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Osteoporosis

osteoporosis


Osteoporosis is a condition that affects bone strength.
Bone is made of collagen fibres  and minerals. It is a living tissue and contains cells that make, mould and resorb bone. Initially, as you grow, bone formation exceeds bone resorption. But, as you get older, this reverses and, after about the age of 45, you start to lose a certain amount of bone material. Your bones become less dense and less strong. If you have a lot of bone loss, then you have osteoporosis. If you have osteoporosis, your bones can break more easily than normal, especially if you have an injury such as a fall.


Who is at risk of osteoporosis?

  • All men and women have some risk of developing osteoporosis as they become older, particularly over the age of 60. Women are more at risk than men. The following situations may also lead to excessive bone loss
  • If you are a woman and you had your menopause before the age of 45.
  • Have already had a bone fracture.
  • Have a strong family history of osteoporosis.
  • Have a body mass index (BMI) of 19 or less (that is, you are very underweight
  • Have taken, or are taking, a steroid medicine (such as prednisolone) for three months or more.
  • Are a smoker.
  • Have an alcohol intake of more than four units per day.
  • Lack calcium and/or vitamin D.
  • Have never taken regular exercise, or have led a sedentary lifestyle .
  • Have, or had, certain medical conditions. For example, an overactive thyroid, coeliac disease, Cushing's syndrome, Crohn's disease, chronic kidney failure, rheumatoid arthritis, chronic liver disease, type 1 diabetes or any condition that causes poor mobility.

Osteoporosis symptoms and problems

  • A bone fracture after a minor injury such as a fall
    • Fragility fractures are most commonly of the hip, wrist, and vertebrae (the bones that make up the spine).
  • Loss of height, persistent back pain and a stooping (bent forward) posture

How is osteoporosis diagnosed?

Before any symptoms develop
If you are found to be at increased risk, or your risk is uncertain, you may be referred for a DEXA scan.

Other tests
A newer test to look for osteoporosis is called digital X-ray radiogrammetry (DXR).

What can I do to prevent osteoporosis?

  • Exercise
  • Food and diet
  • Smoking and drinking
  • Hormone replacement therapy

Do I need treatment for osteoporosis?

If you are found to have osteoporosis and you have already had a fragility fracture, treatment is usually recommended to help prevent a further fracture. The bisphosphonate drug alendronate is usually suggested first.
If treatment is started, repeat DEXA scanning on a regular basis may be suggested to look at how effective treatment is.

Medication for osteoporosis

Bisphosphonates
These are a group of drugs that include alendronate, risedronate and etidronate. They are the most commonly used drugs to treat osteoporosis. They work on the bone-making cells. They can help to restore some lost bone, and help to prevent further bone loss.

Strontium ranelate
This drug may be an alternative for certain people with osteoporosis if a bisphosphonate is not suitable or is not tolerated - for example, because of side-effects. It can help to slow down bone loss and also help to build new bone.

Denosumab
This drug may be an alternative for women with osteoporosis who have been through the menopause if a bisphosphonate is not suitable or is not tolerated. It is given twice a year by injection and helps to slow down bone loss.

Raloxifene
This is another option for some women with osteoporosis. It is usually only used if a woman has already had a fragility fracture. It works by mimicking the natural effects of oestrogen. This gradually reverses the excessive breakdown of bone that happens at the menopause and makes bones stronger.

Parathyroid hormone peptide drugs
These drugs are suggested for people who have already had a fragility fracture. An example is teriparatide.

Calcium and vitamin D tablets

Lifestyle

There are a number of lifestyle measures that are also important in treating osteoporosis. They include weight-bearing exercise, muscle strengthening exercises, not smoking, and keeping any alcohol drinking to within the levels as described earlier.
Prevent falls


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