Check your risk of Osteoporosis:
How can we know that the organs in our body are functioning well if we don’t check them regularly? This is particularly true in the case of our bones and joints. If we never have a check-up, there is no way of knowing how porous our bones have become, how much risk there is of fragility, or whether our bones can break easily. Furthermore, if we don’t know the cause of something, we cannot know how to prevent it.
Understanding Bone Composition:
There are many types of bones in our body. Long bones, such as those of the arms and legs; square segment bones, such as those in the spine, wrist, and ankle; bones with a dense composition, called compact bones (cortical bone); and bones with the characteristics of a hive (cancellous bone). Women are three times more likely to break their bones than men, as women’s bones are thinner and more porous.
Our bones consist of:
- Periosteum – a dense membrane, mainly found in long bones. Children have more periosteum than adults. It serves to assist in the growth of bones and their repair when broken.
- Bone marrow – helps to produce blood cells. The cell composition that allows broken bones to reattach themselves.
- Joints – the free components of our body that allow us to move.
- Ligaments – the complex organs, especially the knee joints, that provide stability.
- Muscles – a particular type of tissue that connects two parts of a bone, such as the muscle of the knee to the pelvis at one end and the knee joint at the other, allowing us to bend and stretch.
- Nerves – that receive signals from the brain and send them to other parts of the body through the spinal cord and nervous system, allowing us to move our arms, legs, and body. They also cause sensations in our skin.
- Blood vessels – bring blood to feed our muscles and other body parts, like our bones and joints.
- Hormones – the secretions from the endocrine glands which allow humans to have a normal life, such as natural body growth, sexual functioning, and the control of calcium in the bones.
The substances which make up bones are calcium, magnesium, iron, and other substances, such as electrolytes, sodium, and potassium. For calcium to be acquired by the bones, it must first be present in the blood vessels. This can be achieved directly by eating foods containing calcium, thus allowing direct absorption into the bloodstream.
Bone origin and density:
While we are still in the womb, our bones begin as cartilage and then continue to acquire more and more calcium from birth up until adolescence at the age of 16-17. After the age of 25, the amount of calcium received by the bones will reduce.
Risk factors to thin or porous bones:
- Hormones: This is particularly the case for female hormones. The reduced production of estrogen during menopause, especially in early menopause, can cause bones to become thin or porous and can result in a hunched posture.
- Genetics and gender: Petite and thin women are at risk, as are all those who are underweight.
- Ethnicity: Osteoporosis is uncommon in people of African descent.
- Age: The body will reach peak bone mass by the age of 25, after which, bone density remains stable until the age of 40.
- Food: Eating a diet low in calcium or with a high-fat content is also a risk factor.
- Daily life: Exposing yourself to the sun for extended periods of time between 10:00 – 14:00, when the sun is at its strongest, can lead to skin cancer. Exposure is recommended only before midday or after 15:00.
- Alcohol and smoking: These habits slow down the absorption of calcium.
- Medications: Some, such as steroids taken for long periods, can cause bones to thin, become porous, and lead to muscular atrophy.
This results from a decrease in bone density together with structural deterioration of the bone. In addition to reducing bone strength, osteoporosis can cause bones to become more fragile and susceptible to breaking easily. If spinal fractures occur, the nerves can become compressed, leading to paralysis, and an increased chance of hip fractures.
However, consuming large quantities of calcium may not always result in better calcium absorption into the bones due to a hormone deficiency. Vitamin D, on the other hand, helps stimulate calcium absorption and is, therefore, also an important dietary consideration.
How do I know if I have Osteoporosis?
We can assess the density of bones by performing a medical examination. In general, tests are carried out in three places where easy-breaks tend to occur; these are the lumbar spine, hip, and forearm or wrist. A score lower than -2.5 is a diagnosis of osteoporosis. In most cases, measurements are taken from the hip and spine, as these figures give a more accurate indication, especially for those who are at menopause age and who are entering osteopenia.
Bone density check? Complete the form below to make an appointment.
20% of Thai women between the age of 40 to 80 years suffer from osteoporosis. Symptoms might not show in the early stage, but osteoporosis can be diagnosed with a bone density test. Bone mineral density scores are calculated as a T-score (T) which is used to diagnose the density of the bones. The results of these tests can be interpreted as follows:
- T-score greater than –1 is considered normal bone density
- T-score between –1 and –5 indicates Osteopenia
- T-score lower than –5 indicates Osteoporosis
- In cases where no bones are broken, calcium samples may be taken, and the body examined. Treatment is then based on the identified symptoms.
- In cases where bones have not moved significantly, and surgery is not required, a brace can be used on the patient. This brace may be worn for 2 – 3 months, or even longer when necessary, until the bone has re-joined.
- For bones that have broken and moved significantly, such as in hip fractures, a surgeon would recommend surgery to ensure that the bones heal faster. A brace is not needed for extended periods, but either permanent or temporary metal pins may be required.
You can protect against Osteoporosis:
- Take regular exercise 3 times a week (at least 20-30 minutes each time) to help keep a stronger and denser bone mass.
- Adjust your day-to-day life; get some sunshine (but avoid 12:00 to 15:00).
- Avoid alcohol, smoking, and tannin in tobacco.
- Ensure you consume sufficient amounts of calcium and vitamin D, such as from milk, dried fish, cheese, shiitake mushrooms, soybeans, kidney beans, dried shrimps, as well as green leafy vegetables, like wild betel leaf, kale, water mimosa, neem, and sweet basil. Reduce your intake of high-fat content foods which lead to bone thinning.
- Protect against gender hormone deficiency by consulting a doctor for an examination, and receive hormone replacements on a regular basis.
Should people with Osteoporosis exercise?
Yes, they should, but it depends on the intensity of the exercise. Walking or swimming are the safest options. People aged 70 and over are at much greater risk and should take care to avoid falls.
Risk groups for Osteoporosis:
- Women entering old age or menopause
- Individuals who consume caffeinated drinks and salty foods on a regular basis
- People who drink alcohol and smoke
- Those who take steroids, cancer medications, anticonvulsants, anticoagulants, or have received thyroid hormones for extended periods
- People with a family history of osteoporosis, or a history of broken bones from falls
If 3 of the 5 points above apply to you, you should consult your doctor for a diagnosis to protect against osteoporosis.
Strengthening our bones is much like depositing money in a bank – we store calcium for our bones when we are strong and save it so that our bones can draw upon it when needed. Osteoporosis can be prevented.
Professor Emeritus Charoen Chotigavanich, M.D.
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