Interview with Dr Joanna Bayley on osteoporosis. Dr Jo explains what osteoporosis is and how to avoid it.
Osteoporosis is a weakening of the bones that happens as we get older. We normally think of our bones as a “static structure”. Actually our bones are constantly breaking down and remodelling. This is good news if you break a bone. It allows the bone to fix itself. In osteoporosis, the balance between breaking down and remodelling gets unbalanced. There is too much breaking down and not enough remodelling.
We become more at risk of fractures, especially in the spine, hip and wrists.
One of the big problems is that people don’t have any sysmptoms until they have a fracture.
There are treatments available to stop it getting worse. But it’s best if we can avoid osteoporosis in the first place.
People start to become at risk of osteoporosis in their early 50s. For women, their risk starts to go up around the time of menopause. (This is due to changes in oestrogen levels.)
Typically, people don’t get fractures from osteoporosis for another 20 years.
There’s a big opportunity to correct osteoporosis but most people aren’t aware that they have it.
As you get older your risk goes up.
Women are more at risk than men as they normally have smaller bones.
Shorter people are more at risk than taller people. This means that different races are more at risk. For example Asian people are more at risk than Africocarribean people as they tend to be shorter.
Any condition that prevents you from absorbing calcium will put
you at risk. (e.g. coeliac disease or inflammatory bowel disease.) Eating disorders can also put you at risk of osteoporosis.
Hormonal conditions e.g. an over active thyroid or being on long term steroids.
Family history of hip fractures.
Smoking is a big risk factor for osteoporosis.
Drinking more than the recommended amount of alcohol puts you at risk of osteoporosis. (Women 14 units a week. Men 20 units a week.)
HRT can reverse the affect the fall in oestrogen. In the UK, HRT is not recommended for osteoporosis alone (as there are other risks of HRT.)
The DEXA scan can be a useful test. But it only gives a snapshot.
Two big things are giving up smoking and reducing the amount of alcohol you drink.
Nutrition. It’s important to eat calcium. Most people get calcium through diary products. If you’re vegan, you need to consider where to get calcium from.
Lots of nuts and vegetables also contain calcium.
Some people (e.g. people who can’t absorb food) need to take a calcium supplement.
Vitamin D is important to prevent osteoporosis. We get most of our vitamin D through sunshine. Plus a smaller amount from our diet. During the winter (depending on where you live), you might need to take a vitamin D supplement. (Normally you can buy drops or pills at the pharmacist.)
Being overweight puts extra strain on your bones. So it’s a good idea to reduce weight if you are over weight.
Exercise helps with bone remodelling. It helps strengthen muscles and preserve your balance.
You need to do a mixture of high impact exercise (running, aerobics) and resistance exercise (e.g. hand weights).
A group of drugs called biphosphonates can help prevent the progression of osteoporosis. Normally they are prescribed by your GP or rheumatologist. It’s important to exercise at the same time.
Dr Orlena is a health coach. She helps busy mums go from "I can't lose weight" to feeling fit and fabulous. Find out more about her here.