www.womanthismonth.com 65 June 2013 | A part of the normal ageing process, osteoporosis is, simply put, a condition where the bones may become porous and waste away. In average human beings, the bone density gradually starts wearing off from the age 30 onwards, but for some, this bone loss is more rapid. Women are more likely to develop this condition since they have lighter frames and smaller bones to begin with. Breaking a bone due to osteoporosis is tougher to deal with compared to fractures in those who do not have the condition. Osteoporotic bones often heal more slowly and less completely than normal bones, probably because they contain fewer bone minerals and other materials essential for healing. Often, osteoporotic spinal fractures can have a devastating impact. They lead to chronic back pain, loss in height, deformity, immobility, increased number of bed ridden days, and even reduced pulmonary function. Their impact on women’s quality of life can be profound, resulting in a loss of self-esteem and development of a distorted body image and depression. Two experts in Bahrain give us the lowdown on this condition and provide tips on keeping it at bay. Preventing Osteoporosis Our expert: Dr Jamal Saleh, orthopaedic surgeon, founder Orthocare Centre “Certain individuals are at a higher risk of developing osteoporosis earlier than others. These include people who have medical conditions such as rheumatoid arthritis, lactose intolerance, cancers, multiple sclerosis, and diabetic bone disease or mal-absorption syndromes. Too much smoking, abuse of alcohol or the use of corticosteroids also puts the bones at a greater risk,” he observes. However, from his own experience Dr Jamal knows that osteoporosis should not be confused with low bone mineral density, a condition that can arise out of Vitamin D deficiency. “I was only 41 when I was diagnosed with osteoporosis. I’d been suffering from a malabsorption syndrome for years and had stopped consuming dairy products since then. I had been on corticosteroids, which put me in the high risk category. I started exercising and took regular doses of Vitamin D and calcium supplements in addition to the medication. Now, my bone mineral density levels are back to normal. I’m not sure whether it was osteoporosis or just Vitamin D imbalance, which resulted in weak bones,” says Dr Saleh. The most effective way to prevent osteoporosis in this high-risk group is to have optimal levels of Vitamin D levels, at around 75 ng/dl. “More than 80 per cent of people in Bahrain are deficient in Vitamin D and without this essential nutrient, the intake of calcium is useless,” says Dr Jamal. “A campaign is now underway in Bahrain to have food such as wheat flour fortified with this vitamin to serve the interests of the larger population.” Managing Osteoporosis Our expert: Dr Sumod Sukumaran, orthopaedic surgeon, KIMS Medical Centre Family studies show that there’s a motherdaughter link in the development of osteoporosis, so if your family members have a strong history of a thin body frame, hormonal imbalance, unexplained fractures and trauma, chances are you have inherited this condition. Women with such a family history should opt for early screening, including bone density tests from the age of 40 to get an early diagnosis. Once they’ve started undergoing treatment, annual checkups and screenings are recommended to keep track of their progress. Know your medication According to Dr Sukumaran, osteoporosis is a highly treatable condition, which can be reversed substantially through medication and changes in lifestyle. Osteoporosis medications are primarily of two types, medicines that slow bone loss and drugs that increase the rate of bone formation. It’s the hormones that primarily assist in bone building, as they transport minerals and nutrients to the bones. Parathyroid hormones which increase the rate of bone formation form a distinct category of anabolic drugs, and are currently the only osteoporosis medicine approved by the FDA that rebuilds bone. Treatment to boost parathyroid hormones aims at not only building bone but also lowering the risk of bone breakage. Doctors will sometime prescribe bisphosphonates, which act directly on the bone structure to reduce the rate of bone loss. It is mostly prescribed for post-menopausal women with low bone density or to prevent osteoporosis that is induced by corticosteroids. Hormone replacement therapy is another treatment option for post menopausal women, depending on whether they’ve had their uterus removed; in which case, only estrogen is prescribed. However, there are side effects to the treatment and patients need to consult their physician before embarking on any longterm medication. Bone-building exercises Women who are active and especially those
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