Dr Sarah Jarvis
My Weekly’s favourite GP from TV and radio writes for you
One in two women and one in five men over 50 will break a bone because of osteoporosis. More than 300,000 Britons suffer fractures from minor bumps every year. At best, a broken bone is painful and debilitating. At worst, it can spell the loss of independence. But you can cut your risk.
“Osteo-” is anything to do with bones, and “-porosis” means porous. So osteoporosis is basically thinning bones.
Your bones are made up of a network of tough connective tissue, called collagen, and minerals – mostly calcium. They’re also being broken down and built up all the time. That’s why bones heal when you break them. When you’re growing, the building up happens faster, then the two balance each other. Once you’re over about 45, bony material starts being reabsorbed faster than it’s laid down. This means your bones become less dense and strong, making you prone to breaks from minor falls.
The older you are, the greater the risk. You could break a hip or a wrist by tripping over from standing height. Your spine bones can also collapse with minor trauma, causing severe ongoing pain. Women lose bone quicker, especially after menopause – 66% of osteoporosis fractures are in postmenopausal women. The hormone oestrogen offers some protection, so you’re at higher risk if you went through the menopause early (under 45) or are underweight due to conditions like the eating disorder anorexia, which lowers oestrogen.
TAKING HIGH DOSE STEROID TABLETS SIGNIFICANTLY INCREASES YOUR RISK OF OSTEOPOROSIS. ALWAYS TALK TO YOUR DOCTOR ABOUT BONE PROTECTION
Osteoporosis often runs in families, so a parent or sibling with osteoporosis (or a hip fracture) means your risk is higher too. Having the joint problems rheumatoid arthritis or ankylosing spondylitis, or bowel problems like Crohn’s disease (that can affect absorption of vital nutrients) can also make you more prone.
If you have a broken bone from a minor fall, or if your doctor thinks you’re at risk, they’ll refer you for a bone scan – similar to an X-ray, usually of your hip and spine. It tells your doctor if your bones are normal, a bit thin (osteopenia) or whether you have osteoporosis.
If you’ve broken a bone and have osteoporosis, or if you have other risk factors (including being older), your doctor may recommend regular tablets – usually one called alendronate, taken daily or weekly. These can delay the start or progression of osteoporosis. So can HRT, although this is usually only given around the menopause.
Fortunately, there’s lots you can do to protect your bones: u Keep your alcohol intake down (ideally under 2 units a day but definitely under 4) u Don’t smoke u Exercise regularly. Weight bearing exercise helps strengthen bones and the muscles that support them, so brisk walking, jogging, dancing and lifting small weights are ideal. Swimming and cycling are great for your heart but not your bones u Get enough calcium. Low fat dairy foods (milk, yogurt, cheese), tinned fish with bones, soya products like tofu, spinach, dried figs or apricots, pulses and fortified bread or cereals are all good sources u Get out in the sun for 15-20 minutes a day with face and arms uncovered, from April-October to top up your vitamin D levels u Take10 micrograms a day of vitamin D in winter, and all year if you’re over 65 or don’t get out much. Next Week: How to live until 100
IF YOU’VE FALLEN, YOUR GP CAN REFER YOU TO A FALLS SERVICE FOR ADVICE AND EXERCISES TO AVOID FURTHER FALLS AND POSSIBLE BROKEN BONES