Osteoporosis

Osteoporosis is a common bone abnormality. Bones are living tissue and act as storage for calcium and other minerals. At any time your body needs calcium, it simply extracts it from your bones by breaking them down. Simultaneously, new bone is built to replace the parts utilized. The constant process of dissolving and reforming bone persists throughout life and is termed as “bone remodelling”. Osteoporosis develops when this balance is disturbed; disintegration occurs faster than creation of fresh bone, resulting in decrease of bone mass. If you take a look at the inside of a healthy bone, it looks just like a sponge. In osteoporosis, more and more holes begin to appear and enlarge in this ‘sponge-like’ interior, as the removal of bone is greater than the build-up. Consequently, bones become fragile and susceptible to fracture.

There are two types of osteoporosis: primary and secondary. Primary osteoporosis reveals itself as we get older, particularly after menopause in females. The hormone oestrogen plays an important role in regulating bone turnover and healthy growth and maturation of bones. Lower oestrogen levels at the advanced stage of life highly increase bone resorption, bringing about general bone loss. For this reason women are four times more likely to be afflicted with osteoporosis than men in general. Other risk factors that you cannot control are having a small body frame or a parent/sibling with osteoporosis. These elevate chances of disease in both males and females. 

Secondary osteoporosis crops up due to the effect of an agent or other diseases. These may include the following:

• Vitamin D or calcium deficiency. Any underlying pathology meddling with the absorption or processing of this vitamin and mineral can be related. Examples include kidney disease and certain gastrointestinal diseases/surgery.

• A diet deficient in fruits and vegetables and excessive intake of caffeine or alcohol.

• Some bone marrow disorders, joint diseases and medications (steroids).

• Hormonal pathologies, for example high levels of thyroid promote bone loss. Parathyroid and adrenal gland hormones are also associated.

• Eating disorders such as anorexia increase risk of weaker bones by lowering the levels of female and male sex hormones.

• An inactive lifestyle and prolonged immobilization can have problematic effects.

• Cancer treatment medications.

In osteoporosis your bones become brittle and prone to fractures. Even mild stress such as coughing or bending, or falling from standing position can crack your bone. Common sites which fall prey to this are the hips and spine. Your risk is higher especially if your mother or father has experienced a hip fracture. Post-operative complications of hip fractures are quite serious and may cause significant disability or death. Bones in the spine simply crumple and make you appear shorter. At times the disease is present silently and you will not know you have osteoporosis until a fracture shows up.​

When to seek expert advise

The discreet nature of osteoporosis highlights the importance of regular health check-ups for early identification of various disorders and medical advice to avoid preventable disease. It is recommended that you register with the Family Health Service Line at The Aga Khan University Hospital to access long-term quality care.

It is a good idea to talk to your doctor about osteoporosis if you went through early menopause or are currently at menopause, have taken steroids over a period of several months or one your parents ever had a hip fracture. This will facilitate an early detection and your family physician will be able to diagnose and treat osteoporosis before it causes a broken bone. Even after a fracture, further problems can be dispelled by taking the right steps. If necessary, you may be referred to the Musculoskeletal and Sports Medicine Service Line at The Aga Khan University Hospital.​​

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