With a disease like osteoporosis, prevention is definitely a far wiser option than cure. Because awareness of osteoporosis is so limited, not many people even know that such a health condition exists. So they do not know that steps need to be taken to prevent it until it is too late. Then all that is left is to tackle the disease head on and do everything possible from that point on to fight osteoporosis.
The first step to fight osteoporosis is to get a correct diagnosis. This can be a little difficult since the symptoms of the disease are so generic. It is common for the symptoms of osteoporosis to be dismissed as nothing more than the aches and pains of stress and age. Yes, you need your doctor to diagnose you, but if you can recognize the symptoms yourself and check to see if you have any risk factors, then you can broach the idea to your doctor and encourage an early diagnosis. In more than 50% of osteoporosis cases, the patients are not diagnosed at all. This makes it all the more important for you to educate yourself. Read our article on Osteoporosis in Women to learn more about the symptoms of this disease as well as a comprehensive list of risk factors.
When to See a Doctor
After cardiovascular disease, osteoporosis is the most prevalent health care problem in the world. So if you think you have osteoporosis or know from reading about osteoporosis that you are at high risk, then you should see your doctor. Do not think that you will only get this disease if you are old. Men and women as young as 25 have experienced loss of bone mass and their osteoporosis got worse simply because they were not diagnosed early on. If you are lucky and have not yet developed the disease, then you have it in your power to prevent it. See your doctor if you have any pain in your bones, have had a fracture after a seemingly small fall or find that your spine is curving into a hunch. If osteoporosis runs in your family, you should inform your doctor and get an annual bone screening to determine if any bone loss is occurring.
Preventing Osteoporosis
Let’s take a look at the various ways in which you can fight osteoporosis by preventing it from ever developing. Doing just one or two of the following will not make a difference. You can only fight osteoporosis effectively if you adhere to all of them.
Nutrition to Fight Osteoporosis
Fill your fridge with a variety of fruits and vegetables, green leafy vegetables in particular. Reduce your junk food intake and eat more whole grains, fresh foods, dairy and lean meats.
The main nutrition you need to improve bone health is calcium, about 800 mg a day. It can be difficult to get this from just the food you eat so ask your doctor about taking calcium supplements. The next most important thing you need is vitamin D. Spend more time in the sun to get your daily dose. Also talk to your doctor about supplements.
Maintain An Active Lifestyle
Nutrition and exercise go hand in hand. Both are just as important in improving overall health. Exercise though is the main thing you can do to strengthen your bones. It is never too late to begin. The types of exercise that are best suited to fight osteoporosis include strength training, walking, running, aerobics, skipping and swimming. Exercise every day if possible, even if it is just for a short while. Your stamina will increase with time and you will be able to do more as the weeks go by. By maintaining an active lifestyle, you improve other aspects of your health and you build your immunity. Remember that your body is a holistic organism and the infinite functions within it are all inter-related. By ensuring smooth running of these systems through exercise, you can prevent major diseases as well as help your body fight these diseases if they do afflict you.
Quit Smoking
No lifestyle is truly healthy if smoking is a part of it. Smoking damages bones and other organs in your body to unimaginable extents. The longer you smoke, the more irreparable the damage gets. If your goal is to fight osteoporosis in the long run, then you should quit smoking as soon as possible.
Reduce Alcohol and Caffeine Intake
Alcohol should be reduced to one unit a day. If you can reduce it more, all the better for you.
Caffeine is just as bad as alcohol when it comes to fighting osteoporosis. Having large quantities of caffeine on a daily basis renders your body incapable of absorbing the calcium it needs. So you should reduce your caffeine intake too.
When you think of caffeine, you probably think only of coffee, but there are several other beverages that also contain high levels of caffeine such as tea, chocolate, soft drinks and even the energy drinks that are advertised as ‘healthy’. Limit your intake of coffee to two to three cups a day. Avoid sodas and energy drinks altogether or have them as little as possible. As for chocolate, one or two pieces a week is more than enough.
These recommendations may seem like a tough act to follow, but consider the alternative if you don’t. Your bones can get so brittle that a simple cough can break your ribs, your spinal cord can start to compress because your vertebrae is not strong enough to provide sufficient support, you may die or be permanently injured from an operation to fix a hip fracture. Sounds awful. It is. If you still have not developed osteoporosis, count your blessings and start incorporating these preventive measures now.
But we’re not all that lucky. Maybe you didn’t know about osteoporosis soon enough. Maybe you have been unknowingly increasing your risk for the disease your whole life and have now developed weak bones. It is harder to fight osteoporosis at this point, but there is still some hope.
Diagnosing Osteoporosis
Osteoporosis is a sneaky medical condition. You don’t know you have it until the symptoms get really bad. If you are at high risk for osteoporosis or if you remotely suspect that you may be afflicted by it, tell your doctor. You will have to undergo some tests to confirm the diagnosis. Timely and accurate diagnosis is the first step to fight osteoporosis. Before the screening, your doctor will first ask you a few questions like the following:
- Have you recently had a very bad fall or accident and suffered a fracture?
- Do you feel more imbalanced of late? Are you clumsier than usual and do you find yourself tripping a lot?
- Are you on any medication that is known to be a a risk factor for osteoporosis such as anti-seizure medications or steroids?
- Do you exercise regularly or at least maintain some level of physical activity?
- Was there a time when you were maybe confined to your bed or not allowed to exercise or move around much because of an illness or injury?
- Did anyone in your family ever suffer from osteoporosis?
- Do you smoke? How much?
- Do you drink? How often?
- When did you start menstruating? Were your periods regular? When did your periods stop (in case patient has reached menopause)?
- Do you get enough vitamin D and calcium in your diet?
- Do you find that you are having difficulty performing certain movements which were not difficult at all before? Examples include bending over to pick something off the ground and rising from a chair.
- Have you been experiencing any pain in your joints, hip or back?
Your answers to these questions will help your doctor get an idea of whether or not you fit the bill for osteoporosis and it will serve as a guideline for the changes you need to make in your life to prevent or fight osteoporosis.
Screening Your Bones
The first test to diagnose osteoporosis is a bone screening. A DEXA (dual-energy x-ray absorptiometry) machine is used to check the density of minerals in your bones. The screening is totally painless. All you have to do is lie down while the technician holds a wand-like device over you. The device can read your bone mineral density from the outside. This test emits a small amount of radiation so it will not be an option for you if you are pregnant.
The results of this test are expressed in what is known as a T-score. This score will tell you whether your bone mineral density (BMD) is within normal range. Here are the numbers which will indicate whether your BMD is normal or low.
- From +1 up to -1 indicates that your BMD is within normal range.
- From -1 up to -2.5 indicates that your BMD is low enough to suggest that your bone mass is starting to deteriorate, a condition called osteopenia, a pre-cursor to osteoporosis.
- From -2.5 to anything less is a sure sign that you have osteoporosis.
If you know you are at high risk for osteoporosis, you can take this BMD screening test regularly to monitor density levels.
X-Ray
A conventional x-ray may also be recommended to check for minor fractures. Sometimes, hairline fractures can occur which you can be completely unaware of. If steps are not taken to help the fracture heal, the crack will get wider and wider and develop into a full-fledged fracture.
Your T-score, x-ray and the observations made from the questions and answers will help you doctor diagnose whether or not you have osteoporosis and the extent of the damage to your bones.
Treatment for Osteoporosis
Once you learn you have osteoporosis and have come to terms with it, you have to decide on a treatment option with your doctor. There are so many medications used to treat osteoporosis that it can be very overwhelming.
Bisphosphonates
These are used not just to treat osteoporosis but to prevent it as well. No osteoporosis treatment is complete without bisphosphonates. In fact, they are the first line of defense to fight osteoporosis. Bisphosphonates prevent the loss of bone density by slowing down or completely halting the breaking down process that is a natural part of the orthopedic system. They have been shown to thicken bones. Following are some of the types of bisphosphonates that your doctor may prescribe.
- Ibandronate sodium: This one has been shown to reduce the patient’s risk of spinal fractures.
- Zoledronic acid: This is responsible for increasing bone mass as well as reducing the risk of fractures overall.
- Alendronate sodium: Increases density of bones and also lowers risk of fractures. Alendronate sodium is one of the bisphosphonates that is also designed for men. The others are usually prescribed to post-menopausal women.
- Risedronate sodium: This has the same benefits as alendronate sodium and is also designed for both men and women.
How to Administer Bisphosphonates
Bisphosphonates are pretty strong drugs so they need to be taken in the prescribed manner so as to make it less uncomfortable for your body to assimilate. If taking bisphosphonates in pill form, it can cause irritation to the esophagus. Follow the steps below to reduce this.
- Take your pill first thing in the morning on an empty stomach.
- Drink a full glass of water to wash down the pills properly.
- Remain in an upright position either sitting or standing for at least half an hour after taking the pills.
- If you are on any other type of medication, wait half an hour after your bisphosphonates to take them.
- Do not eat for at least half an hour after taking bisphosphonates.
- If you forget to take your bisphosphonates first thing in the morning, do not try to make up for it by taking it at a later time in the day.
Side Effects of Bisphosphonates
- Heartburn is common among patients who take bisphosphonate pills.
- Stomach pain is another common side effect of bisphosphonates if they are not taken properly.
- Other types of stomach issues such as diarrhea, constipation and gas are also likely.
- Sometimes, muscle cramps can occur.
- If not administered in the manner prescribed above, bisphosphonates can also lead to trouble swallowing.
- If you are taking bisphosphonates via injection, some of the side effects include dizziness, fatigue and blood in the urine.
- There is research to support the claim that bisphosphonates increases your risk of developing thigh fractures,
- It is also thought that bisphosphonates may put you at high risk of developing osteonecrosis of the jaw. This is a condition that causes pain in the jaw followed by loss of bone tissue in that area.
Who Should Not Take Bisphosphonates
There is no such thing as a drug without side effects. The reason you may not experience side effects with certain drugs is because your body has found a way to deal with them without causing you discomfort. So just because you do not feel side effects does not mean you are not having them. It thus becomes important to assess whether the known side effects of a particular drug can harm a patient with prior medical conditions.
- If you suffer from kidney problems, then bisphosphonates are not the drugs for you as it will just aggravate your condition.
- Similarly, those who suffer from digestive issues or heartburn should also steer clear of bisphosphonates.
- Bisphosphonates should be avoided during pregnancy.
Hormone Therapy
This is usually an option open to post-menopausal women since it is their depleting levels of hormones which causes their osteoporosis. By replacing the lost hormones in the body, the osteoporosis can be brought under control plus the bones are encouraged to get thicker and stronger.
There are two hormones involved in hormone replacement therapy – estrogen and progestin. A combination of both hormones can be administered or of estrogen alone.
However, since estrogen alone is a risk factor for uterine cancer, it is only prescribed for women who have had their uterus removed. Otherwise, a combination of estrogen and progestin is prescribed.
Men get injections of testosterone, the male equivalent of estrogen. Testosterone can also be introduced to the body via skin patches and gels.
Hormone replacement therapy is usually the last resort to fight osteoporosis. It is only recommended if all other options have been exhausted as the long-term effects of this form of medication are not very well studied. If you do have to get hormone therapy, then ensure that it is only a short-term solution while you explore other options.
Other Medications to Fight Osteoporosis
- Calcitonin: Your thyroid gland produces a hormone which helps your body to integrate calcium and which is instrumental in building bones. In medicine form, it is usually administered by a nasal spray or an injection and helps to reduce the rate at which your bones are thinning.
- Denosumab: An injection for women, administered once in six months to post-menopausal women who are at high risk for the disease. It slows down the thinning of bones and allows them to grow stronger.
- Raloxifene: This increases bone thickness and slows down bone thinning. It is only prescribed for women.
- Parathyroid hormone: This is normally injected on a daily basis and is used to fight very severe forms of osteoporosis in both men and women. Parathyroid hormone is only advised when other medications prove ineffective as it is very expensive and the long-term effects are not yet known.
Home & Lifestyle Changes to Fight Osteoporosis
- Wear low heels if you have osteoporosis. This will lower your risk of tripping or slipping and thus reduce your risk of fractures. If you are at high risk for osteoporosis, avoid wearing very high heels as they have a negative impact on the bones and are suspected of making them weaker.
- You have to protect yourself against accidents and falls. There may be places around your house that are just waiting for an accident to happen. Remember that your balance is also affected when you have osteoporosis so you may not be able to prevent a fall in the same way as someone without osteoporosis would. Install hand rails around the house in places where you think you might trip like the shower or any steps.
- Make sure that your slippers, footwear have a good grip so that they help you to keep your balance.
Coping & Getting Support for Osteoporosis
Osteoporosis is a painful, uncomfortable condition which can take a little getting used to. You will have several challenges to face and the mental stress of it can get you down and prevent you from giving your best to fighting the disease. You can alleviate this stress by talking about osteoporosis.
Discuss your situation with family and close friends. By involving them in the process of healing and talking to them about your fight with osteoporosis you enable them to understand what you are feeling which can make like easier for you.
However, it will help you even more if you talk to someone who actually knows what you are going through. Talking to other sufferers of osteoporosis can help you feel less alone. It can also help you discover new ways in which to fight osteoporosis.
There are several ways in which you can find like-minded people to talk to. The simplest is to search online for an osteoporosis support group. Your interactions with the patients will be restricted to the internet, but you will get to talk to way more people than a physical support group. This means that you have access to more ideas of how to fight osteoporosis.
Prefer something more personal? Talk to your doctor about starting a support group with other osteoporosis patients. Your doctor will know of other patients who are suffering from the disease and he/she can help you form a group that meets as often as needed.
If this is not an option, you can simply start a support group yourself by putting up fliers at clinics, medical stores, the supermarket, your work place, old age homes and any other place you can legally put them up. You’d be surprised at the response you get. Osteoporosis is more prevalent than you think and there are lots of confused, depressed patients who need to talk about their condition with other people who will understand.
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