Osteoporosis-who gets it?-by Dr Harold Gunatillake

Harold Gunatillake



Osteoporosis means porous bones.

“Kids must play outdoor in the sun to achieve strong bones for life”

Our weight bearing bones seem to grow till you are 30 years, then they begin to lose density.

In a study of 1,642 postmenopausal women in Sri Lanka had an estimated prevalence of 45% having osteoporosis. In men it drops to about 6%.

The difference can be explained by the fact that men work outdoor and their bones gets strong, whilst most women mostly stay at home and is also affected by hormonal imbalance after menopause.

Osteoporosis is estimated to affect 200 million women worldwide – approximately one-tenth of women aged 60, one-fifth of women aged 70, two-fifths of women aged 80 and two-thirds of women aged 90.

This is a condition where most of the weight bearing bones become weak and brittle. The body has a system to replace bone tissue as it wears off.

New bone formation is due to osteoblastic activity and bone removal is due to osteoclastic activity.

 In osteoporosis the bone creation by osteoblasts may not happen after a certain age and they become brittle to the extent of collapse.

Our bones are constantly being rebuilt through out life. The components of the bones are collagen, a protein that forms the basic framework, calcium phosphate, mineral in the matrix, that hardens the bones.

Formation of new bone is due to osteoblasts as mentioned earlier, and breakdown of the bones is caused by an oblong shaped cell called the osteoclasts.

In osteoporosis there is more osteoclastic activity

There are no early symptoms to indicate osteoporosis of bones. In your youth and adulthood there may not be any symptoms until may be when a bone fractures after a fall.

Then a plane x ray of the bone will reveal the osteoporotic changes.

It is important that kids and during the school going period they must participate in sports activities. In such a situation the bone density declines very slowly, compared to those kids not participating in outdoor activities.

Adults should not lead an inactive form of life. They must walk over 10,000 steps, daily.

1). It is also observed that people who suffer from type 1 diabetes, rheumatoid arthritis and inflammatory bowel disease are linked to early osteoporosis.

2). A diet low in calcium and vitamin D has the greatest chance of developing osteoporosis.

3). Those who are on long term steroids used in asthma has a greater risk of developing osteoporosis

When your spine start changing shape and in posture- that would be an early sign of osteoporosis. Those people who walk about with a bent spine below the neck region has osteoporosis unless the condition is suspected early in life.

The vertebral bones may get crushed or get compressed fractures, and it makes hard to stand, walk, sit, or lift objects. They suffer a lot with pain and may have sleepless nights.

The best way to prevent such deformity of the upper spine, as we call it a ‘Kyphus’, is to keep your bones as strong as possible by treating or preventing osteoporosis.

Osteoporosis is the commonest cause of compressed fractures of the spine, and hip fractures after a slip and a fall.

Bone density Scan

People who are over 60, leading an inactive life, including all women should have a bone density scan for peace of mind.

How to stop the progression of osteoporosis

If you are diagnosed having osteoporosis your doctor will prescribe a bio phosphate: Actonel, Boniva, Foosamax or Reclast.

These medications will reduce your bone loss and build up some bone density.

The side effects of these drugs are: Gastrointestinal problems such as ulcers in the esophagus, acid reflux, and nausea.

Hormonal replacement for women

Hormone replacement for women, once used widely for menopause symptoms is much less used today because of concerns about cancer risk, blood clots, heart disease and stroke.

Evista not being a hormone, produces bone-strengthening effects as good as the hormones without cancer risk. Again, the risks involved are blood clots and increased hot flashes.

Prolia is an antibody that slows breakdown of bone. It is given to post-menopausal women twice a year who are at high risk of fractures from osteoporosis

Side effects of Prolia are muscle pain, higher risk of infections and lowering of calcium levels.


Bone building foods

Calcium is the most abundant mineral found in the body and most of it is found in our bones.

It is one of the most important minerals involved in the treatment and prevention of osteoporosis. Adequate amounts of calcium in your diet can help reduce bone loss by 30 – 50 percent!

Eating calcium rich foods can help protect your bones no matter what your age. A glass of milk, eating salmon, tuna, herrings, cheese, and leafy veggies like spinach will provide the calcium and they help absorption of vitamin D. Vitamin D helps the body absorb calcium.

Postmenopausal women need 1,200 mgs calcium and at least 400 IU to 600 units of vitamin D daily

Calcium in food: We know that dairy has calcium, but other foods do, too.

Low-fat milk or soy milk (8 ounces): 300 milligrams calcium

Cottage cheese (16 ounces): 300 milligrams calcium

Low-fat yogurt (8 ounces): 250-400 milligrams calcium

Canned salmon (3 ounces): 180 milligrams calcium

Calcium-fortified orange juice (6 ounces): 200 milligrams-260 milligrams calcium

Cooked spinach, turnip greens, collard greens (1/2 cup): 100 milligrams calcium

Cooked broccoli (1/2 cup) 40 milligrams calcium

A calcium supplement may be necessary to make sure that you are getting enough.

It is advisable for you to check your calcium and vitamin D levels in your blood on your annual checkup, including magnesium.

Magnesium is also credited with stabilizing functions in bone building. If there is no stabilizing magnesium during bone synthesis, this will also decrease bone density.

Calcium supplements: All the calcium bottles on store shelves can be confusing. Basically, there are two types of calcium — calcium carbonate and calcium citrate — that can be purchased over the counter.

Calcium carbonate must be taken with food for the body to absorb it. Many women have side effects from calcium carbonate — gastrointestinal upset, gassiness, and constipation.

 If you take calcium carbonate with magnesium, however, you will not likely have the constipation. “It acts just like Milk of Magnesia and seems to help move things through.”

There are no bad effects on cardiovascular health by taking calcium supplements.

Walking daily makes your bones and muscles work against gravity- which puts stress on the skeleton, which strengthens bones. So, walking is better for bone strength than swimming where gravity does not have any beneficial effects on bones.

What is the best pain medication for osteoporosis?

When you are in your seventies and over, if osteoporosis of the spine is not taken care of during the early stages, you are heading for a very painful situation. Furthermore, with compression fractures of the vertebrae you could get severe pain, due to pinching of the nerves that radiate out from the spinal cord. It could be very debilitating pain which most pain killers do not seem to help.

Further due to weakening of the spine due to osteoporosis, the vertebrae can crumple, lose height and result in a hunched posture.

The pain could be unbearable, lasting during the day with movement, and having sleepless nights.

There are over the counter medications like aspirin, Panadol, ibuprofen, and naproxen to relieve the pain for most people, though they have their bad side effects.

When all pain medications do not seem to help, there is evidence that CBD oil may be an effective treatment for osteoporosis by slowing down the progression of the disease and relieving pain.

Just one drop of hemp oil is all that is required under your tongue nightly and you become a changed person overnight and you relate to other members of your family most cordially.

It is the best solution for osteoporotic excruciating pains.

The Journal of Bone and Mineral Research published a study showing that the cannabidiol (CBD) strengthens bones and accelerates the healing of fractures.

So viewers please remember there is light at the end of the tunnel, and you should take my advice. Please do.

In conclusion:

Please check your calcium, vitamin D and magnesium levels in your blood annually. Enjoy foods containing them. Most of all, exercise is very important, minimum would be walking 20,000 steps a day.

Hope you enjoyed watching this video.

Goodbye for now. Stay safe.


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