LD Articles

Production of excess levels of thyroid hormone also speeds the rate of bone turnover, increases the risk of developing osteoporosis. This can be easily treated to keep thyroid hormones in the normal range. Consuming excessive levels of alcohol is the reason for osteoporosis in five percent of male sufferers, with an increase in hip fracture risk of almost three times above that for non-drinkers. Alcohol affects the osteoblasts, bone building cells, reducing their activity. Alcohol abuse can also cause poor absorption of nutrients and calcium and increase the likelihood of us falling, both of which factors increase the risk of developing osteoporosis or fractures.

Disease of the gastrointestinal tract and operations on the stomach can increase our risk of developing osteoporosis, but the exact mechanism is not clear. Coeliac disease, an intolerance to gluten in the diet, results in inflammation of the lining of the intestine, causing poor absorption of vitamins and minerals. Half of patients suffering with coeliac disease were shown in a study to be exhibiting low bone density even on the correct diet.

Testing for bone density is usually recommended for anyone with a higher than average risk of developing osteoporosis. Osteoporosis can show up on a spinal x-ray as can an osteoporotic fracture, but it takes a loss of 30 percent of bone mass before it shows on an x-ray. This is not an accurate or sensitive way of measuring bone density which is now done by DEXA scanning or Dual Energy X-ray Absorptiometry. It is a reliable and accurate account of your bone density and thereby the risk of fracturing a bone. DEXA scans use very low doses of radiation and there is no undressing or discomfort involved in the scan.

A general practitioner or a specialist in osteoporosis such as a rheumatologist may prescribe treatment on the basis of a scan or if there has been a fracture or other risk factor. Scan results fall in a range which is compared to the average, falling into normal, osteopoenic (some bone loss) to osteoporotic. In men other tests will be undertaken to look for any specific conditions which might impact on bone density, as treating them can have significant affects on increasing bone density. Testosterone replacement therapy can be given by tablets, implants, patches and injection, but has its risks as well as benefits which should be discussed with the doctor.

The bone removal part of the bone turnover process is performed by osteoclasts and they are compromised by bisphosphonate treatment which allows osteoblasts, the cells which build bone, to work without being opposed and so able to build more bone. Examples of these drugs are etidronate, risedronate and alendronate. Calcitonin has a similar action against osteoclasts and helps reduce pain in acute vertebral fracture. Anabolic steroid treatment is also used, especially if a muscle building effect is required. Vitamin D and calcium supplements do not have a clear role in bone density in men but are catered for by getting some sun and a good diet.

We are responsible to some extent for keeping our bone density up to normal levels, with exercise and dietary intake being relevant factors. Genetic variation accounts for significant amounts of variation in our bone densities but our behaviour can also change it. Typical recommendations are to take a well-balanced diet and choices are suggested from four varied food groups: fruit and vegetables; pulses, eggs, nuts, fish and meat; milk and other dairy; breads and cereals. Milk and cheese foods are high in calcium and their consumption is important.

As our bones are a living and dynamic tissue, if we do not use them then they will lose strength as they are not being used. Regular impact activities in weight bearing exercise stimulate bone to become denser to resist the stresses. Useful exercise types are running, fast walking, aerobics, tennis, weight training and skipping, all activities with impacts. There is much less or no impact in cycling and swimming and so they are less therapeutic. Three times a week exercise for a continuous twenty minute period is a common recommendation. Exercise and drug therapies are continually being innovated.