What is Osteoporosis?

Osteoporosis (brittle bones) occurs when bones become thin and therefore more prone to fractures (breaks).

The onset is gradual and there may be no signs until the bones become so weak that they fracture. The most common fracture sites are wrists, hips and the spine. Osteoporosis may result in pain, disability and loss of independence. Osteoporosis affects around 1 in 2 women. More women die from the after-effects of osteoporotic fractures than from all cancers of the ovaries, cervix and uterus put together. Men fare better, but even so, 1 in 5 will suffer from osteoporosis after the age of 50.

What are the risk factors?

If you have had any of the following then you have an increased risk of osteoporosis: -

Strong family history of osteoporosis

Early menopause or hysterectomy(under the age of 45)

Irregular or infrequent periods for more than 6 months

Prolonged past or current use of steroids

Anorexia nervosa, or low body weight

Malabsorption problems eg coeliac disease, Crohn's disease

Thyroid problems

Renal problems

Spontaneous or low impact fracture of: Wrist, Hip or Spine

Loss of height

Smoking

Excess alcohol intake

Low calcium intake

Lack of exercise

Can osteoporosis be treated?

It is never too late or too early to start doing something to prevent osteoporosis. Leading an active healthy life and including a diet with sufficient calcium can help prevent osteoporosis and improve general health. Osteoporosis can be treated; there are treatments available that may slow down the bone loss and reduce the risk of fractures. If you have been prescribed a medication it is important that you take it regularly and follow your doctor's instructions.

How would I know if I had osteoporosis?

Osteoporosis can continue for a long time without apparent ill effects and the sufferer may feel entirely well. The major problems with osteoporosis are its lack of early signs and symptoms. Hence, the most frequent event preceding the diagnosis of osteoporosis is a fracture. If you fall in to any of the above risk categories and are close to or in the menopause, it would be wise to have a bone scan to determine whether your bone mineral density indicates a risk of developing osteoporosis. A useful way to predict the risk of fracture caused by osteoporosis is the fracture threshold. The bone mineral density of people at risk is compared with average measurements for the population in the same age group. People at risk of osteoporosis show significantly lower levels than the average. The fracture threshold will vary with age, as the 'normal range' varies with age, and from bone to bone. Nearly all fractures of the vertebrae occur in individuals with mineral density below the fracture threshold.

The following may indicate the presence of osteoporosis:

fracture following a minor injury

loss of height

back pain

How can I find out if I have Osteoporosis?

By having a bone density scan, using a small DEXA Scanner (Dual Energy X-Ray Absorptiometry) which checks the bone density of the forearm, and produces a report showing the results as normal; osteopenic – where the bone density is slightly lower than expected; or osteoporotic – where the bone density is very low, and may be at risk of fracture. A normal x-ray of bone cannot reliably measure bone density. A bone density scan, called a dual energy x-ray absorptiometry (DEXA) scan, is used to measure the density of bones and compare this to a normal range. This examination is currently the most accurate and reliable means of assessing bone strength. Used in conjunction with risk assessment it gives a reliable evaluation of fracture risk. Once diagnosed by a bone density scan, steps can be taken to slow down or reverse bone loss. Apart from diet and lifestyle changes, there are various treatments, depending on the severity of the problem.

How does the scanner work?

The scanner used is an Osteometer DTX200, recommended by the World Health Organisation as being comparable to the full DEXA scan results. A very low x-ray dose of radiation is used to measure the density of the bone in the forearm, this is very close to the density of the bone in the hip, if this scan shows reduced density at the forearm your G.P. might recommend a full DEXA scan of the spine and hip, or may commence treatment as a result of the findings.

How does bone density vary?

In childhood and early youth, bone formation is at its most rapid and crucial stage – not only are bones increasing in length as height increases, they also increase in strength and density. A baby's skeleton at birth contains less than 25g of calcium, or less than 1% of the total weight. This proportion doubles during growth to about 2% and by maturity a male skeleton typically contains over 1,200g of calcium. So the provision of adequate calcium and vitamin D is vital, especially for females who, on average, have 25% less bone mass than males to start with. Vitamin D is important because it increases the absorption of calcium from food and plays a vital role in bone mineralisation. A well balanced and calcium-rich diet and adequate exposure to sunlight are the best route to this.

Normal Bone	Osteoporotic Bone

Remember, if diagnosed early, osteoporosis can be treated.