Treatment and prevention of osteoporosis explained

Written in association with: Dr Taher Mahmud
Published:
Edited by: Top Doctors®

What is osteoporosis and how common is it?

Osteoporosis is a progressive weakening of the bones and development of fractures. Some osteoporosis fractures may be silent, so anyone you know who may have lost height or have had intermittent back pain may well have osteoporosis. Osteoporosis affecting the hip is unfortunately very consequential - about 1100 patients die every month following a hip fracture in the UK - which translates to about 10% of osteoporosis patients. Another 10% don't survive the next 11 months, a quarter will go into an institution, and 80% who survive are not independent again. Yet we could have identified those patients who go on to have a hip fracture decades earlier and with simple interventions, could have prevented the progression to the fracture and all its consequences. Multidisciplinary approach to osteoporosis can result in improved bone health and reduction of future fractures.

How can osteoporosis be treated?

Osteoporosis fortunately can be treated in a number of different ways, including lifestyle changes - which are the foundation of all treatments - and pharmaceutical interventions. Regarding lifestyle, nutrition, particularly vitamin D and optimising calcium and other nutritional factors is important. Exercise has a critical role to play too, as muscle strength is very directly coupled with bone strength, and by improving muscle tone and muscle strength we are able to improve bone density and bone strength, and prevent fractures. There are a number of pharmaceutical agents which can be helpful - with these different interventions, we are able to reverse osteoporosis and reduce the risk of future fractures.

Is osteoporosis inevitable? Can it be prevented?

Osteoporosis can be prevented - our bones change throughout our life, reach their maximum level of strength around the age of 35, and then we might lose bone gradually over time. Precipitously, around the menopause about 5% of bone can be lost per year over a four of five year period. Interestingly, we also lose bone during any periods of inactivity and during pregnancy. 5% of bone is lost with each pregnancy.

There are a number of factors that increase bone strength or reduce bone strength throughout our life. Nutrition is a key factor in increasing strength, particulary the intake of vitamin D and calcium, but also exercise and muscle strength.

Things that affect bone loss are periods of inactivity, because as we lose muscle strength we lose bone. Other factors include drinking excess alcohol, which has a negative effect on the bone and smoking can reduce bone strength and produce bone loss, which increases likelihood of a future fracture. Certain medical conditions can also have a negative impact on bone health be that thyroid, diabetes, inflammatory bowel disease, inflammatory joint conditions or even treatments, such as steroids.

If you do have any of those conditions it is important that they are treated appropriately to reduce the negative consequences on your bone health.

Dr Taher Mahmud

By Dr Taher Mahmud
Rheumatology

Dr Taher Mahmud is a distinguished consultant rheumatologist based in central London and Tunbridge Wells. He is renowned for his expertise in osteoporosis, osteopenia, osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and inflammatory arthritis.

Dr Mahmud qualified in medicine from King's College London before undertaking training at various esteemed institutions including St Thomas', and Pembury Hospitals. He also completed an esteemed research fellowship at King’s College Hospital, also gaining an MD and a Master’s in biochemistry. He further honed his skills in rheumatology through specialist training at King's College, the Lupus Unit at St Thomas', and Guy's Hospital Rheumatology Units. Dr Mahmud has served as a consultant rheumatologist since 2000, and was awarded fellowship of the Royal College of Physicians in 2014. Boasting more than 30 years of experience, Dr Mahmud has held various prominent roles throughout his career, including as cofounder and clinical lead for osteoporosis at the London Osteoporosis Clinic, and has also received a Clinical Excellence Award in recognition of his excellence and dedication to his practice. He currently sees private patients at HCA UK, The Shard and 25 Harley Street.

Additional to his clinical practice, Dr Mahmud has held a number of esteemed positions in public associations throughout his career, with a particular focus on improving patient experience and outcomes, including as a member of the MTW Patient Experience Committee and as an organiser and chair of conferences on patient experience at the Royal Society of Medicine. In recognition of his commitment to drive improvement in this area, he was awarded an NHS Innovations award for patient feedback. He has also been actively involved in medical education throughout his career, having lectured and trained a wide range of medical students and fellow practitioners.

With a wealth of expertise and experience, Dr Mahmud continues to make significant contributions to the field of rheumatology. He has appeared in numerous peer-reviewed publications and has authored his own book on the subject of patient care and feedback. Dr Mahmud is passionate about raising awareness of the prevention of osteoporosis fractures and maintaining healthy bones. He has appeared on several podcasts as an expert speaker on bone health and osteoporosis and the menopause. Dr Mahmud is also a member of various professional organisations, including the American College of Rheumatology, British Medical Association, British Society of Rheumatology, General Medical Council and the Royal Society of Medicine.


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