Osteoporosis is usually diagnosed in hospital, often after a fall or if you fracture a bone. Your doctor will measure your bone density using a dual-energy X-ray absorptiometry (DEXA) scanner. Osteoporosis is diagnosed when bone density is found to be significantly lower than average. Scans are painless and take approximately 10 to 20 minutes.
Treatment of osteoporosis
If you have causes of osteoporosis you need to be careful of vigorous, high-impact exercise. However, leading an active lifestyle will improve balance, coordination and develop muscle strength. All these can reduce the risk of falling and fracturing a bone. Beneficial exercise includes swimming, gardening, walking, golf and Tai Chi.
Eating a diet rich in calcium is important for maintaining healthy bones. Good sources of calcium include milk and dairy products, such as hard cheese and yogurt, dried apricots or figs and some green leafy vegetables such as watercress and curly kale.
Postmenopausal women with causes of osteoporosis should aim to take 1,000mg of calcium every day, either in their diet or as a supplement. This can be obtained from 600ml of milk with either 50g of hard cheese (eg Cheddar or Edam), one pot of yogurt, or 50g of sardines.
Your body also needs vitamin D to absorb calcium properly. Vitamin D is found in certain foods, including cod liver oil, oily fish such as sardines and herrings, margarine and egg yolks. It's also made by your skin when you're in the sunlight. The National Osteoporosis Society recommends about 20 minutes of sun exposure to the face and arms, every day during the summer, to provide you with enough vitamin D for the year. However, to reduce your risk of getting skin cancer, you should cover your skin between 11am and 3pm, and don't allow your skin to burn.
You should try not to drink fizzy drinks or have too much caffeine, salt or animal protein, as these can affect the balance of calcium in your body. Eating plenty of fruit and vegetables can help to cancel out the effects of too much protein in your diet.
Medicines
Your doctor may prescribe the following medicines to help prevent fractures and increase your bone density.
- Bisphosphonates work by slowing down bone loss. Examples include alendronate (eg Fosamax), etidronate (eg Didronel), risedronate (eg Actonel), ibandronate (eg Bonviva), and zoledronate (eg Aclasta).
- Strontium ranelate (eg Protelos) is a medicine that stimulates new bone to grow and reduces bone loss. You may be prescribed this if you can't take bisphosphonates.
- Calcitonin (eg Miacalcic) is a hormone made by the thyroid gland (a gland in the neck) that blocks the action of the cells that break down bone.
- Parathyroid hormone peptides (parathyroid hormone (Preotact) and teriparatide (Forsteo)). Teriparatide is very similar to parathyroid hormone - this hormone helps to regulate calcium levels and the activity of cells involved in bone formation.
- The selective oestrogen receptor modulator (SERM) (raloxifene eg Evista) is a synthetic hormone that works by copying the effects of oestrogen on the bones.
Hormone replacement therapy (HRT) is a prescription-only treatment that relieves symptoms of the menopause by restoring hormones to a premenopausal level. HRT has also been shown to reduce causes of osteoporosis, but you probably won't be prescribed it to treat or prevent the condition. Deciding whether to take HRT is your choice and your GP will discuss the risks and benefits with you.
By Bupa's
