Osteoporosis: You can feel it in your bones

They say you know you’re getting old when everything hurts and what doesn’t hurt, doesn’t work.

Oh my, you can feel it in your bones: It’s the big O (not that O word, you one-track-minded you!) that women after menopause most dread. Osteoporosis, according to a fact sheet handed out to media members at an MSD (Merck Sharp & Dome) lunch affair to celebrate a bright new day in osteoporosis treatment, is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures, especially of the hip, spine, and wrist although any bone can be affected.

Of course, people cannot feel their bones getting weaker. You don’t know you have osteoporosis until you trip or have a bad fall and break a bone. Ouch! You can go break a glass, break your heart or somebody else’s or even break a promise, but breaking a bone is something else. Thus, it’s important to bone up on osteoporosis. Here are some hard facts from www.nof.org:

Men Get It, Too

• Eighty percent of those affected by osteoporosis are women. Yes, even men get osteoporosis, making up 20 percent of the osteoporotic population.

• Some people are more likely than others to develop osteoporosis. Among the risk factors are: being female; older age; family history of osteoporosis or broken bones (does your mother or grandmother have it?); being small and thin; low sex hormones (low estrogen levels in women, including menopause, missing periods (amenorrhea); low levels of testosterone and estrogen in men; diet (low calcium intake, low vitamin D intake, excessive intake of protein, sodium, and caffeine, but more on this later); inactive lifestyle; smoking; alcohol abuse; certain medications such as steroids, some anticonvulsants, etc.; certain diseases and conditions such as anorexia nervosa, rheumatoid arthritis, gastrointestinal diseases, etc.

• Approximately one in two women and one in four men over 50 years old will have an osteoporosis-related fracture in their remaining lifetime.

Knowing all this, how do we prevent osteoporosis?

Top Hip Tips

To optimize bone health and help prevent osteoporosis, heed these top hip tips:

1) Get the daily recommended amounts of calcium and vitamin D.

2) Engage in regular weight-bearing and muscle-strengthening exercise.

3) Avoid smoking and excessive alcohol.

4) Talk to your healthcare provider about bone health.

5) Have a bone density test and take medication when appropriate.

The bone of contention is vitamin D and its vital role in bone health.

“To be able to absorb calcium, vitamin D is very important. No matter how much calcium you take, it’s useless without vitamin D,” stresses Dr. David John Hosking, consultant physician, City Hospital, Nottingham, general medicine and metabolic bone disease.

A bright and sunny day warmly welcomed Dr. Hosking on his arrival to the Philippines. But on the way to his hotel, the good doctor was amazed at the tons of billboards blighting the cityscape, a lot of them advertising glutathione or whitening products.

Dr. Hosking couldn’t help asking himself, “Why do Filipinos want to be white when the Caucasians are dying to have the former’s beautiful brown complexion?”

We Shun The Sun

According to Dr. Hosking, it’s a big irony that vitamin D (the sunshine vitamin) deficiency is very high in the Middle East. “It is very, very hot there, but nobody goes out in the sunshine.”

Dr. Hosking and Dr. Sandra Tankeh-Torres, rheumatologist at Cardinal Santos Medical Center, can’t stress enough how important vitamin D is to calcium. “Vitamin D is required for adequate calcium absorption, normal bone formation, and neuromuscular coordination,” Dr. Torres points out in her very stimulating talk. “New findings on vitamin D show that it improves the coordination of the nerves and muscles.”

Dr. Torres highlights the age-old myths about aging. “They say you’re prone to falls kasi matanda ka na. It’s not about age. It’s because you’re not going out in the sun — the cheapest and most available source of vitamin D — that your vitamin D in the body gets lower and lower. But if you keep your vitamin D, there is an improvement of the neuro-muscular coordination of your body. Aging makes you prone to osteoporosis. It’s a play of everything — menopause, sedentary lifestyle, and diet.”

Care for caffeine?

Caffeine is a primary suspect. “And it’s not just coffee that’s got caffeine,” Dr. Torres clarifies. “There are also the cola drinks, energy drinks and yes, chocolate is chockful of caffeine. There are some teas that are high in caffeine. You really shouldn’t be taking more than three cups of black coffee. Of course, if you add milk, there’s a saving factor. So, in the end, it’s everything in moderation.”

Zeroing in on calcium, Dr. Torres notes, “Inevitably, you have to go back to childhood. You must drive these kids to increase their calcium. After they have their milk as infants, you don’t see them drinking milk anymore. Then they change their diets and shy away from milk and are now into sugar drinks and softdrinks. We’re not saying don’t drink these; we’re saying don’t forget milk.”

Of course, aside from dairy products, some of the best sources of calcium, according to Dr. Torres, are shellfish (like oysters and shrimps), oats, dark green vegetables (like malunggay), nuts (brazil nuts, almonds), soya products (tofu), sardines or salmon with bones, dilis.

RX: Alendronate and Vitamin D

If you’re taking calcium supplements, check the elemental calcium content. The common preparations are: calcium carbonate, which must be taken with meals and poses a higher risk of kidney stone formation; and calcium citrate, which is digested easily and does not cause kidney stones.

In 2006, MSD launched Alendronate/cholecalciferol, the first and only treatment that contains a weekly dose of two therapies — alendronate and vitamin D — in a single, one-weekly tablet. It offered a great alternative to doctors and patients in the management and treatment of osteoporosis.

On the other hand, Dr. Torres notes that sunlight exposure is the major source of vitamin D. But alas, on top of not going out in the sun, we also slather on gobs of sunscreen with the highest SPF that we can find.

Dr. Torres lists other sources of vitamin D as: fatty (oily) fish such as tuna and sardines, egg yolk, and supplemented dairy products.

The very absorbing task at hand, according to Dr. Torres, is to make people aware that vitamin D and calcium should go together perhaps like a horse and carriage or like love and marriage.- CONSUMERLINE By Ching M. Alano, Philippine Star