1. What is Osteoporosis?

Osteoporosis is a disorder of the skeleton in which bones become fragile and susceptible to fractures. If it’s not prevented or treated, it can progress painlessly until a bone breaks.

2. Who Gets Osteoporosis?

Anybody can get osteoporosis; but women are more likely to develop osteoporosis than men because their oestrogen decreases at menopause, which often results in significant bone loss. However, men also get osteoporosis. People with a family history of osteoporosis or fragility fractures are more susceptible to getting osteoporosis.

3. What Causes Osteoporosis?

The most common causes of osteoporosis are inadequate diet, smoking, heavy drinking, insufficient weight-bearing activity and a decrease in oestrogen or testosterone.

4. How is Osteoporosis Diagnosed?

The most common test for diagnosing osteoporosis is called a DEXA test (dual energy x-ray absorptiometry).

5. What can I do to Prevent Osteoporosis?

• Eat a balanced diet
• Exercise
• Avoid smoking and excessive drinking

6. When Should I Have a Bone Density Test?

If you’re a woman, it can be helpful for you to establish a baseline for your bone density either at the age of 50 or around the time of menopause, whichever comes earlier. Establishing a baseline can help you to determine your rate and amount of loss during menopause. Examining your test results can increase your awareness of osteoporosis and encourage you to take preventive measures against it.

Men aged 50 or older should be tested. And whether you’re a man or a woman, bone density tests are usually advisable if you:

• have had a fracture resulting from minor impact
• have a chronic disease that causes bone loss
• take antiseizure drugs
• take high doses of thyroid medication

Screening package starts at $379.

Ageing and Bone Health

Approximately 200 million women suffer from osteoporosis worldwide. A third of women over the age of 50 years will suffer from an osteoporosis-related fracture at some point in their lives in Europe and in the United States. Annually, 1.7 million hip fractures are related to osteoporosis. Locally, the number of osteoporotic hip fractures has increased five-fold over the last 30 years.

Bone Mass

Osteoporosis (literally – porous bone) is a condition characterised by low bone mass and increased bone fragility. Bone is a living tissue. Bone mass is a balance between new bone being produced and existing bone being lost (resorbed). During childhood and adolescence, bone is produced faster that it is resorbed. This results in a steadily increasing bone mass. Bone mass peaks in the early 20s and gradually declines after. There is a more rapid decline in bone mass in females after menopause.

Significance of Osteoporosis

The significance of osteoporosis is the case with which sufferers fracture their bones. Healthy bones only break when significant forces are applied to them. Osteoporotic bones break with mild injury. Common fractures encountered with osteoporosis include vertebral compression fractures, hip fractures and wrist fractures. All these occur with simple, low energy, falls. The aim of treatment for osteoporosis is to prevent such fractures from happening.

A vertebral compression fracture is usually caused by a fall onto the buttocks and results in the front of the spine being crushed.

While a vertebral compression fracture is often left to heal on its own, hip fractures routinely require surgery to fix them or to replace the joint.

Risk Factors for Osteoporosis

Non-modifiable risk factors

• Advanced age
• Female gender and menopause
• European and Asian ancestry
• Family history of osteoporosis
• Past history of an osteoporotic fracture
• Small stature

Modifiable risk factors

• Excessive alcohol consumption
• Vitamin D deficiency
• Smoking
• Malnutrition (especially from low calcium intake)
• Inactivity

Diagnosis of Osteoporosis

The diagnosis of osteoporosis made through a DXA or Bone Density scan. This is a simple investigation using X-rays to determine bone density in the hip and spine. The values are compared to that of the peak bone mass of the population (bone mass of the population in their 20s) and the diagnosis of osteoporosis is made based on how much the obtained values differ from peak bone mass.

It is recommended that ladies below the age of 60 should undergo a bone density scan if they have risk factors for osteoporosis. For those without risk factors, the bone density should be screened at the age of 65.

Prevention

Act now by signing up an Osteoporosis Screening Package at $377.

Package includes:

• Bone Mineral Density Scan – Hip and Spine scan
• Specialist Consultation

Treatment for Osteoporosis

Multiple different drugs are available for improving bone mass. Te indication for starting treatment is established osteoporosis diagnosed with a DXA scan. These drugs are not recommended for low bone mass if the criteria for diagnosis of osteoporosis have not been met. If the probability is more than 3% for a hip fracture or more than 20% for other major fractures, treatment should also be started.

These medications work by increasing bone production, decreasing bone resorption or both. They are used in conjunction with calcium and vitamin D supplementation as well as lifestyle modifications outlined above.

Conclusion

The prevalence of osteoporosis is increasing. The impact of osteoporosis can be minimised with appropriate lifestyle and dietary modifications. Once diagnosed, the risk of osteoporosis fractures can be reduced with appropriate medical treatment.

Do seek advice from a medical professional if you have concerns about osteoporosis as the outcome in terms of fracture risk reduction is far better with early osteoporosis than with severe osteoporosis.

Osteoporosis

Osteoporosis is a common condition in which the bones are brittle due to a low bone mass density or reduction in bone strength. As a result, a simple fall may actually fracture any brittle bones especially at the hips, wrist or the spine.

How soon could one be affected by Osteoporosis?

Osteoporosis is an age-related disease which is more common in women than men. Women with early menopause before the age 45, either naturally or through surgical removal of the ovaries, are at higher risk of developing osteoporosis. Besides, elderly who are confined in bed or with low physical activity may be more prone to osteoporosis. Men or some individuals may get osteoporosis at a younger age if they are on long term intake of some medication (e.g. steroids, thyroid medications) and certain medical conditions (e.g. rheumatoid arthritis, hyperparathyroidism, eating disorder) place a person at a higher risk. Smoking and excessive alcohol consumption have been greatly associated with the increased incidences of osteoporosis well.

What are the symptoms of Osteoporosis for men and women respectively?

Osteoporosis gradually develops over the years and may not have any signs or symptoms during the early stages. The symptoms usually appear in its advanced stages where fractures have occurred. Depending on the location of the fractured bone, one may feel pain at the affected area, for instance pain at the neck , lower back may indicate spinal bone fracture. Some may experience a loss of height over time or develop a stooped posture (also known as “dowager hump” as it is more common in women).  Nevertheless, symptoms of osteoporosis in men are similar to that in women.

Tips on daily Bone Care for women

Regular physical activities especially the weight bearing exercises (e.g. tai-chi, yoga, aerobics) and resistance exercise (e.g. weight-lifting) can help build stronger bone and maintain healthy bone density. It is important to choose the correct exercises for your age and existing health conditions to prevent unnecessary injury. Besides, calcium intake either from natural food sources (e.g. milk products, green leafy vegetables, bean curd) or supplementation of at least 1,000mg coupled with vitamin D is recommended especially for women of menopausal age. Quitting smoking and the reduction of alcohol consumption are both beneficial to prevent or slow down the progression of osteoporosis.

Osteoporosis Self-assessment Tool for Asians (OSTA) is a quick and easy tool to assess the risk of developing osteoporosis. The current available OSTA chart is developed for Asians aged 45 and above and by using just the present weight and age, one can determine their osteoporosis risk of either being too high, moderate or low.

Bone Mineral Density (BMD) screening is the best way to diagnose osteoporosis especially if your OSTA shoes that your are in high or moderate risk group. However, even if you are in the low risk group, BMD screening is still recommended if you have any risk factors mentioned earlier.

Osteoporosis  Screening Package @ $379

(Includes Specialist Consultation & BMD Screening).

Drinking Milk is Not Enough to Prevent Osteoporosis!

Women, as they grow older, and especially after menopause, lose up to 20 percent of their bone mass in the five to seven years after menopause! Although osteoporosis affects men as well, in the last three decades since 1960s, the number of osteoporotic hip fractures in Singapore rose five-fold per 100k population in women over the age of 50.

In April, the Osteoporosis Society of Singapore [OSS] launched a campaign encouraging postmenopausal women to take early action to protect their bone health, instead of delaying to after their first bone fracture.

Singapore has the highest number of osteoporotic fractures in Asia yet many postmenopausal women, to the frustration of doctors here, are leaving it to after they have had their first fracture before taking preventive action.

Studies show that one in every five patients usually dies within the first year after a hip fracture. Of those who survive, more than half will lose their ability to walk and will end up bedridden or wheelchair-bound.

Drinking your calcium in the form of milk while good for bone health is not enough for those at risk of postmenopausal osteoporosis.

You Might be of High Fracture Risk due to Osteoporosis

Once you have menopaused, the OSS is encouraging postmenopausal women to undergo bone mineral density (BMD) screening.

The OSTA test will determine if a postmenopausal woman is at high, moderate or low risk of having a low BMD. Those who are at high risk or moderate risk with other risk factors should have their BMD tested.

Patients with pre-existing osteoporotic fractures may heighten their risk of further fractures by two to four times. Therefore it will be prudent for patients with high risk of fractures to seek medical attention before their first fracture. The situation is expected to worsen when the proportion of Singapore population aged above 65 triples by 2030.

Too Late for More Milk to Prevent Osteoporosis

For osteoporotic patients, where the bone density has begun degenerating, medication is necessary as osteoporosis is a progressive one.

In a normal situation, drinking your milk and eating your cheese and sunning yourself for vitamin D will be good measures to build bone health but will not be sufficient when you identified with the bone degenerative condition – osteoporosis.

When faced with this, you need to medicate under your doctor’s supervision.

The International Osteoporosis Foundation reports that patients on medication reduce their risk for fracture by about 30-70%. But not all patients are found to be compliant.

Many stop taking their prescribed medication or fail to take it regularly. This is largely because osteoporosis is not associated with any visible to the eye symptoms. As a result, many fail to realise the hidden severity of osteoporosis until it is too late – after a fracture.

Patient compliance with prescribed treatment is most important whether they take oral medication or opt for the convenience of injections.

Patients who find it hard to comply with the regime of taking oral medication regularly, can consider other options such as yearly intravenous infusions.

Those with previous fractures, high-risk scores on OSTA should seek their doctor’s advice right away. Without medication, their risks of further fractures double or rise as high as four times.

Osteoporosis is a condition in which bones become weak and brittle. If not prevented or if left untreated, osteoporosis can progress painlessly until a fracture (crack or break in the bone) occurs, typically in the hip, spine and wrist. One in three persons with hip fractures suffers considerable loss of function and becomes dependent on others, while one in five people dies within a year of sustaining a hip fracture.
Bone mass peaks between the ages of 25 to 30. After that, any additional calcium that a person takes is only used for replacing the bone tissues. Thus, the foundation for good bones at a later age begins now. To prevent osteoporosis, get enough calcium and vitamin D, engage in weight-bearing & resistance exercises, and avoid smoking and limit alcohol intake.

Men don’t get Osteoporosis? Think Again

While women are more likely to get osteoporosis compared to men, men also suffer from osteoporosis. Worldwide, osteoporosis affects approximately one in three women and one in eight men over the age of 50. Osteoporosis in men related to a decrease in testosterone. Compared to women, osteoporosis develops at a later age in men. Although both men and women lose bone density with age, since men begin with a higher bone density, they reach osteoporotic levels later. Additionally, unlike women who undergo rapid bone loss after menopause, men don’t. Besides age, it can affect men who have eating disorders.

How do I check whether I have Osteoporosis?

You can do a Bone Mineral Density scan (specifically a densitometry or DEXA scan) which is used to determine your risk of getting osteoporosis.

Bone Mineral Density Scan + Specialist Consultation @ $379 ONLY

Currently, we are offering a price of $379 for a hip and spine scan including a consultation with our specialist for the explanation of the result.