Osteoporosis is a disease that makes your bones weak and brittle. People with the disease can break their bones too easily, even after a minor fall or bump. Breaking a bone can be serious, especially if the bone is in the hip. People who break a hip sometimes lose the ability to walk on their own and may need care in a nursing home. That’s why it is so important to avoid breaking a bone in the first place.
How do I know if I have osteoporosis?
Osteoporosis does not cause symptoms until you break a bone. But your doctor or nurse can have you tested for it. The best test is a bone density test called the “DXA test.” It is a special kind of X-ray.
What’s new with the diagnosis?
In the meantime, DXA no longer only looks at bone density, but also at architecture. The Trabecular Bone Score (TBS for short) helps to further assess the fracture risk based on the bone architecture of the bone balks.
Experts recommend bone density testing for females older than 65. That is because people in this group have the highest risk of osteoporosis. Still, other people should sometimes be tested, too. Ask your doctor or nurse if you should be tested.
What can I do to keep my bones as healthy as possible?
You can:
– Eat foods with a lot of calcium, such as milk, yogurt, and green leafy vegetables (table 1 and figure 1)
– Eat foods with a lot of vitamin D, such as milk that has vitamin D added, and fish from the ocean
– Take calcium and vitamin D pills (if you do not get enough from the food that you eat)
– Be active for at least 30 minutes, most days of the week
– Avoid smoking
– Limit the amount of alcohol you drink to 1 to 2 drinks a day at most
What else can I do to avoid fractures?
It sounds simple, but you can prevent a lot of fractures by reducing the chances of a fall. To do that:
– Make sure all your rugs have a no-slip backing.
What medicines are available?
Bisphosphonates are the most commonly used. These drugs are deposited in the bone and inhibit the osteoclasts, which are cells that break down the bone. This keeps the bone stable and protects against fractures, especially in the spine.
If this is not enough, drugs are used that also stimulate the osteoblasts, which are cells that naturally build up the bone. These drugs are called teriparatide, denusomab or the new romosozumab. However, the latter causes such a strong build-up of bone that, without precautions, there can be a sharp drop in bone density with fractures after discontinuation. This can be prevented by administering bisphosphonates.