Osteoporosis – Top ten Frequently Asked Questions

Osteoporosis is low bone density, also called brittle bone. Bones become thinner and brittle; a small injury can make the bone break.

If you have Osteoporosis, your chance of developing fracture with a simple fall becomes high. A fracture is a big medical issue for its’ immobility, chance of chest and urine infection, bedsores in elderly and so on. Do not forget the loss of work and economic burden with this.

Throughout the life, old bone is removed (resorption) and new bone is added (formation) to the skeleton. During childhood and teenage years, new bone is added faster than old bone is removed.

As a result, bones become larger, heavier, and denser. Bone formation continues at a pace faster than resorption until maximum bone density is reached at around the age of 25 years.

After that age, bone resorption slowly begins to exceed bone formation. Bone loss is most rapid in the first few years after menopause in women.

If you have not developed adequate bone density in your childhood and adolescence, you will be at risk, this is common in people with poor socio-economic status.

Menopause is a natural risk but risk becomes more if periods stops early in women, called Premature Ovarian Failure.

Other important risk factors are sedentary lifestyle, lack of exercise, excessive drinking, use of steroids for a long period.

Loosing height is very common and used to be considered as normal. Now we know we stoop forward because we loose height and back bones (vertebra) get crushed due to weakness. This is Osteoporosis or brittle bone of spines.

Prevention in this context will mean improving bone density in early life by good nutrition and physical activity in terms of sports. We need to remain active, taking regular physical exercise, avoiding smoking and excess alcohol.

Osteoporosis is a silent disease. People may not know that they have osteoporosis until their bones become so weak that a sudden strain, bump or a simple fall causes a fracture. Collapsed vertebral fracture may present with severe back pain and loss of height.

X-ray is not a good test for osteoporosis, by the time X-ray will detect it will be too late. Also X-ray can not quantify Osteoporosis. We need to see the bone density; this is done by a test called DEXA Scan. This is painless, does not require injection, and takes around 30 minute to finish.

Osteoporosis in India has gained relatively little attention until recently. It is likely 30-40% of people above the age of 50 years in India have it. Also this is happening around 10 years earlier than people in the west. In the west women are more affected but it seems in India it is equally common in men.

We need to eat healthy food including proteins along with regular Vitamin D (you remember most of us are deficient in Vitamin D). Women need Calcium from around the age of 45 years. Then we have medicines to be taken orally or injection to improve bone density.