Osteoporosis for dummies

Learn about ‘the silent disease’ with this simple guide to osteoporosis. What is it, how can you prevent it and what are the treatment options?

What is osteoporosis?
The word ‘osteoporosis’ literally means bones with holes. Osteoporosis is a medical condition in which the bones become less dense and can break more easily. Your bones are not stagnant – like all the other cells in your body, the calcium in your bones is constantly being broken down and renewed. When children are growing, calcium is being produced faster than it is being broken down, which causes bone growth. Those at risk of osteoporosis are experiencing the opposite – the calcium is being removed more quickly than it can be replaced. This can happen for a number of reasons. If you don’t have enough calcium in your diet then the body will take it from your bones to supplement your body’s needs. If you are low on vitamin D then your body will be unable to absorb the calcium you are eating. Testosterone and oestrogen are both important hormones in the production of calcium. When women go through menopause their oestrogen levels drop, which leads to a drop in calcium production.

What is osteopenia?
Osteopenia is the condition between healthy bone density and osteoporosis. If you have osteopenia it means that your bone density is low, and that you are at risk of developing osteoporosis. This is usually the stage at which your doctor will recommend some lifestyle and diet changes to try to slow or reverse your rate of bone loss.

What are the symptoms of osteoporosis?
Until you have a fracture, there are no symptoms of osteoporosis. This is why it is sometimes known as the ‘silent disease’. Many Australians are not diagnosed with osteoporosis until after they have a fall and sustain a fractured bone.

How can I get tested for osteoporosis and osteopenia?
The most common way to test for osteoporosis and osteopenia is through a bone density test. The test is a simple, painless scan which measures the density of your bones, usually in your spine and hip. The test is called a dual-energy absorptiometry scan, or a DXA scan.

Can I get a Medicare rebate for my bone density test?
Some people are eligible for Medicare rebates for the DXA scan. These people include:

  • those who have previously been diagnosed with osteoporosis
  • those who have had a fracture due to osteoporosis
  • those over 70 years of age
  • those who suffer from a chronic illness which can increase the risk of osteoporosis, such as rheumatoid arthritis, coeliac disease and liver disease
  • those who have used corticosteroids for an extended period.

Click NEXT to find out how you can prevent osteoporosis. 

How can I prevent osteoporosis?
There are many ways to help avoid osteoporosis. You should ensure that you consume the required level of dietary calcium every day. For adults this is 1000 mg, or 1300 mg for men over 70 and postmenopausal women. It is also important to keep your vitamin D levels up. You can get your vitamin D levels checked with a blood test when you next visit your GP.

Weight bearing exercise is another important part of preventing osteoporosis. Weight bearing exercise helps to promote bone density and improve balance, which can help you to avoid falls and fractures. Weight bearing exercises can include fast walking, jogging, jumping rope, tennis, netball or dance. It is also important to do strengthening exercises, such as resistance training and weightlifting. If you haven’t done much exercise before, or you have other injuries or conditions which prevent your from exercising, you can get a special program made up by a sports physiotherapist or physiologist which will help to minimise your risk of injury. It is also important to talk to your GP before you take up a new physical activity to minimise your risk.

I have been diagnosed with osteoporosis. What now?
No matter when you are diagnosed with osteoporosis, it is never too late to start treatment. The biggest risk factor for osteoporosis is age, so the sooner you start the better. If you have already been diagnosed with osteoporosis it is important to talk to your GP about the best way to increase your exercise while minimising your risk of falls and other injuries. You may also be able to make dietary changes which will help to minimise your bone loss.

There are also medications which can help to slow and reverse bone loss. These include, but are not limited to:

  • Bisphosphonates help to slow the ‘breakdown’ process. These medications are commonly used in Australia to treat osteoporosis in both men and women.
  • Selective oestrogen receptor modulators (SERMs) – sites in the female body called ‘oestrogen receptors’ respond to the hormone oestrogen. SERMs mimic the action of oestrogen and therefore reduce bone loss. SERMs have been shown to reduce the risk of spinal fractures.
  • Strontium ranelate – similar to bisphosphonates, strontium ranelate slows down the ‘breakdown’ process of bones but also increases the ‘build-up’ process.
  • Denosumab – this is a twice yearly injection given under the skin. Denosumab slows the breakdown of bone.
  • Testosterone therapy – men with symptoms of testosterone deficiency and low testosterone levels can improve their bone density with testosterone replacement. Doses of testosterone are given by injections, implants, skin patches, oral capsules, gels or creams to bring the blood levels back up to normal.

There are also more extreme treatments for those with severe osteoporosis, or for whom other treatments are not possible.

For more extensive information, you can read the Osteoporosis Information Sheet at the Better Health Channel website, or visit the Osteoporosis Australia website

Have you had any experience with osteoporosis? What advice would you give to our other members about this silent disease?