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The answers to
questions such as -
What is osteoporosis?
Am I at risk?
Can I prevent
osteoporosis?
What are the treatments
for osteoporosis?
Osteoporosis
Osteoporosis literally means 'porous bones'.
The bones in our skeleton are made of a thick outer shell
and a strong inner mesh filled with collagen (protein),
calcium salts and other minerals. The inside looks like
honeycomb, with blood vessels and bone marrow in the spaces
between bone. Osteoporosis occurs when the holes between
bone become bigger, making it fragile and liable to break
easily. Osteoporosis usually affects the whole skeleton but
it most commonly causes breaks (fractures) to bone in the
wrist, spine and hip.
Bone is alive and constantly changing. Old, worn out bone is
broken down by cells called osteoclasts and replaced by bone
building cells, called osteoblasts. This process of renewal
is called bone turnover.
Facts and figures
One in two women and one in five men in the UK will
suffer a fracture after the age of 50
Every 3 minutes someone has a fracture due to
osteoporosis
An estimated 3 million people in the UK suffer from
osteoporosis
Each year there are more than 230,000 fractures which
include over
- 70,000 hip fractures
- 50,000 wrist fractures
- 120,000 spinal fractures
Osteoporosis costs the NHS and government over £1.7
billion each year, that's £5 million each day!
Are you at risk?
We are all potentially at risk of osteoporosis because of
the bone loss that occurs as we get older, particularly as
we are living longer as a population, but there are also
many other factors, which can increase your risk of
osteoporosis:
For women:
a lack of oestrogen, caused by
early menopause (before age 45)
early hysterectomy (before the age of 45), particularly
when both ovaries are removed (oophorectomy)
missing periods for six months or more (excluding
pregnancy) as a result of over-exercising or over-dieting
For men:
low levels of the male hormone, testosterone (hypogonadism)
For
men and women:
long-term use of high dose corticosteroid tablets (for
conditions such as arthritis and asthma)
close family history of osteoporosis (mother or father),
particularly if your mother suffered a hip fracture
other medical conditions such as Cushing's syndrome and
liver and thyroid problems
malabsorption problems (coeliac disease, Crohn's disease,
gastric surgery)
long-term immobility
heavy drinking
smoking
If you think you may have one
or more of these risk factors you are at increased risk of
developing osteoporosis. You need to discuss your risk with
your doctor and find out how to prevent and treat the
disease. If you have broken a bone after a minor bump or
fall you may already have osteoporosis and you should
discuss this with your GP.
Do I have osteoporosis?
Because you cannot see of
feel your bone getting thinner you will probably be quite
unaware of any problems with your bone health. Osteoporosis
is a silent disease and for most people, the first sign that
something is wrong can be when they break a bone, often in
the wrist or spine after a minor incident, although not all
fractures are due to osteoporosis.
Can I be tested for
osteoporosis?
A normal x-ray of bone cannot
reliably measure bone density but is useful to identify
spinal factures, explains back pain, height loss or kyphosis.
A bone density scan, called a
dual energy x-ray absorptiometry (DXA) scan, is used to
measure the density of bones and compare this to a normal
range. This test is currently the most accurate and reliable
means of assessing the strength of your bones and your risk
or fracture.
Can I prevent osteoporosis?
Your genes determine the
potential height and strength of your skeleton but lifestyle
factors can influence the amount of bone you invest in your
bone 'bank' during your youth and how much you save in later
life.
Follow a 'Bone-Friendly' diet
Healthy bones need a
well-balanced diet, incorporating minerals and vitamins from
different food groups.
You especially need to ensure that your diet is rich in
calcium. The best sources of calcium are milk and dairy
products such as cheese and yogurt. Non-dairy sources of
calcium include green leafy vegetables, baked beans, bony
fish and dried fruit.
Click here
to download our information leaflet on
Calcium rich foods and bone health
or order our booklet
Diet and Bone Health
for £3.
Take
regular, weight-bearing exercise
Like muscles and other parts
of the body, bones suffer if they are not used. They need
regular weight-bearing exercise that exerts a loading impact
and stretches and contracts the muscles, stimulating bone to
strengthen. Good bone building exercises include running,
skipping, aerobics, tennis, even brisk walking. Try to
exercise at least three times a week for a minimum for 20
minutes. If you haven't exercised for a while, start gently
and check with your doctor if you have another health
problem and are worried about exercising.
What else can I do?
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If
you are a smoker - give up! Smoking has a toxic effect
on bone in men and women. It can cause women to have an
early menopause and may increase the risk of hip
fracture in later life. Stopping smoking will benefit
your bones and your general health and fitness.
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Watch what you drink! Drinking too much alcohol is
damaging to bone turnover. Limit your alcohol intake to
a maximum of 21 units per week for men and 14 units for
women.
There has been concern, as the result of some research
studies, that a high vitamin A intake may increase the risk
of broken bones. Studies suggest that a daily vitamin A
intake greater than 1500 micrograms retinol equivalents (RE)
(not far in excess of the reference nutrient intake [RNI]
700 micrograms/d RE for men; 600 micrograms/d RE for women)
may be associated with lower bone mineral density and a
higher risk of hip fracture. However not all studies have
confirmed this link and further research is urgently
required. Since excessive amounts of vitamin A might be
attained from supplements containing retinol, older people
might want to avoid higher doses of pure cod liver oil.
(pure cod liver oil for instance could provide 1200
micrograms RE of vitamin A in a 10ml dose).
A government committee is examining this issue and any firm
recommendations will be posted when they are available.
Meanwhile if you are taking a number of dietary supplements
it may be useful to calculate the total amount of vitamin A
being consumed and avoid excessive amounts.
Note:
• Retinol –measured in retinol equivalents (RE) - is the
type of Vit A that there is concern about .It occurs in fish
and dairy products. Vit A as carotene in vegetables is not
going to cause these potential problems
• Retinol may be expressed in IU (international units).
1000IU =300 micrograms
Treatments
For people who have been
diagnosed with osteoporosis there are a range of treatments
available. The most common treatments include:
Bisphosphonates
are non hormonal drugs, which help maintain bone density and
reduce fracture rates.
Calcium and
vitamin D
supplements can be of benefit for older people to reduce the
risk of hip fracture.
Hormone
replacement therapy (HRT)
is oestrogen replacement for women at the menopause, which
help maintain bone density and reduce fracture rates for the
duration of therapy.
For more information on the NOS' position on
HRT click here.
Selective
Estrogen Receptor Modulators (SERMs)
are drugs which act in a similar way to oestrogen on the
bone, helping to maintain bone density and reduce fracture
rates specifically at the spine.
Testosterone
therapy is testosterone placement for men with low
testosterone levels to help maintain bone density.
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