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The backbone of life
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Keep your bones healthy to prevent osteoporosis
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OCTOBER 20 is International Osteoporosis Day. It is important for you to understand what osteoporosis is, whether you are at risk for developing it and if there are any ways of preventing it.
What is osteoporosis?
Osteoporosis is a condition where bones thin and weaken to the point where they break easily. This often affects bones in the hip, spine, and wrist.
In young healthy adults, bones continue to grow, reaching their greatest strength around ages 20 to 35.
After that, bones slowly become weaker as one grows old. The risk of osteoporosis increases with age. Osteoporosis usually starts developing in women after menopause, as women produce much less of the hormone estrogen then.
Estrogen helps women's bones stay strong as it helps deposit calcium in the bones. So, low level of estrogen weakens the bones.
Other causes of osteoporosis:
* A family history of osteoporosis.
* Too little calcium in the diet or not enough weight-bearing exercise such as walking or climbing stairs.
* Surgical removal of the ovaries, which reduces estrogen levels.
* Long-term use of certain medicines, such as steroids, thyroid medication, anticonvulsants, and aluminium-containing antacids.
* Chronic diseases like diabetes, hyperthyroidism, and congestive heart failure.
* Long periods of bed rest during serious illness, which speeds up the loss of calcium from bones.
What are the symptoms?
You may have no symptoms until a bone breaks. Broken bones are the most common problem for people with osteoporosis. Often it is bones in the hip, arm, or wrist that breaks.
The bones of the spine are also a common area of thinning. Over time, the bones of the spine (vertebrae) may collapse , one at a time, causing loss of height, back pain, and a stooping posture.
How is it diagnosed?
Your physician may discover you have osteoporosis from an X-ray taken for some other problem.
Otherwise, the diagnosis might be made with a test to measure your bone mineral density, such as a DEXA scan.
How is it treated?
The aim of treatment is to slow down the loss of bone and to a small extent, rebuild bone. Treatment includes increasing the calcium your body gets, usually through diet and supplements. Most adult women should have 1000 mg of calcium a day. (see table)
There are several medicines that slow bone loss and help reduce fractures. These include
bisphosphonates such as alendronate, calcitonin, selective estrogen receptor modulators (SERMs) such as raloxifene hormone replacement therapy helps prevent osteoporosis. However, your physician is the best judge of whether you need it or not.
If you are taking medicine to treat osteoporosis, be sure to take it as directed.
For example, medicines such as alendronate must usually be taken with a full glass of water in the morning, on an empty stomach. You must remain upright for at least a half hour after taking it.
Include low-fat milk and dairy products, green leafy vegetables, citrus fruits, and shellfish in your diet. Take a daily calcium supplement if your physician recommends it.
Do weight-bearing physical activity, such as walking, regularly. Be sure to exercise your upper body also. Weight-bearing exercise helps prevent bone loss and strengthens muscles, which can help prevent falls.
How to reduce risk of injuries?
If you have osteoporosis, you can reduce the risk of injury and broken bones if you:
* Avoid lifting heavy objects.
* Avoid unusually vigorous physical activity.
* Wear slippers or shoes that provide good support.
* Use support for walking, such as a cane, if you need it.
* Keep areas where you will be walking, well lit and uncluttered. If you walk outside, avoid uneven surfaces that could cause a fall.
* Avoid using small rugs that slip easily on your floors.
GITA ARJUN
(The author is a Chennai-based obstetrician and gynaecologist with a special interest in women's health issues)
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