Anushka Nanayakkara
How is Osteoporosis diagnosed?
If doctor suspects that the patient is at a risk, he/she may ask her/him to undergo a DEXA scan. DEXA stands for Dual Energy X-ray Absorptiometry. It is a scan that uses special X-ray machines that check the bone density and confirm osteoporosis. Most of the time however, osteoporosis is often first diagnosed when you break a bone after a minor bump or fall.
How do you to prevent osteoporosis?
The following will help prevent bone loss. The advice is for everyone, but if someone has a higher risk of osteoporosis, it is particularly important.
Stop smoking. Heavy drinking should also be avoided.
Exercise: Regular weight-bearing exercise is best. This means brisk walking, aerobics, dancing, running, etc.
It is never too late to start. More vigorous the exercise, the better. Regular exercise is the best - at least 30 minutes of moderate exercise or physical activity 4-5 times per week.
When you exercise, the pulling and tugging on the bones by the muscles stimulates bone-making cells and strengthens the bones. It also gives strength to the supporting muscles around bones. This helps to increase tone, balance, etc, which may help to prevent falls.
Diet: It is important to take sufficient calcium and vitamin D. The recommended daily dose of calcium is 1000 to 1500mg. This can be obtained either by taking calcium tablets, or by drinking a pint of milk a day, plus eating 60 grams of hard cheese such as Cheddar, or one pot of yoghurt (125 g).
These could raise the blood cholesterol level. Butter is not a good source of calcium. Small fish (Sprats) are obviously a good source. A vitamin D supplement may also be helpful - a daily intake of 800 units of vitamin D will reduce the fracture risk. The body can produce Vitamin D on exposure to sunlight, but many elderly people require vitamin D supplementation.
What about Hormone Replacement Therapy?
In the past, after menopause women were treated with Hormone Replacement Therapy (HRT). HRT contains oestrogen, and it was thought that replacing oestrogen after menopause would prevent osteoporosis. While it does indeed do that, recently it has been shown there are certain long term risks in taking HRT; hence HRT is not recommended for the prevention of osteoporosis any longer, unless the individual is subject to an early menopause.
If someone has already got osteoporosis, are there any chances of recovery? The same measures discussed earlier must be continued. These include calcium and vitamin D supplementation, exercise and non-smoking.
There are in addition several drugs. Bisphosphonates is a group of drugs that includes alendronate, and are the most commonly used drugs to treat osteoporosis. These can help to restore some lost bone, and prevent further bone loss. The risk of bone fracture is reduced by taking one of these drugs.
Several other drugs such as strontium ranelate, calcitonin, raloxifene and Parathyroid hormone are also used, often in patients who cannot be given bisphosphonates. None of these drugs should be taken without consulting a doctor.
What about avoiding falls?
Yes, avoiding falls will prevent fractures. Special care should be taken to prevent falls, when you grow old. Check your home hazards such as uneven rugs, trailing wires, slippery floors, etc. Regular exercise can improve balance and stability, and helps prevent falls. Taking certain drugs which make you drowsy can also worsen the risk of falls.
