WHAT IS OSTEOPOROSIS?
Osteoporosis literally means “porous bones.” It is a skeletal condition characterised by loss of bone minerals and material, and a deterioration of bone microarchitecture, resulting in bone fragility.
HOW DOES OSTEOPOROSIS DEVELOP, AND WHO IS AT RISK?
Bone is living tissue; each day, old bone is removed and new bone is formed. Osteoporosis occurs when the rate of removal is faster than the rate of formation, which occurs as age advances. Women are four times more prone to osteoporosis than men, especially after menopause or early-menopause. Other factors are a family history of osteoporosis, or a small and thin body frame. Caucasian and Asian people are also more prone to osteoporosis.
WHAT CAN BE DONE TO REDUCE THE RISK OF OSTEOPOROSIS?
Exercise is recommended to reduce the risk; at least 45 minutes three times per week. It is also advisable to reduce or stop cigarette smoking, as nicotine is toxic to osteoblast (the bone-forming cells) and reduce caffeine intake.
Increasing exposure to sunlight (at least15 minutes daily) is a useful way to reduce the risk, as sunlight stimulates the skin to produce vitamin D to improve calcium absorption. Adequate calcium intake through consumption of dairy products, sardines, anchovies, and green leafy vegetables can also help.
The recommended calcium intake is 1200mg per day. To ensure adequate intake, calcium supplements are available, although the recommended amount of supplemented, elemented calcium is 400 to 600mg daily.
HOW DO I KNOW THAT I HAVE OSTEOPOROSIS?
Osteoporosis is silent in early to moderate stages, while in later stages it may cause bone pains, curvature of the spine, and loss of height. Acute severe back pain may be due to a compression fracture of spinal vertebrae.
It is recommended that post-menopausal women, especially those with other risk factors, are screened. The gold standard for diagnosis is a DEXA scan; a short, painless procedure similar to taking a photograph of the bone, that costs around RM120.
Quantitative ultrasound “bone scans” offered in shopping centres are just a tool for screening and not enough for a full diagnosis. If the results show a low bone density, confirmation should be done with a DEXA scan.Often ultrasound scans are too sensitive, and a false positive diagnosis may be made if confirmation is not sought.
IS OSTEOPOROSIS TREATABLE?
Yes.There are many modalities of treatment including lifestyle modifications and various pharmaceutical agents. Prescriptions depend on the severity of the disease and vary from calcium and vitamin D supplements to antiresorptive agents (most common) and anabolic (bone-forming) medication.
This article was written by Dr. Joseph Yap Chong Kiat for The Expat magazine.
Source: The Expat October 2012
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