The Uppingham Surgery
www.uppinghamsurgery.nhs.uk 23rd May 2013

Osteoporosis

Osteoporosis literally means 'porous bones'

The bones in our skeleton are made of a thick outer shell and a strong inner mesh filled with collagen (protein), calcium and other minerals. The inside looks like honeycomb, with blood vessels and bone marrow in the spaces between bone. The bone looks like scaffolding.

Osteoporosis occurs when the holes between bone become bigger, or the scaffolding becomes less.

Causes
  Bone is alive and constantly changing no matter what age you are. Old, worn out bone is broken down by cells called osteoclasts and replaced by bone building cells, called osteoblasts. This process of renewal is called bone turnover.
In childhood the cells that make new bone work faster, enabling the skeleton to increase in density and strength. During this period of rapid bone growth it takes the skeleton just two years to completely renew itself; in adults this takes seven to ten years. Bones stop growing in length between the ages of 16-18 but continue to grow in strength into your mid-twenties. By this age your bones have reached their maximum potential strength (peak bone mass).
It is therefore very important to ensure that children and teenagers have a diet high in calcium and take plenty of exercise. The more you use your bones, the stronger they become. These two factors are very important throughout our life.
Up until the age of 35 a balance between bone breakdown and new bone formation means that bone density stays stable. After this age bone loss increases as part of the natural ageing process. This can lead to osteoporosis and an increased risk of fracture, particularly in women, due to accelerated bone loss at the menopause.

Who is at risk?
  We are all potentially at risk of osteoporosis because of the bone loss that occurs as we get older, particularly as we are living longer as a population. There are also many other factors which can increase your risk.

Women

A lack of oestrogen, caused by
  • Early menopause - before the age of 45
  • Early hysterectomy - again bore the age of 45 and especially if both ovaries removed
  • Missing periods for 6 months or more as a result of over-exercising or over-dieting.

Men

  • Low levels of the male hormone testosterone

Women and men

  • Long-term use of corticosteroid tablets (for conditions such as asthma)
  • Maternal history of a hip fracture or family history of osteoporosis
  • Malabsorption, inflammatory bowel disease (Crohn's disease or ulcerative colitis) and gastric surgery
  • Long-term immobility
  • Heavy drinking
  • Smoking
  • Low body weight
  • Some patients taking thyroid hormone replacement treatment

Prevention
 
  • Ensure that the children in your family have a diet high in calcium and take plenty of exercise. We need about 800-1200mg of calcium daily and more at the time of puberty.
  • Physical activity is very important for building and maintaining strong bones. Regular weight bearing exercises, walking and jogging is better for bones than non-weight bearing exercise like swimming.
  • Stop smoking - it is a high risk factor in osteoporosis. Bone density improves if you stop smoking.

Recommended web sites
 

National Osteoporosis Society

A national charity dedicated to improving the prevention, diagnosis, and treatment of osteoporosis

Osteoporosis

Information from the BBC about osteoporosis
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