Osteoporosis (OP) literally means porous bones i.e., bones filled with tiny holes. It is generally thought of as an old woman’s illness but sadly OP and its precursor, osteopaenia, are much very common. It is a silent disease with most people not realising they have it until they suffer a fracture or do a DEXA scan which measures bone density. 

The major problem is that the fragile bones lead to greater risk of fracture, which can have serious repercussions. The risk of a hip fracture in women is equal to the combined risk of breast, uterine and ovarian cancer. Men do not escape either with the risk of a hip fracture more likely in men over 50 than prostate cancer.

THE SCIENCE BIT: Bones are living tissues and are constantly remodelling

  • Resorption dissolves minerals and proteins in old/damaged bone – done by osteoclasts
  • Bone formation remineralise the bones – this is done by cells called osteoblasts

Bone mass reaches its peak by age 30 and from 40 onwards resorption exceeds formation, i.e., we are losing bone density

The delicate balance between formation and resorption is influenced by many factors including:

  • Intake of minerals especially Calcium (Ca) and Magnesium (Mg)
  • Hormones
    • Parathyroid hormone (PTH) – breaks down bone
    • Calcitonin hormone (produced by the thyroid) – builds bone
    • Oestrogen – slows down PTH and stimulates calcitonin to build bone
    • Testosterone – stimulates bone building
    • Stress hormones e.g., cortisol disrupt bone building
  • Vitamin D – needed for Ca absorption
  • Stomach acid – needed for mineral absorption; reduces with age

Risk factors

  • Gender – women more susceptible
  • Race – Caucasian
  • Genetics
  • Medications – some drugs can accelerate bone loss e.g., steroids, antacids, laxatives
  • Lifestyle – smoker, sedentary, excessive exercise
  • Diet – high caffeine, alcohol
  • Hormonal – irregular periods, lack of periods, early menopause, postmenopausal
  • Digestive issues – low stomach acid, Coeliac Disease, Irritable Bowel Disease
  • Eating disorder
  • Underweight

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