Osteoporosis is sometimes called the ‘silent disease’ because people usually don’t notice their bones becoming thinner and weaker until they break. As the disease progresses, even a slight bump or fall can cause a serious fracture.
According to official Australian Institute of Health and Welfare figures, 924,000 Australians have osteoporosis, that’s 3.8 per cent of the population.
In 2017–18, there were 6,838 hospitalisations for osteoporosis for people aged 50 and over. In 2017–18 there were 93,321 hospitalisations for minimal trauma fractures in people aged 50 and over.
Osteoporosis affects about 3 per cent of people aged 35-64, with the numbers of people affected increasing steeply in those aged 65-79, and again in those aged 80 or over. Osteoporosis affects one in two women and one in three men.
The National President of the Pharmacy Guild of Australia, Trent Twomey, said any bone can be affected by osteoporosis, but the most common sites are the hip, spine and wrist.
‘Anyone with specific risk factors for osteoporosis should be investigated by their doctor. In addition, it is recommended that anyone over 50 who breaks a bone from a minor bump or fall should be investigated for osteoporosis,’ said Adjunct Professor Twomey.
‘Fractures can lead to chronic pain, a loss of independence, disability and even premature death – so managing bone health to avoid fractures is a priority,’ he said.
Women are at a greater risk of developing osteoporosis because of the rapid decline in oestrogen levels during menopause. When oestrogen levels decrease, bones lose calcium and other minerals at a much faster rate with the result that a bone loss of approximately 2 per cent per year occurs for several years after menopause.
Men also lose bone density as they age but testosterone levels in men decline more gradually so their bone mass generally remains adequate until they are older.
Certain conditions and medicines can have an impact on your bone health and these include:
- Corticosteroids – commonly used for asthma, rheumatoid arthritis and other inflammatory conditions
- Low hormone levels – in women: early menopause; in men: low testosterone
- Thyroid conditions – over active thyroid or parathyroid
- Conditions leading to malabsorption eg: coeliac disease, inflammatory bowel disease
- Some chronic diseases eg: rheumatoid arthritis, chronic liver or kidney disease
- Some medicines for breast cancer, prostate cancer, epilepsy and some antidepressants
Calcium is a key to minimising the risk of osteoporosis. Calcium helps to build bones and maintain bone strength. Almost all of the calcium in our body is in our bones, with just a little dissolved in blood and other fluids to assist with healthy functioning of the heart, muscles and nerves.
Healthy Bones Australia says our bones act like a calcium bank, storing calcium and releasing it into the bloodstream when needed. If calcium intake is too low then osteoporosis, or brittle bones, can result.
The recommended daily intake of calcium is about 1000mg for young adults, and for teenagers and older adults about 1300mg a day is recommended. This equates to three or four serves of dairy foods each day, but calcium is also present in many nuts, vegetables and tofu.
Calcium absorption is reduced (and the risk of osteoporosis increased) by the lack of vitamin D, as well as excessive intake of caffeine, alcohol, and many soft drinks.
Pharmacies can help
‘Your pharmacist can advise on appropriate supplements if you need them, check on medicines you are taking and recommend what type of exercise would be best for you,’ said Adjunct Professor Twomey.
‘Likewise, if you smoke – a major risk factor for osteoporosis – and want to give up, your pharmacist can provide you with smoking cessation products and support which suit your needs. Some pharmacies also conduct bone density screening to assess your risk of developing osteoporosis,’ he said.
‘Sometimes a doctor will prescribe medicine to reduce the risk of developing osteoporosis, or to prevent it from worsening. Your pharmacist can advise you how and when to take this medicine, what side effects to watch out for, and whether other medicines are appropriate.
‘Fortunately, the risk of developing osteoporosis can be reduced by maintaining healthy and strong bones,’ said Adjunct Professor Twomey.