Osteoporosis & risk factors for fractures? | Dr Jay Deshmukh
What are the major symptoms of osteoporosis?
- In the early stage of bone loss, there are no symptoms. But once there is significant osteoporosis, there could be backache caused by fractured or collapsed vertebra, loss of height over time, a stooped posture and a bone that breaks much more easily than expected.
What are the risk factors for osteoporosis?
- Dr Jay Deshmukh:- Our growing age itself is a risk factor for osteoporosis. However, post menopause stage in women and men above 60 years are at the greatest risk of osteoporosis. Both being underweight or overweight increases the risk. Hence an ideal body weight should be the aim. Having a parent with osteoporosis puts you at a greater risk especially if your mother or father fractured a hip. Men and women with a smaller frame are at increased risk. Reducing levels of testosterone in men and oestrogen in women increases the risk. Overactive thyroid and parathyroid gland and overactive adrenal glands can cause osteoporosis. Certain medications like steroids, medications used for fits, gastric reflux, cancer can cause osteoporosis. The risk is more in individuals with kidney or liver disease, rheumatoid arthritis and lupus.
What about lifestyle and osteoporosis risk?
- People who spend a lot of time sitting have a higher risk of osteoporosis than those who are active. Walking, running jumping, dancing and weight lifting seem particularly helpful. Excessive alcohol and tobacco consumption in any form increase the risk.
What are the complications of osteoporosis?
- Bone fractures, particularly in the spine or hip, are most dangerous. Hip fractures are often caused by a fall and can result in disability and even an increased risk of death. Fractures of the spine may not always be associated with falls. Besides backache, lost height and a hunched forward posture are common.
How to prevent osteoporosis?
- Dr Jay Deshmukh:- Good nutrition and regular exercises are essential to keep our bones healthy throughout our lives. Not being underweight or overweight helps. Men and women between the ages of 18 and 50 need 1000 milligrams of calcium per day. The amount increases to 1200 mg when women turn 50 and men turn 70 years. Good sources of calcium include milk, curds, buttermilk, dark green leafy vegetables, orange juice, salmon or sardines.
What about calcium supplements?
- The total calcium intake from supplements and diet combined should be no more than 2000 mg per day for people older than 50 years. Too much calcium has been linked to kidney stones and can increase the risk of heart disease.
What about Vitamin D?
- Vitamin D improves the absorption of calcium and improves bone health in other ways. Some Vitamin D can be obtained from sunlight exposure. 600 to 800 units of Vitamin D per day as supplements above the age of 50 is sufficient.
Which is the best form of exercise to prevent osteoporosis?
- Dr Jay Deshmukh:- Combined strength training exercises, weight bearing and balance exercises are important. Weight-bearing exercises such as walking, jogging, running, stair climbing and skipping done throughout life prevent osteoporosis in old age. Swimming, cycling and exercising on machines such as elliptical training provides a good cardiovascular workout, but they don’t improve bone health.
How is the diagnosis of osteoporosis made?
- Measuring the bone density by a machine known as Dexa scan is necessary. In this test low levels of radiation is used to determine the proportion of minerals in the bones.
What is the treatment of osteoporosis?
- The treatment is based on the assessment of the risk of a fracture in the next 10 years based on the DEXA scan. Those with increased risk of fracture the most widely used medications are bisphosphonates. Monoclonal antibody medications like denosumab, hormone replacement therapy and bone building medications like Teriparatide are frequently used under doctor ‘s supervision.
How to prevent falls in old age?
- Wear low heeled shoes with nonslip soles, check your house for slippery areas, rugs or electric cords. Keep rooms brightly lit, have grab bars at commonly used areas and make sure you can get in and out of bed easily.
Author: Dr Jay Deshmukh
Dr Jay Deshmukh is Chief Physician and Director, Sunflower Hospital, Nagpur Honorary Physician to Honorable Governor of Maharashtra and PondicherryCentral. Dr Jay Deshmukh is an M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD From Internal Medicine – Bombay and New Delhi.