Osteoporosis

Osteoporosis is a global public health problem. The lifetime risk for a woman to suffer an osteoporotic fracture is 30-40%. In men the risk is about 13%. Osteoporosis affects more than half of women and nearly a third of men over the age of 60.

About a third of people who fracture a hip die within a year from related complications. Another third never return home. Many who do go home lose their mobility and independence. More women are hospitalised with a hip fracture due to osteoporosis than from breast cancer and the World Health Organisation has identified osteoporosis as a priority health issue.

By 2050 the worldwide incidence of hip fracture in men is projected to increase by 310% and by 240% in women. In women over 45 years of age, osteoporosis accounts for more days spent in hospital than any other disease, including diabetes, myocardial infarction (heart attack) and breast cancer. The great majority of individuals at high risk (possibly 80%) who have already had at least one osteoporotic fracture are neither identified nor treated.

Osteoporosis is a disease of bone in which bone mineral density (BMD) is reduced and bone micro-architecture disrupted.

Osteoporosis is mostly a silent condition which usually first becomes apparent when a broken bone occurs.

Some people are more at risk to develop osteoporosis due to their history of fractures as adults, family history, advanced ageing, European ancestry or dementia. These are called non-modifiable risks. Risks that can be influenced if awareness is raised includes stopping smoking, supplementing with calcium and Vit D, reducing alcohol intake, increasing physical activity, maintaining a healthy body weight and managing oestrogen deficiency. Being on long term oral steroids also increases your risk for osteoporosis.

Dual energy X-ray absorptiometry (DEXA) is the gold standard for diagnosing osteoporosis. If on treatment, follow up with a DEXA scan should be done every two years.

Postmenopausal women, women with premature menopause in particular and anyone with risk factors should be tested for osteoporosis.

Progesterone, oestrogen and testosterone are all important hormones to maintain bone integrity. Lack of calcium and Vitamin D also increase the risk of osteoporosis.

General treatment for osteoporosis includes lifestyle management including weight bearing exercise, Vit D and calcium supplements and Bisphosphonates. Treatment with BHRT is recommended to maintain and build bone density.

Healthy lifestyle advice includes:

  • Dairy foods as a major source of calcium.
  • Soya beans are a good non-dairy option. They contain calcium but also flavonoids and isoflavones.
  • Tea is high in flavonoids and more protective compared to coffee.
  • Prunes are rich in flavonoids.
  • Omega 3.
  • Supplementation with calcium, magnesium, zinc, copper, Vit D, Vit K and Vit C.
  • Avoid excessive intake of Vit A.
  • Isoflavones strontium ranelate.

For further advice and to arrange an appointment please call the Medical Clinic on 01243 771455.