What is osteoporosis?
Osteoporosis is a bone disease, which causes the bones to weaken and deteriorate over time. When the disease develops, the small spaces inside the bone increase, resulting in reduced density and mass, increasing the risk of fractures.
The most common cause of the disease is ageing. Bone becomes more fragile and prone to fracture with age. Menopause, and the hormonal changes associated with it, can also contribute to the development of osteoporosis.
Certain medical conditions, such as hyperthyroidism, untreated rheumatoid arthritis and chronic pulmonary pathology, may also lead to osteoporosis. The use of certain medications, in particular cortisone, can cause osteoporosis.
Other risk factors for the condition include smoking, low BMI, low Vitamin D levels, excessive alcohol use, family history of osteoporosis, and premature menopause.
What are the symptoms?
In the early stages of the disease, there are often no symptoms. As the disease develops, the risk of a fractured bone increases.
How is it diagnosed?
In order to diagnose the condition, your doctor will perform a thorough physical examination and conduct blood tests to check for any underlying conditions that may be causing bone loss.
A bone density test is the most important test in making the diagnosis of osteoporosis. This a special kind of x-ray that is used to measure the density of the bones in the parts of the body that are most at risk of osteoporosis, including the wrists, hips and spine. The test is painless, and generally only takes around thirty minutes to complete.
The bone density will calculate the patient’s “T-score” which is the standardised measure used to quantify bone mass.
A T-score below -1 indicates osteopenia (pre-osteoporosis)
A T-score below -2.5 indicates osteoporosis
Bone densities should ideally be repeated yearly or two yearly.
How can it be treated?
Treating osteoporosis is important as it prevents fractures from occurring.
Even significant osteopenia (pre-osteoporosis) should ideally be treated to prevent osteoporosis from developing.
Adequate calcium intake is essential for healthy bones. This is either completely through dietary means or with a calcium supplement as well.
Vitamin D levels will be checked by your doctor and if low Vit D supplements will be prescribed.
Weight-bearing exercises such as walking are essential to keep the bones healthy.
If your doctor thinks your fracture risk is high, she will suggest medical treatment in addition to the lifestyle changes and supplements.
The mainstay of osteoporosis treatment is bisphosphonate treatments, which are either taken orally, infused via a drip yearly, or given as subcutaneous injections.
Bisphosphonates have been shown to reduce fracture risk. They can be used for approximately five years continuously. Thereafter a “treatment holiday” should be given to prevent complications.
If needed, there are treatments other than bisphosphonates, which your doctor can discuss with you.