smoking
  • Reduce your alcohol and caffeine intake
  • Eat a healthy diet with plenty of calcium-containing foods, such as dairy products
  • Try to do 30 minutes of weight-bearing exercise, such as walking, every day
  • Moderate exposure to sunlight to encourages your body’s natural production of Vitamin D
  • Reduce risk of falling;
  • Review medication as some can cause dizziness or drowsiness
  • Eyesight check
  • Avoid high heels and wear non-slip soles
  • Walking sticks or frame can help balance
  • Hip protectors will decrease the risk of fractures after falling
  • If you live alone consider having an alert system that can be activated if you have fallen

Treatment Options

Calcium

Enjoying a healthy, balanced diet, with a variety of foods and a good intake of calcium, is a vital step to building and maintaining strong, healthy bones. If there is not enough calcium in the blood the body takes calcium from the bones. The recommendation is for an average adult to consume 1,000mg of calcium per day. Postmenopausal women and men aged over 70 years are recommended to have 1,300mg of calcium per day.

  • Dairy foods have the highest levels of calcium
  • Other sources of calcium including sardines, spinach and almonds
  • Supplements are also good but ensure you speak to your pharmacist to discuss

Vitamin D

Vitamin D is important because it helps the body absorb calcium in your diet. We obtain most of our Vitamin D from the sun but it is important to remain sun safe. Other sources of Vitamin D include;

  • Fatty fish such as sardines, salmon, herring and mackerel
  • Liver
  • Eggs
  • Fortified foods such as low-fat milks and margarine.

Vitamin D checks are available through local GP’s. If your levels are not adequate supplements may be required but it is important to talk with your local pharmacist to ensure they do not interfere with current medication.

Bisphosphonates

Bone cells are created and broken down in a constant cycle. Bisphosphonates encourage bone density by slowing the breakdown process and are commonly used in Australia to treat osteoporosis in men and women. Oral tablets should be taken on an empty stomach because food can reduce their absorption. Please speak to your pharmacist before taking bisphosphonates as instructions vary. Also it is important to tell your dentist you are using a bisphosphonate prior to any dental work

Hormone replacement therapy

Hormone replacement therapy (HRT) is treatment for osteoporosis in women with low oestrogen levels, usually due to menopause. HRT increases bone density and reduces fractures and is available as a pill, patch, implant, pessary and cream. However, HRT also increases risks of blood clots, certain types of cancer, heart attacks and stroke. It is no longer widely recommended as the benefits do not outweigh the risks but it is considered a first line treatment for women less than 60 years of age who are at risk of bone density decline and osteoporosis.

Men with low testosterone levels may benefit from testosterone replacement. Testosterone can be given by injections, implants, skin patches, oral capsules, gels or creams to bring blood levels back to normal.

Exercises

  • Choose weight-bearing activities such as brisk walking, jogging, tennis, netball or dance
  • Strength training (or resistance training) is also an important exercise for bone health. It involves resistance being applied to a muscle to develop and maintain muscular strength, muscular endurance and muscle mass physiologist) who can recommend specific exercises and techniques.
  • Activities that promote muscle strength, balance and coordination such as Tai Chi, Pilates and Yoga are also important, as they can help improve balance, muscle strength and posture
  • A mixture of weight-bearing and strength-training sessions throughout the week is ideal. Aim for 30 to 40 minutes five times a week

At Community Pharmacy, our stores run an annual bone density scan and our pharmacists are always available to speak about Vitamin D and calcium products which are right for your individual needs. We are also available to discuss any prescription medications you are taking and to discuss any of their side effects which you might be experiencing.

 

References

Better health channel
PSA selfcare

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