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Dr Duncan

Osteoporosis

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We all love to give our Grans a big hug because, well, they’re often so small and cuddly. And yet, when you get the opportunity of going through those old biscuit tins containing photos of your grandparents when they were tall and you were small, you may find yourself asking the question, “How come Gran’s shrunk?”  But if you take time to compare the photos of then and now, you’ll notice that she has not only lost some centimeters in height, but she’s also developed a stoop as if she’s constantly scouring the floor looking for something she’s dropped. Well the reason behind this loss of height and alteration in her once proud posture could well be the often very painful condition called osteoporosis.

Osteoporosis is a silent disease of the bones that makes them weaker, softer and much more likely to break or collapse. And it’s not just the physical pain and limitation to life’s normal activity where osteoporosis impacts, it’s also a pain in the national wallet too. Economists predict that this bone threatening condition will cost Australia $25.3 billion a year by 2025. And that means $25.3 billion that can’t be spent elsewhere!

So what is osteoporosis: who’s at risk and what can each one of us do to reduce the risk of developing the condition?

Our bodies are built on scaffolding made of bone. Bone is a living, changing part of our bodies and adapts to the stresses put on it by strengthening the bits we use and “putting into mothballs” the bits we stop using. This constant remodeling is under two different sorts of bone cells - one that lays down new bone and the others that thin out the bits that are not under current stress. Obviously it needs to stay in balance in order that it doesn’t get too dense or too thin, and this control is regulated by certain hormones. 
Bone density reaches its maximum in early teenage years, and the denser your bones are in those years, the more likely they are to withstand the gradual thinning process that accompanies advancing age. And the best way to make sure teenagers get strong bones is to ensure that they have enough calcium in their diet from birth onwards, and that they are physically active during those growth years so that their growing bones demand more calcium to support their strengthening muscles. From then on it’s a matter eating food that contains enough calcium for your particular needs, normally around 1000 to 1300 mgms calcium per day, and being physically active.

  • But certain groups of people are at greater risk of developing osteoporosis: Older people.
  • Post menopausal women who are Caucasian or of Asian origin.
  • Those with a strong family history of osteoporosis.
  • People who smoke, or who drink more than 2 standard drinks of alcohol per day.
  • People who take certain medications such as steroids.
  • Those with a sedentary lifestyle.
  • People with thyroid disease.
Osteoporosis really becomes a problem when the bones become critically thin and then start to fracture. Most of us think of breaking a bone when we fall off a bike or a skate board, but just imagine that you could break some ribs just by sneezing; or just the sheer weight of your upper body was enough to crush the vertebra in your spine? And it’s that second group of fractures, spinal compression fractures, that contribute to your Gran shrinking! She can literally loose several centimeters in height due to compression fractures of some of her vertebrae. These are often described by experts as silent fractures as they are only picked up on Xrays. From my experience, these fractures are far from silent and can be excruciatingly painful, it’s just that Grans are a pretty tough bunch and don’t like to complain! And as well as spinal fractures, simple falls that become increasingly common the more you age can lead to hip and wrist fractures that take weeks to months to recover from.

So the more we can do to prevent fractures the better for everyone concerned. And the keys are physical activity and adequate calcium intake in those critical early years, followed by a lifetime of regular and enjoyable activities to challenge all the bones in your body, and finally maintaining a healthy, calcium rich diet. Also:

  • Don’t smoke.
  • Use alcohol sparingly as it’s a very sneaky chemical.
  • Avoid wearing raised heels as you mature. Pride comes before.....!
  • Check the home on a regular basis for potential pitfalls.
And whilst there are some effective medications currently available, with more promising ones predicted in the near future, all medications do have the potential for side-effects, so if you don’t need them now, why put yourself in a position to depend on them later? And if you’re concerned that you might be at risk of having, or developing osteoporosis, then your GP can refer you for a simple safe test to assess your risk profile and then give you appropriate advice - it’s called a Bone Densiometry Test.

One of my Grans was 4 foot 10 inches in the old language when she died: she had bandy legs from rickets and a terribly deformed spine probably from osteoporosis - but she had a wicked smile and baked some cracking tarts and we loved her. So cherish your Grans, and if you think she’s shrinking, gently suggest she gets a Bone Densiometry Test for osteoporosis. You might just save her a bucket load of pain.


Article written by Dr. Duncan Jefferson. For more articles by Dr. Duncan, click here. For more information on healthcare and private health cover, visit HBF Insurance at hbf.com.au.

The content of these articles is not tailored for any particular individual's circumstances. The author does not take into account your physical condition, medical history or any medication you may be taking. Any advice or information provided by the author cannot replace the advice of your health care professional. The views expressed in this article are those of the author and do not represent those of HBF unless clearly indicated.

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