Osteoporosis is thinning of the bones.
It can lead to an increased fracture risk from a relatively simple fall or force. As a little old lady, a fractured hip or spine can be life changing, if not life threatening. So, we should do all we can to protect our bones.
It’s not just little old ladies either. Although women are at increased risk of osteoporosis after the Menopause, men can get Osteoporosis too: especially if they have been on long term steroids for other conditions.
So, what increases the risk?
1. Smoking
2.Being under weight or overweight
3.Heavy Alcohol use
4.Use of long-term steroids
5.Certain medical conditions like Hyperthyroidism.
6.Family History.
The building blocks of our bones are calcium (from our diet) and Vitamin D3, from the action of the sun on our skin. However, we are all so worried about skin cancer and wrinkles, that we are wearing sunblock which blocks the conversion of Vitamin D in our skin. We are also covering up when we go outside. Unfortunately, sunlight through glass like a window, doesn’t work either.
So, what can we do? Well, we can make sure we are taking enough calcium in our diets: see this link here: https://www.osteoporosis.foundation/educational-hub/topic/calcium-calculator
We can also take at least 10mcg of Vitamin D3 every day and eat lots of fish….and if anyone wants the number of a good fisherman, I just may know one!
Weight bearing exercises like running, walking, skipping does help force our bones to get stronger too.
If you are on long term steroids, depending on how much you have to take you can talk to your doctor about taking something called a Bisphosphonate to help prevent osteoporosis: If you think of your bones as being a brick wall, Calcium and Vitamin D are the building blocks and bisphosphonates are like the workmen laying those bricks.
If you have had an early menopause (before age 40/45) or had your ovaries taken out before age 50, you should have been counselled about the possibility of HRT. Oestrogen is very important in preventing future osteoporosis in these cases. Even perimenopausal women or women who have had menopause at a normal age can reap benefits from HRT. Talk to your doctor to find out if it is right for you.
So, what’s the treatment if you already have osteoporosis? Well, besides the lifestyle measures mentioned above, Vitamin D, Calcium and oral Bisphosphates are all a possibility. Bisphosphonates are usually taken once a week or once a month and can cause heartburn, so you have to take them on an empty stomach, with water, and make sure you sit up for half an hour after. You should not drink milk or have anything containing calcium for about an hour before or after. This can be a pain, so some people prefer to have an infusion every 12-18 month or so, of a Bisphosphonate, instead of having to take it by mouth once a week. There can be a rare side effect of Bisphosphonates called Osteonecrosis of the jaw. It’s so rare that I have never seen it, but before we gave you a bisphosphonate, we would assess your fracture risk to make sure that you are not taking this drug unnecessarily. In some cases, HRT can also be used to treat osteoporosis in women. There are other second and third line options too.
If you are worried that you may have osteoporosis because you have a risk factor mentioned above, or if you have had a fragility fracture, then please come in and we can assess your fracture risk using a validated tool!
If not, then still be sure to not smoke, take your Vitamin D3, eat lots of fish, take a walk and stick to 2 glasses of wine at night. Enjoy!
