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Holes in Your Bone!

When the skeleton loses more than it can restore

“The bone is a living tissue!” that statement made by my husband’s attending physician shocked me at first. I thought I was hearing things. After all the accident left me shaken, I had barely slept, not had a proper meal in the past 24 hours and 18070618_xlwas at the brink of exhaustion.

“It is constantly being replaced,” he continued, “Its mechanism and function cannot entirely be explained. But it works without fail every time, labouring quietly to fix your husband’s broken bone. Don’t worry he’ll be up and running in no time,” concluded the physician with a smile.

I glanced at my husband, who was drifting in and out of consciousness, and half-heartedly smiled at the doctor.

Bone: A Living Tissue

Most words, known to man today, have a Greek or Latin origin. The word ‘Osteoporosis’ is no exception; ‘osteo’ meaning ‘bone’ and Greek ‘poros’ refers to ‘passage/pore’. Osteoporosis causes the bones to become weak and brittle.

The bone is constantly being absorbed and replaced throughout life. As the skeleton loses old bone, new bone takes its place. While this process is rapid during childhood, with age it slows down. After a while, bone replacement cannot keep up with the loss of bone thus causing Osteoporosis.

Osteoporosis affects all. The Health Promotion Board (HPB), Singapore, states that women are more prone to osteoporosis than their male counterparts. Oestrogen is known to play a vital role in bone growth. The level of oestrogen drops in women after menopause. This explains the rise in the incidence of osteoporosis in women after menopause. Women can lose up to 20% of their bone mass five to seven years after menopause.

Men on the other hand are protected by oestrogen and testosterone. Though osteoporosis is relatively less common in men, excessive alcohol intake, smoking or extreme thinness can decrease the level of such hormones in their body, resulting in bone loss.

The Silent Attack

The early stages of bone loss go by unnoticed in most cases. The patient might be unaware of this condition until they suffer from a broken bone. In extreme cases, the bone can be so brittle that even a cough or a sneeze may fracture a rib or cause partial collapse of one of the spinal bones.

Some of the commonly affected sites are, the lower forearm near the wrist, the spine and the hip. Some signs of advanced osteoporosis may include, fracture of the hip, spine and wrists, back pain, and loss of height over time. Osteoporosis can be diagnosed via a Bone Density Test.

 Treatment Options Available

Osteoporosis is a condition that cannot be reversed. There are a variety of ways by which this condition can be managed. Calcium and vitamin D, hormone replacement therapy (HRT), and bisphosphonates are commonly used to manage osteoporosis.

Calcium and Vitamin D you’re Bone’s Best Friend13819011_high

It is essential that one takes the daily recommended dose of nutrients, calcium being no exception. The daily dietary recommendation of calcium in adults is around 800mg. This may vary based on age. Calcium is lost daily via various bodily excretions such as urine, faeces and sweat. However, the lost calcium can be replaced by eating calcium-rich food.

Cheese, yogurt, milk, dark leafy vegetables like spinach, and soya beans are rich in calcium. So eat health every day and don’t wait until it’s too late!

Individuals on osteoporosis medication are given calcium and vitamin D supplements. This ensures that the body has enough calcium to allow the specific osteoporosis medicines to work. However, calcium alone is not effective in the management of osteoporosis.

Hormones to the Rescue

The use of HRT, especially oestrogen, when started soon after menopause, can help maintain bone density. However, when used in the long run oestrogen therapy can increase a woman’s risk of blood clots, endometrial cancer, breast cancer and possibly heart disease.

In men testosterone replacement therapy can be considered. This may help increase bone density, however there is a lack of sufficient studies to prove its effectiveness. Osteoporosis medications are better studied in men with osteoporosis and are recommended instead of or in addition to testosterone.

 The Role of Bisphosphonates

Bisphosphonates are especially useful for treating and preventing osteoporosis in postmenopausal women. Their main function is to help repair weakened bone and increase bone mass and bone strength. This helps reduce the incidence of fractures both at the spine and hip.

Bisphosphonates are also available for the treatment of osteoporosis in men.

In a Nut-shell

When my husband went back for his review a month later, the X-ray reflected new bone growth. I could not help but reflect on the conversation I had with his attending physician.

The way bone works is fascinating. However, to prevent deterioration it needs to be cared for. Weight bearing exercises, like Tai Chi, brisk walking, dancing, hiking, jogging, and aerobics can help put force through the bone and strengthen it. Resistance exercises like weight-lifting, push-ups help when done regularly.

In order to keep our machine well-oiled and functioning, we need to feed it with the proper nutrients. A well-balanced diet and exercise should do the trick and keep osteoporosis at bay.


 Risk factors for osteoporosis include:

  • Family history of osteoporosis
  • Early menopause before the age of 45
  • Lifestyle choices like, leading a sedentary lifestyle, excessive consumption of alcohol, and smoking
  • Low bone density
  • Dietary factors like, low calcium intake, anorexia
  • Prolonged use of steroids and other medication for conditions like seizures, depression, gastric reflux, cancer, etc.
  • A small or petite body frame



Kavitha Mallavarapu
Posted by ezyhealth on Jun 10 2014. Filed under Medical Section. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.

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