Is Osteoporosis Preventable?

The word "osteoporosis" means "porous bone", and it occurs when bones become weak due to loss of minerals. Thus, the affected bones become more prone to break compared to the healthy bones.

Bones are made up of different minerals, and calcium is one of those main minerals. It strengthens the bones and makes them thick. BMD is bone mass density. When BMD is less this is an indication for porous and weak bones. People who have low bone density are at increased risk of osteoporosis.

The maximum density of bone is gained until an individual reaches 30 years old, so we should take measures to gain maximum density before that. Unfortunately, some risk factors for osteoporosis can’t be changed like being female, if you belong to an Asian and Caucasian group, small or thin bones, needing steroids for any medical condition or a family history.

How to prevent osteoporosis?

• Eating a lot of calcium containing food - High calcium source of food includes milk, yogurt, almonds, cheese, green veggies like broccoli and some fishes with bones like salmon.  At least 1000 mg of calcium should be consumed by men and pre-menopausal women daily. Post - menopausal women and men older than 70 years old require 1300 mg of calcium daily.
• Taking calcium supplements - Calcium supplements recommended by your doctor have both advantages and disadvantages. Calcium supplements are in two forms calcium carbonate and calcium citrate. Calcium carbonate needed to be taken after a meal as it requires gastric acid for absorption while calcium citrate is taken empty stomach. These supplements can cause constipation.
• Exposure to sunlight - Vitamin D is needed to absorb calcium. The synthesis of Vitamin D takes place in the skin when there is adequate exposure to sunlight. Peak UV rays between 10 a.m. to 2 p.m. should be avoided, as it can cause skin cancer.
• Exercise regularly - Bones like muscles get stronger when weight bearing exercises are done. The exercises which work against gravity are helpful. These include jumping, running, cycling, hiking, jogging and playing tennis.  When you will be doing exercise earlier it will make you bone mass bank larger and less prone to osteoporosis.
• Maintain healthy body weight - Low body weight is one of the risks of osteoporosis. Women who lose more weight to an extent that their periods stop causes estrogen to decrease. Thus, they don't have much circulating estrogen to maintain bone density. Other than pregnancy if your periods stop for more than 6 months, this is a risk for osteoporosis.
• Reduce the risk of fall - The old age and people having osteoporosis are at higher risk of fracture. Maximum care is necessary to avoid fractures.
• Alcohol and smoking cessation – Both these substances affect the absorption of calcium from a diet. Therefore, they should be stopped.

Medicines used to prevent osteoporosis

• HRT (Hormone Replacement Therapy)

HRT is considered effective in postmenopausal women. 

• Bisphosphonates:

They slow down the bone loss process and decreases the risk of fracture by improving the bone mass density.  

1. Alendronate
2. Risedronate
3. Etidronate
4. Zoledronic acid

They are also used in people who are on Corticosteroids for long and among women with post menopause. They can have gastric effects in some people so they should be taken empty stomach to minimize the effects.

Other medicines include Tibolone and Raloxifiene.