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Health and Wellbeing - February 2020

29 Jan 2020

Bone health: Understanding osteoporosis

By Amanda Olsen

When you hear the term “osteoporosis” meaning “thinning of the bones” what first comes to mind?

I’ve asked many of my patients this question over the years and a common response is: “oh, that’s just an old woman’s disease, right?” … wrong! The truth is osteoporosis can occur in a younger or older person, woman or man. While it’s true that the highest prevalence of the condition is in women over the age of 50 and in menopause, one cannot exclude younger women or men.

Let’s begin by explaining the structure of a bone and how osteoporosis occurs. The outside of your bone is hard and solid and protects the inside which has a honeycomb appearance. Bones become stronger by breaking down old parts of itself and replacing it with new bone. Your bones use several minerals to help this process and to maintain its strength – calcium and vitamin D being two important players. Calcium is a mineral that is found in many foods, predominantly in dairy products but also found in leafy greens and beans for those who are lactose-intolerant or vegan. It’s essential to bone health, and its absorption into the bone requires vitamin D. When one has osteoporosis, there is a disruption to the absorption of these minerals and the rate of removing old bone is faster than the bone’s ability to replace it which leads to fragility.

What are the common risk factors?

Menopause. Typically occurring in women around 50 years of age or older, there is also a sub-group of younger women who experience early-onset menopause. Menopause results in a rapid decline in the hormone oestrogen, which affects the body’s ability to absorb minerals into the bones, hence why osteoporosis is common in this group.

Men over the age of 70. As men get older, their testosterone levels also naturally decline, though at a slower rate than women, leading to the belief osteoporosis is a “woman’s disease”. However, it’s worth noting it was found that men over the age of 50 represent 30 per cent of diagnosed fractures in Australia. So, men, I hope you’re all reading this too!

Know your family history. If a close relative such as a sibling or parent is diagnosed with osteoporosis, the chances of you also having it is very high.

Low calcium and vitamin D. Intake usually due to a poor diet and underexposure to the sun. Sun safety is key (especially in Australia) so only a few minutes outside is enough to get a sufficient amount!

Lifestyle. If you are sedentary, your bones and muscles don’t have the opportunity to strengthen and support your system. Also, be aware that smoking and excessive alcohol intake also inhibits mineral absorption into the bone.

Osteoporosis is a “silent disease” – one typically experiences a fracture(s) from a minor incident to bring awareness. It’s then confirmed via a DEXA scan which requires a referral from your GP. Discuss any possible risk factors you believe you may have with your GP and together you can decide if it’s appropriate for investigation.

I’m diagnosed with osteoporosis – what can I do for myself now?

Bring your DEXA scan results to your GP and discuss their interpretation. Some cases require more than just dietary changes and exercise, so prescription medication designed to assist in either slowing down the bone loss or help rebuild bone may be warranted.

Calcium and vitamin D supplements are overall good things to start taking under the guidance of your GP.

EXERCISE!! As a physiotherapist, I cannot stress this one enough. Go out and move your body. You need weight-bearing exercises to help build bone. So, lift those weights, go for those walks or runs, climb that mountain you’ve been wanting to climb or simply use the stairs at work. Anything that puts pressure through your bones is the best version of exercise to help keep them strong. If you’re not sure what exercises to do, go to your local physiotherapist and ask for a program that is safe and effective.

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