HEALTH Too close to the bone?

EARLY DIAGNOSIS?Knowing the signs of osteoporosis and getting tested are key for the early diagnosis and management of the condition.

Too close to the bone?


Ask the pharmacist
Karen Jordan

Bones are the scaffolding of our bodies. They protect our organs, enable movement, produce blood cells and even store minerals. Bone cells are constantly being built up and broken down. After the age of 30 – yes, 30! – we start to lose bone mass with women’s stores depreciating faster. Weakening bones can lead to osteoporosis; literally meaning ‘porous bone’.
Osteoporosis is more common in women especially after the menopause where oestrogen levels (which have a protective effect on bones) fall. One in three women and one in 12 men in Ireland over 50 are affected, which means there are around 300,000 people in Ireland living with osteoporosis.
Risk factors for osteoporosis include being female, over 45, smoking, a family history of osteoporosis, maternal hip fracture under the age of 75, a low BMI, taking certain medications, existing medical conditions such as rheumatoid arthritis, coeliac disease or diabetes, drinking more than three units of alcohol per day and calcium or vitamin D deficiency.
As bones become more fragile, sufferers are susceptible to falls and fractures. Stooping and poor posture can affect breathing as the lungs have less room to take in air. Daily activities can get harder to do and people may even feel a loss if independence.
Symptoms of osteoporosis can develop slowly over years with a fall or bone fracture often the first sign. Other indicators can be a loss of height of 2cm or more, stooping and development of a hump or pain in the back or hip. Getting your thyroid function checked is important as an imbalance can increase bone loss. Blood tests can be useful too to measure your levels of calcium and vitamin D.
A DEXA (Dual Energy X-ray Absorptiometry) scan, which measures bone density, is the most accurate way to diagnose osteoporosis. Patients will lie on a table for 10-15 minutes during which time an X-ray passes over the body to get a picture of the spine and hips, investigating the thickness and porosity of the bones. The result of this test is a T-score, which compares your bone density to that of healthy young adults. A T-score of -1 to -2.5 indicates osteopenia, low bone mass, whereas -2.5 or less is confirmation of osteoporosis.
Every 30 seconds, someone in the EU has a hip fracture due to osteoporosis. Don’t be a statistic! There are many positive lifestyle choices we can all take to minimise the risks.  Getting active through weight-bearing exercise such as brisk walking, dancing, or aerobics triggers the bones to make new cells. Chemicals in cigarettes can speed up loss of bone, so give up smoking. Your pharmacist can advise you on ways to kick the habit.
Calcium gives bones strength and rigidity. We should aim for three servings a day in the diet from milk, cheese or leafy vegetables. Calcium supplements are also available as chewable tablets or capsules.
Vitamin D3 is essential for healthy bones, as it enhances the absorption of Calcium and regulates the immune system. The so-called ‘sunshine vitamin’, it is made through the action of sunlight on the skin. Vitamin D3 supplements have been shown to reduce the risk of fracture and falls in senior citizens, so it’s worth getting your levels checked. Vitamin D supplements are available as tablets, capsules and may be combined with calcium or other minerals.
If diagnosed, your doctor will prescribe medications to manage the condition and these may include calcium and vitamin D supplements, or medications to increase bone density or protect the bone from further breakdown. Some of these are tablets or sachets that are taken daily, once weekly or once a month. Other treatments are in the form of daily or even twice yearly injections. Please speak to your pharmacist about the many treatments available.
Don’t take osteoporosis lying down. Knowing the risks and early diagnosis is key. You can’t turn back the clock but there are lots of ways to prevent osteoporosis. If you have more than one risk factor mentioned above, speak to your pharmacist or doctor about getting your vitamin D levels checked and a possible DEXA scan.

Karen Jordan is a pharmacist in Lally’s LloydsPharmacy, Mill Street, Westport.