Breaking Bones?

Most of us are familiar with the name osteoporosis. But how much do you really know besides it has got to do something with weakening of the bones. And no, it's not restricted to females alone. Read on to know more.

What is it?
"'Osteo' means bones and 'porosis' means soft, so in simple terms osteoporosis means soft or fragile bones. There are two main types of osteoporosis, post-menopausal and senile. Post-menopausal affects women after menopause i.e. early by age 45. The reason being, women loose hormonal protection after menopause. The second type is senile osteoporosis, which affects both sexes after 65 years," informs Dr Shreedhar Archik, consultant orthopedic surgeon, Lilavati Hospital.

How common is it?
Osteoporosis is a common disease characterised by porous, weak bones that fracture easily. "It's most commonly seen in women after menopause – particularly those who are small boned or underweight. It's the most common disease involving the bones and is estimated to affect 200 million people worldwide. It's sobering to note that one in three women over the age of fifty will develop a bone fracture related to osteoporosis at some point in her lifetime. Men are also not immune to this disease – although osteoporosis in males receives less focus. Still, one in five men will develop a fracture related to osteoporosis – with the most serious being a fracture of the hip," informs Dr Ashish Arbat, consultant orthpedic surgeon, Fortis Hospital.

Young are affected too
It is found that around 15 to 20 per cent of cases seen in younger women and 45 to 50 per cent in elderly. For e.g. a woman with age of 30, working in a call center, due to her sedentary lifestyle as per the working hours and shifts, she is being lethargic and low in activities. On diagnosis she is found deficient in vitamin D and bone minerals. She has been advised for intake of calcium and regular exercises, says Dr Umesh Shetty, orthopedic surgeon, Aviva Hospitals. Dr Archik says that agrees that young women can get osteoporosis simply because of low vitamin D, and recounts the case of a 36 year-old-patient who had fracture both hips due to low vitamin D.

Causes
Certain factors that increase the risk of osteoporosis can't be controlled – including age, sex, and genetics. Dr Arbat explains that women are more prone to developing osteoporosis because they have less bone tissue, and their rate of bone loss accelerates after menopause due to lowered estrogen production. Osteoporosis becomes more common with advancing age – a factor that few can control. This disease is more common in Caucasians and Orientals and in people who are small boned. Hormonal levels also play an important role in the development of osteoporosis. Women who undergo an early menopause are at greater risk of osteoporosis if they don't go on hormone replacement therapy due to a decline in estrogen levels. People who are underweight have a higher risk of developing this disease as do people who get inadequate quantities of calcium in their diet. Restricting calories excessively and eating a diet that's low in calcium and vitamin D can increase the risk of osteoporosis.

Alcohol and smoking play a part in accelrating osteoporosis. Lack of exercises, sedentary life style also play a major part in the development of porosis. Certain drugs like steroids or diseases like coeliac sprue or rheumatoid arthritis also cause early osteoporosis, informs Dr Archik.

Diagnosis
Osteoporosis it can be diagnosed by the posture and by the chief complaints of the patient by an expert. Besides that routine blood tests for vitamin D3, B12, serum Ca (to measure the level of calcium in the blood), BMD DXA (to measure bone mineral density) are done.

Treatment
On comparing the symptoms shown and the diagnosis of the patient, treatment process includes medications followed by physiotherapy exercises. Improvement in their lifestyle and diet is another major area. Calcium and vitamin D are the basic drugs. There are also specialised drugs which the doctor decides after looking at the DEXA report.

Role of vitamin D
Dr Arbat says that Vitamin D is important for the proper utilisation of calcium and most experts now recommend getting at least 800 mg per day. One way to offset this is to get at least 1,000 mg of calcium each day. (Those over the age of 50 need 1,200 mg). The best source of vitamin D is 15 minutes of sun exposure on bare skin three to four days per week. Some doctors recommend vitamin D supplements for people who can't get adequate sun exposure. More recent studies show that vitamin K and magnesium also play an important role in maintaining bone health.

Prevention

Physical activity is another factor that's beneficial for stimulating bone growth and preventing osteoporosis. High impact exercise such as walking, running, and jumping rope are ideal for increasing bone density. Weight bearing exercises such as weight lifting and strength training on a regular basis also helps to preserve bone mass and reduce the risk of osteoporosis.