Osteoporosis is a condition that causes thinning and weakening of bones. Brittle bones are more prone to fractures. These fractures may happen even with very minimal trauma. Although any bone can be affected, the fractures typically occur in the hip, spine and wrist.
Worldwide, 200 million women suffer from osteoporosis and a woman’s risk of hip fracture is the same as her combined risk of developing breast, uterine and ovarian cancer. In Singapore, the number of osteoporosis - related hip fractures in women over 50 years is 8 times more than that of breast cancer cases.
Although women 50 years or older are most at risk for osteoporosis, younger women and men can also be affected.
Peak bone mass is attained by the age of 30. After that, bone mass gradually decreases. In pregnant and lactating women, the pace of bone loss will temporarily increase if the increased calcium demands of pregnancy or breastfeeding are not met by increased dietary intake of calcium. In women, there is also a significant decrease of bone mass in the immediate period following the onset of menopause.
Osteoporosis is called the ‘silent disease’ because bone loss occurs without symptoms and is painless. The condition often is not detected until it is quite advanced. Some signs in the advanced stages may include:
Do so at least 3 times a week, but it is important to avoid exercise that can injure weakened bones. Patients who have not exercised before or suffer from medical problems should consult their doctor first.
Get enough calcium, vitamin D and phosphorus either through food or supplements. An adult under 50 needs 1,000 mg of calcium daily. Adults over 50 need over 1,200 mg of calcium daily.
Vitamin D is needed by the body to absorb calcium. Vitamin D can either be obtained through the skin from exposure to sunlight or through diet. An adult under 50 years needs 400-800 IU of Vitamin D daily while adults over 50 needs 800-1000 IU of Vitamin D daily.
If you have difficulty getting the calcium and vitamin D that you need from your diet, you can take supplements.
Risk factors can be divided into those that can be changed and others that cannot.
Osteoporosis can be detected through a Bone Density Test most commonly done using a DEXA scan. The test can determine if you have osteoporosis by measuring the bone mineral density or bone strength at the hip and spine.
The test is quick and painless and is similar to having an x-ray taken but uses much less radiation.
Although there is no cure for osteoporosis, several treatments are available that can prevent further bone loss and improve bone strength. This can significantly reduce the risk of fractures. Medication, exercise and nutrition all play a role in treatment.
Currently most of the approved osteoporosis medications are known as ‘antiresorptive’ agents because they stop resorption (or depletion) of bone mineral from bones. Medicines that can stimulate bone formation are also available. Your physician can help you decide which treatment is best for you.
If you are diagnosed with osteoporosis, your physician may recommend one of the following medications:
Bisphosphonates that include agents like Alendronate (Fosamax®), Risedronate (Actonel®), Ibandronate (Bonviva®) and Zoledronic Acid (Aclesta®). Selective Estrogen Receptor Modulators such as Raloxifene, Nasal Calcitonin (Miacalcin®), the newer agent Strontium (Protos®) that may have a double action of stopping bone resorption and stimulating bone formation or the anabolic (bone forming) medication Teriparatide (Forteo®) that is given as a daily injection. It is important to note that the choice of drug therapy can be complex. Your treatment will be tailored for you.
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