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Signs and symptoms of osteoporosis

Osteoporosis often goes undetected until a minor injury or normal movement like walking or standing causes a bone fracture.

Signs and symptoms of osteoporosis are either absent or are so subtle that they go unnoticed. However, there are known risk factors that increase your chance of developing this ‘silent disease’.

If your doctor suspects that you might have osteoporosis, they will request a bone density scan to help make a diagnosis.

If you are menopausal or post-menopausal, you have a higher risk of developing osteoporosis due to a lack of estrogen and might want to consider taking action to improve your bone strength

Factors that affect bone strength

Lifestyle factors that affect bone strength include high alcohol intake, lack of exercise, poor nutrition and smoking.

Low calcium or vitamin D levels

Calcium is vital for maintaining bone strength. Our bodies absorb lower levels of calcium past the age of 60. Vitamin D helps your body absorb calcium. As you age, your body makes less vitamin D, and it’s thought that your gut stops absorbing it at the usual rate. Falling vitamin D levels prevent your body from adequately absorbing calcium, which is vital for bone strength.

Low levels of estrogen

Your body uses estrogen in the process of laying down new bone. Falling estrogen levels during menopause can interrupt this process.

Medical history and family history

Family history can be a good indicator of your bone strength. You are more likely to break a bone if one of your parents broke their hip. If you have a history of breaking bones, or a condition that weakens your bones, you are more likely to sustain

Low Body Mass Index (BMI)

Low body weight can mean you have less bone tissue. If you have a trip or fall, your bones take more of the impact if you have no layer of fat to cushion them, increasing your risk of breaking a bone.

Taking certain medications

Some medications, including steroids, epilepsy medications, and some cancer treatments, can affect bone strength. Always consult with your doctor before changing or stopping any medication.

Reduce the risks of developing osteoporosis or breaking a bone

  • Maintain a healthy weight Staying within the parameters of a normal BMI means your bones will bear less impact if you fall. If you’re underweight, your doctor might want check for underlying causes or advise on increasing your calorie intake.
  • Eat a healthy diet Keep alcohol intake to a minimum and eat foods rich in calcium and vitamin D to help your body maintain bone production. Your doctor will advise whether you need to take supplements.
  • Exercise Exercising creates a feedback loop that tells your bones that they need to grow stronger to cope with the increasing demands. Therefore, regular, load-bearing exercise is recommended to help build bone strength.
  • Take measures to prevent falls Ensure your home is clutter-free, and you have furniture or mobility aids to hold on to if you feel unsteady. Wear a sturdy pair of slippers indoors and well-fitting shoes outdoors. Discuss other falls prevention measures with your doctor or nurse.

Simple lifestyle changes can reduce the risks of developing osteoporosis or breaking a bone, as well as improving overall wellbeing as you age.

Treating Osteoporosis

Osteoporosis cannot be cured, and it gets progressively worse with age. Treatment aims to prevent bone fractures by halting some of the bone loss associated with osteoporosis.

As part of normal bone health, the body breaks down old bone and replaces it with new bone. Factors such as age, lack of estrogen after the menopause, and the effects of some medications, can interfere with the body’s way of laying down new bone. It reaches a point where more bone is destroyed than replaced, leading to poor bone health.

Reversing some of the factors that cause weak bones helps maintain bone density and strength and reduces the risk of fractures.

Menopause Hormone Therapy

Menopause Hormone Therapy, like HRT, is known to increase bone density significantly and therefore reduces the risk of developing osteoporosis. It works by replacing estrogen in the body so your usual process of laying down new bone can continue. HRT is a preventative measure rather than a treatment, and once you stop taking it, the positive effects on bone strength are quickly lost.

Prescribed medications

Research has shown that there are many effective medications available for treating osteoporosis. Your doctor will decide which is right for you. Some medicines are better at preventing bone fractures in the spine, while others are more effective on non-spinal bones.

Treatments come in various forms including tablet, oral solution, injection, or through an IV drip. The type of medication you receive will determine how often you must take it.

Your doctor will discuss all the suitable medication options with you and may also advise you to take calcium and vitamin D supplements.

Bisphosphonate

Bisphosphonate slows down the rate at which your body breaks down bone. It can be given as oral tablets or as an IV drip.

Bisphosphonate tablets must be taken on an empty stomach with a full glass of water. You then need to stand upright between 30 minutes to 2 hours before eating or drinking anything else. Some next generation bisphosphonate medication passes through the stomach before being broken down and can be given immediately after food, eliminating the need for fasting in the morning.

RANK ligand inhibitors

This osteoporosis injection is administered every six months and works by delivering an antibody that slows down the process that breaks down bone in your body.

Bone formation agents

This once-daily injection stimulates bone formation by direct effects on bone-forming cells (osteoblasts) and also increases the intestinal absorption of calcium.

Hormone therapies

Hormone replacement therapies generally reverse the excessive resorption of bone and preserve bone mass.

Calcium and vitamin D supplements

These supplements work together to protect your bones. Calcium helps build and maintain bones, while vitamin D helps your body effectively absorb calcium.