Bone deep: unveiling the silent epidemic of osteoporosis and how to combat it

Osteoporosis is a growing health concern due to its impact on bone strength and the increased risk of fractures. This silent condition often progresses unnoticed until a bone break occurs, making early prevention and management essential for long-term bone health.

A leading rheumatologist, discusses the importance of understanding osteoporosis and the latest strategies for both preventing and treating this condition. She highlights the role of lifestyle changes, regular screenings, and the newest treatment options to help reduce the risk of fractures and maintain healthy bones as people age.

What is osteoporosis, and who is at risk?

Osteoporosis is a condition where bones lose density and strength, becoming more porous and brittle. While it can affect both men and women, it is more common in postmenopausal women due to the drop in oestrogen levels, which plays a key role in maintaining bone density.

Other at-risk groups include:

• Older adults, typically over 65.
• People with a family history of osteoporosis.
• Individuals with low body weight.
• Those with certain medical conditions (e.g., rheumatoid arthritis).
• Long-term use of medications like corticosteroids.

How can I detect osteoporosis early?

Unfortunately, osteoporosis often goes undetected until a fracture occurs, but early detection is possible with bone density tests. The most commonly used diagnostic tool is a DEXA (Dual-Energy X-ray Absorptiometry) scan, which measures the density of bones in the hips and spine.

Regular screening is recommended for people in high-risk categories, especially postmenopausal women and individuals over 50 who have had a bone fracture. In the UK, the National Institute for Health and Care Excellence (NICE) guidelines support these assessments, making it easier to access DEXA scans via the NHS.

What can I do to prevent osteoporosis?

Prevention begins with a combination of lifestyle changes and nutritional interventions.

These include:

• Adequate calcium and Vitamin D intake: calcium is essential for strong bones, and vitamin D helps the body absorb it. You can get calcium through foods like dairy products, leafy greens, and fortified foods. Vitamin D can be synthesized through sun exposure, but in the UK, due to limited sunlight, supplements are often necessary.
• Regular exercise: weight-bearing exercises, such as walking, jogging, and resistance training, help maintain bone density. It’s important to incorporate these into your routine, as physical activity stimulates bone formation and slows down bone loss.
• Avoid smoking and limit alcohol: smoking is directly linked to reduced bone density, while excessive alcohol can interfere with the body’s ability to absorb calcium. Reducing or quitting smoking and limiting alcohol intake can significantly help maintain bone health.

What are the treatment options for osteoporosis?

If diagnosed, several treatment options can help manage osteoporosis and prevent fractures. In the UK, the NHS offers a range of treatments, including:

Medications

• Bisphosphonates: these are the most common class of drugs prescribed to slow down bone loss and are available through NHS.
• Hormone Replacement Therapy (HRT): for some postmenopausal women, HRT can be an effective option, as it replaces the oestrogen lost during menopause.
• Denosumab: this is a newer medication, given by injection every six months, that helps reduce bone breakdown.

Calcium and Vitamin D Supplements

If dietary intake is insufficient, supplements may be recommended, particularly in the UK where vitamin D deficiency is common due to limited sunlight exposure.

Can osteoporosis affect younger people?

While osteoporosis is more common in older adults, it can also affect younger individuals. Conditions like anorexia nervosa, excessive dieting, or over-exercising can lead to low bone density. Additionally, long-term use of certain medications, such as steroids, can contribute to early-onset osteoporosis. For younger people, it is vital to address any underlying risk factors early, maintain a balanced diet, and ensure they are engaging in weight-bearing activities.

What are the recent advances in osteoporosis management?

Recent developments in osteoporosis management focus on personalized treatment plans based on a person’s genetic risk factors and overall health. Research into bone-building medications, like romosozumab, offers promising options for those with severe osteoporosis. This new class of drugs not only slows bone loss but also helps to actively rebuild bone. While not yet widely available on the NHS, advancements in treatment may soon provide more targeted approaches to preventing fractures.

If you’d like to learn more about osteoporosis prevention and treatment, arrange a consultation with Dr Israa Al-Shakarchi via their Top Doctors profile.