What is Osteoporosis?

Osteoporosis is a condition in which one's bones are weakened and become brittle. Hence, it is very likely for a person with osteoporosis to break their bones. Even common stresses such as bending over can cause fractures for those diagnosed with osteoporosis.

Osteoporosis is more commonly associated with ageing and it occurs when the creation of a new bone does not keep up with the loss of old bone. This condition is developed over several years and is usually only discovered when fractures occur.

Am I at risk for Osteoporosis?

There are many risk factors for osteoporosis which can be uncontrolled or controlled. The factors are listed below.

Are there any complications for Osteoporosis?

Complications of osteoporosis usually result from bone fractures. The most serious complications are hip or spine fractures. While hip fractures are often caused by a fall, spine fractures can occur even if one has not fallen. They can both result in disability.

When do I have to go for screening for Osteoporosis?

All women over the age of 65 and men over the age of 70 should go for screening which entails a bone density test. For those who have risk factors, a bone density scan (DEXA scan) may be done earlier.

Through the scan, one's bone strength is measured and compared to that of a healthy young adult. Bone density can be measured by a machine that uses x-rays to determine the proportion of minerals in your bones. This is a short and painless procedure. A standard deviation is calculated when your bone strength is compared to that of a young adult. This number is called a "T score". The values below show what the "T score" indicates"

- above -1 SD is normal

- between -1 and -2.5 SD is defined as osteopenia (this condition does not mean it will lead to osteoporosis)

- below -2.5 is defined as osteoporosis

How is Osteoporosis treated?

Osteoporosis is treated according to each individual's condition. The treatment aims to slow down the progression of osteoporosis, maintain healthy bone mineral density, prevent fractures, enable an individual to maintain his quality of life and to reduce pain. An active lifestyle with exercises customized to the individual is also crucial to maintain one's bone and muscle strength. Being inactive increases the rate of bone loss as well, so being active and doing simple basic exercises is an important pillar in the treatment of osteoporosis as well!

There are a few treatment options available:

• Hormone-related therapy
• Bisphosphonates
• Denosumab
• Bone-building medications

Hormone-related therapy

Right after menopause, the level of estrogen in a woman decreases. Hence, estrogen can help to maintain bone density in women who have gone through menopause. However, at the same time, there are risk factors which include the risk of breast cancer, blood clots which may result in strokes.

Raloxifene is also another drug which has a similar function to estrogen. This drug causes less serious side effects and may even reduce the risk of some types of breast cancer. A possible side effect is hot flashes and blood clots.

The gradual decline in testosterone levels in men may also be linked to osteoporosis. Testosterone replacement therapy can help improve the symptoms of low testosterone levels. This therapy is often recommended along with other osteoporosis medications. The side effects include sleep apnea, non-cancerous growths of the prostate and blood clots.

Bisphosphonates

Since osteoporosis increases one's risk of fractures, the most widely prescribed medication for this are bisphosphonates. These include:

• Risedronate
• Alendronate
• Zoledronic acid
• Ibandronate

Side effects of these medications include nausea, abdominal pain and heartburn. Some extremely rare complications of these medications is a crack in the middle of the thigh bone and the delayed healing of the jawbone.

Denosumab

Denosumab produces similar or better bone density results compared to bisphosphonates and it also reduces the chance of all types of fractures. This medication is delivered as an injection every six months. It also has very rare complications of causing breaks in the middle of the thigh bone and the delayed healing of the jawbone.

Bone-building medications

For individuals who suffer from severe osteoporosis, these medications may be prescribed:

• Teriparatide is a powerful drug which stimulates new bone growth.
• Romosozumab is the newest bone-building medication and it is limited to a year of treatment.
• Abaloparatide is another drug similar to teriparatide and can only be taken for 2 years.

For more information or if you require a medical consultation, please contact My Healthcare Collective here.