Osteoporosis

Osteoporosis is a disease resulting in thinning and weakening of bones making them more likely to break. The bones in the body constantly go through a process whereby bone is absorbed and new bone is laid down. With age, this balance is disturbed, and while bone continues to get absorbed, new bone is not laid down at the same speed. This loss of bone material starts in the late thirties and becomes marked in women after menopause. The process may go unnoticed till a bone breaks.

• What is osteoporosis?
• What are the causes of osteoporosis?
• How is it diagnosed?
• How is it treated?

What is osteoporosis?

Osteoporosis is a disease resulting in thinning and weakening of bones making them more likely to break. The bones in the body constantly go through a process whereby bone is absorbed and new bone is laid down. With age, this balance is disturbed, and while bone continues to get absorbed, new bone is not laid down at the same speed. This loss of bone material starts in the late thirties and becomes marked in women after menopause. The process may go unnoticed till a bone breaks.

What are the causes of osteoporosis?

Many factors contribute to the development of osteoporosis. Some of these are:

•  A family history of the disease
•  Women after menopause
•  Smoking
•  Drinking coffee or alcohol excessively
•  Eating a diet poor in calcium
•  Poor physical activity
•  Asian population
•  Thin, small build
•  Medical diseases like thyroid or liver diseases
•  Drugs like steroids, medicines for fits or thyroid diseases

How is it diagnosed?

Usually the first suspicion comes when a bone breaks. Some patients who have backache may, on testing, show evidence of osteoporosis. If there has been a loss of height or stooping due to curving of the spine, it may suggest osteoporosis. The diagnosis may require some tests like blood tests to measure calcium and phosphorus. X-rays show evidence of osteoporosis only when the disease is advanced. Early changes may be picked up by a bone density test.

How is it treated?

The best way is to prevent osteoporosis. Women who are approaching menopause should consult their doctor regarding starting hormone replacement therapy. A healthy diet with plenty of calcium and vitamin D is prescribed. Calcium tablets and oral vitamin D preparations may be given if the oral intake is inadequate. Routine exercises are recommended.

Medicines are now available that effectively reverse this process of excessive bone absorption. These include biphosphonates like etidronate and alandronate, and calcitonin. Women need to be put on oestrogen replacement therapy. However, treatment with oestrogens is not without problems and newer drugs like raloxifene are being used which have the beneficial properties of oestrogens without the adverse effects.