
Osteoporosis
Our bone is a living tissue which is constantly being broken down (called resorption) and replaced (called formation) throughout our life. When we are young, our body makes new bone faster than it breaks down old bone because we are at a growing stage of our life. Osteoporosis occurs when the production of new bone cannot keep up with the rate of loss of the old bone. It is a progressive condition and eventually results in weakened bone which is more fragile and prone to fracture.

Click to view Amgen video on Osteoporosis
Risk factors
Osteoporosis affects men and women of all races. It is estimated that 1 in 5 adults are at risk of getting osteoporosis.
- Menopausal women
- Immobility (being bed bound)
- Body frame size (people with BMI less than 19 kg/msq have higher risk)
- Eating disorder or malnutrition (low Calcium intake)
- Thyroid disorder
- Excess alcohol
- Smoking
- Long term medication on steroids
- After bariatric surgery
Symptoms
In the early stages, there are usually NO symptoms until the bone is weakened sufficiently to cause the following symptoms
- Stooped posture
- Loss of height with time
- Back pain (caused by fractured or collapsed vertebrae)
- Bones which fracture more easily
Investigation
Bone Density measurement using DXA (Dual Energy X-ray Absorptiometry) Scan
Conservative Management
- Maintain a healthy body weight (at the healthy BMI for your height)
- Avoid smoking and excess alcohol consumption
- Calcium. Calcium is essential for bone production. Adults between the age of 18-50 years should have 1,000 gm daily and should be increased to 1,200 gm daily after the age of 50 years
- Vitamin D. Vitamin D helps the body to absorb Calcium and improve bone health. People between the age of 50-70 years are recommended to have 600 IU daily increasing to 800 IU after the age of 70 years
- Regular exercise with emphasis on weight-bearing and strength training exercises as well as flexibility and balance exercises. AVOID high-impact exercises.
Medication
Anti-resorption medication can help slow down the bone breakdown process (bone resorption) to allow the bone density to slowly increase over time.
- Alendronate (Fosamax)
- Ibandronate (Boniva)
- Risedronate (Actonel)
- Denosumab (Prolia, Xgeva)
- Raloxifine (Evista)
- Zoledronate (Zometa)
- Teriparatide (bone forming agent)
Discuss with your doctor about your treatment plan
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