What is osteoporosis?
Osteoporosis is a condition where your bones become thin and weak and break easily. Certain parts of the body are affected more than others. The bones most likely to break are the wrist, hip and small bones in the spine. Most people are unaware that they have osteoporosis until a minor bump or fall causes their first broken bone.
Who gets osteoporosis?
Osteoporosis is much more common in women than in men because women have less strong bones than men and they also lose bone very rapidly during the five to 10 years after the menopause. Osteoporosis in men is usually caused by some other illness or treatment. Men, therefore, are usually referred to a hospital clinic. It is estimated that one in two women and one in five men over the age of 50 will fracture a bone, mainly as a result of osteoporosis.
Young women who lose a lot of weight, or who exercise excessively are more likely to get osteoporosis.
What tests will I need to confirm osteoporosis?
For most people, an x-ray to show the broken bone is all that is needed. Blood tests can help your doctor to make sure you have no other health problem damaging your bones. Some patients may need a special DXA scan to see if their bones are thin, but this is only necessary if your doctor wants to change your treatment, or to see whether the treatment is helping your bones.
What can you do to prevent osteoporosis?
It is better to prevent osteoporosis rather than try to treat it once it has damaged your bones. However, both treatment and prevention are possible. So, even if you have already had a broken bone, it is not too late.
Regular exercise and eating a high calcium diet are important throughout life (for recommended calcium intake see below). Calcium is contained in foods such as milk, cheese and yoghurt. The low-fat types contain slightly more calcium per portion that the high-fat types.
Smoking increases the risk of getting osteoporosis, as does heavy drinking. So, it makes sense to stop smoking and cut down on alcohol intake.
It is very important to prevent falls, so take a good look around your home and sort out any problems.
Hormone replacement therapy (HRT) helps prevent the rapid loss of bone after the menopause. However, it is recommended that this should be used only in women at high risk of future fractures where other therapies have been ineffective or are not appropriate.
Calcium supplements are useful for the elderly who do not get enough calcium in their diet; and some people who are housebound or who live in nursing homes will benefit from vitamin D supplements.
Other treatments that can halt bone loss are also available. These include a group of drugs known as bisphosphonates, such as alendronate sodium (eg, Binosto®, Fosamax®), ibandronic acid (Bonviva®), risedronate sodium (Actonel®), and zoledronic acid (Aclasta®). A combined product containing alendronate and vitamin D3 (Fosavance®) is also available. Some of these are taken orally as tablets while others are given by injection.
Raloxifene (eg, Evista®) is another type of drug used to maintain bone density in postmenopausal women. Evista has been shown to reduce the rate of vertebral fractures. Teriparatide (Forsteo®) has also been shown to reduce the rate of vertebral fractures and is used to treat osteoporosis in postmenopausal women.
Strontium ranelate (Protelos®) is the first in a new class of medicines for osteoporosis known as dual action bone agents. It can be used in postmenopausal women to reduce the risk of vertebral and hip fractures and in men at increased risk of fracture.
Denosumab (Prolia®) is an injection that is given every six months. It is suitable for postmenopausal women, and it works by inhibiting the cells that break down bone.
If you need further information about osteoporosis ask your doctor or practice nurse.
Take action now
- Take regular weight-bearing exercise
- Eat a calcium-rich diet - 800mg per day for adults; 1,000mg per day for children and postmenopausal women on HRT; 1,500mg for postmenopausal women not on HRT
- Stop smoking
- Keep alcohol intake below 14 units per week (spread over three or more days) with two or more drink-free days each week. One unit = 1/2 pint of average-strength beer (approximately 250mL); 1/2 glass of wine (76mL); 1 standard pub measure of spirits (25mL).
- Prevent falls by sorting out loose floor covering, poorly lit steps, trailing cables, uneven floors, or clothes that are too long
- Take all medicines exactly as directed by your doctor and do not share them with anyone else
Calcium content of foods
1 pint full cream milk 675mg
1 pint semi-skimmed milk 693mg
1 pint skimmed milk 708mg
1oz cheddar cheese 205mg
5oz pot of yoghurt 240mg
3oz cottage cheese 60mg
2 large slices white bread 60mg
2 large slices wholemeal bread 32mg
Further information available from:
Arthritis Research UK
St Mary's Court
St Mary's Gate
Derbyshire S41 7TD
Tel: 0300 790 0400
National Osteoporosis Society
Bath BA2 0PJ
Tel: 01761 471771
Helpline: 0845 450 0230 (Monday to Friday, 9am-5pm)
Fact sheet provided by MIMS
Date last reviewed: November 2008