By Dr. Khoobsurat Najma
About 50 million people in India have osteoporosis or low bone mass. 80% of urban Indian population is vitamin D deficient.
What is osteoporosis?
Bone is composed of tissue and mineral. In osteoporosis, there is loss of both mineral and tissue. Osteoporosis weakens the bone and results in frequent fractures (breaks) in the bones.
- Osteoporosis can strike at any age.
- Osteoporosis affects both men and women.
- Women and men equally begin to lose bone mass in their mid-30s, after menopause women have faster bone loss.
Most important risk factor is Menopause.
Other risk factors:
- Women are at higher risk than men
- Family history
- Small body frame
- Calcium and Vitamin D deficiency
- Sedentary lifestyle
- Excessive alcohol intake
- Certain medications (heparin, anti-seizure medications and long-term use of oral steroids)
There are no symptoms in early stages. Once bones are weakened, symptoms include:
- Loss of height over time
- Stooped posture
- Bone fracture that occurs easily: Most common fracture sites are wrist, spine, shoulder and hips
- Bone mineral density scan (X ray) called DEXA (Dual-energy X-ray absorptiometry) scan
- Blood tests: serum Vitamin D, calcium, phosphorus, alkaline phosphatase and parathyroid hormone
Screening for osteoporosis
- Screening is recommended for:
- Women > 65 years
- Postmenopausal women < 65 years at risk for osteoporotic fractures
- Screening is done using DEXA scan
- Density is measured by T-score.
- T-score < -2.5 indicates osteoporosis.
- T-score -1 to-2.5 indicates milder form of disease and high risk for osteoporosis.
- In patients with negative results, DEXA scan be repeated every 2 years.
- Building strong bones is the best defense against osteoporosis
- Encourage children to drink milk and play in the sun to ensure adequate calcium, vitamin D synthesis and exercise.
- Take diet rich in protein and calcium along with calcium supplements.
- Spend 10-15 minutes in sun every day to help body produce Vitamin D.
- Vitamin D is found in eggs, milk and oily fish.
- Exercise daily (30 minutes) to strengthen bones. Even those with osteoporosis can benefit by regular exercise.
- Take stairs to strengthen bones and improve bone mass.
- Quit smoking.
- Limit alcohol intake.
- Although bone loss is part of ageing, it can be stopped by medications that prevent further bone loss.
- Medications that prevent further bone loss
- Calcium, Vitamin D supplements
- Hormone replacement therapy for postmenopausal osteoporosis