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[Stellajane]

I picked up a book in the bargain basket at The Works over the weekend called "Osteoporosis : Manage Your Bone Loss". I didn't expect to learn much but thought it worth 99p! However I did learn something I hadn't read before about the two "types" of osteoporosis. This is an American book so may be why I don't recall reading about these classifications before.

Primary Osteoporosis (Type 1) otherwise known as postmenopausal osteoporosis affects postmenopausal women aged 50-65 (sooner if you have an early menopause) and is thought to result primarily from oestrogen deficiency caused by menopause. This makes women prone to vertebral compression fractures or wrist fractures.

(Type 2) or senile osteoporosis is age related and mainly affects the elderly after 70 years of age. This type mostly affects the hard outer cortical bone tissue and generally spares the porous spongy bone tissue. Therefore individuals suffering from senile osteoporosis are prone to hip fractures.





 



 

[Ju Ju]

Interesting. My mum, 87, has the 2nd kind. She has had several falls, resulting in breaks. She used to be the same height as me, but now barely reaches my shoulder. She has to be so careful, but stubbornness gets in the way at times. Understandable. The temptation is to do things for her, but she needs to keep mobile.

[Dancinggirl]

I'm having a bone density scan next week.  I've been off HRT since last November and I've insisted I have one. At 58, having had a premature menopause, I'm really aware I'm at risk.  I did use HRT for most of the last 20 years but I had a scan in my 30s which showed my bones weren't good then!!! WE women are unlucky as the oestrogen deficiency once we are post meno can cause dramatic bone loss.
To be honest I'm more worried about osteoporosis than breast cancer- I'm trying to do all the right things but the pain I'm getting in my hips and lower back is a bit frightening.
I actually think that this is another area that GPs are a bit too causal about and there is not enough emphasis on prevention and treatment for this crippling problem. Lack of calcium and Vitamin D plus appropriate exercise can cause serious long term health problems.
They expect us to work till our late 60s but we need more support to enable us to do this.
DG x

[Rowan]

You will be referred for a DEXA scan on the NHS if you have the following

 Who should have a DEXA scan?

A DEXA scan may be advised if you are at increased risk of osteoporosis. Osteoporosis usually causes no symptoms at first. However, if you have osteoporosis, you have an increased risk of breaking a bone. (See separate leaflet called Osteoporosis for more details.) If a DEXA scan shows that you have osteoporosis, then you may be given advice and treatment to help strengthen your bones. Therefore, a DEXA scan may be advised if you have:
•A fracture following a minor fall or injury.
•Loss of height due to fracture of a vertebra (back bone).
•Taken steroid tablets for three months or more.
•An early menopause (aged less than 45).
•A history of periods stopping (amenorrhoea) for more than one year before the menopause.
•Other disorders associated with osteoporosis such as rheumatoid arthritis or coeliac disease.
•A family history of hip fracture on your mother's side of your family.
•A body mass index of less than 19 (that is, if you are very underweight

I think owing to costs your GP would not refer you just because you are menopausal.

A private scan can cost about £100 if you want to pay yourself.

If you diagnosed with Osteopenia it does not necessarily mean you will go on to develop osteoporosis

http://www.webmd.boots.com/osteoporosis/guide/osteopenia-early-signs-of-bone-loss

[tiger74]

I agree - osteopaenia/osteoporosis can be overlooked. The prospect of developing osteoporosis scares me too.

I have DEXA scans (NHS) every 2 years at the moment because of taking aromatase inhibitors from the age of 47, (interestingly this criterion is not one on the useful list posted by silverlady).  I have also had my ovaries removed.  Thankfully up to now my DEXA scans have been fine in spite of taking a potent anti-oestrogen medication for over 4 years now.  I'm due to switch from the aromatase inhibitor medication next year so my risk of bone thinning should reduce but I may well just pay for an occasional private DEXA scan after that to put my mind at rest.

I have used the following strategies which I hope have helped:

Calcichew D-3 1000mg daily
Vitamin D 25g daily
Consciously increasing my dietary intake of calcium
Cutting out ALL carbonated fizzy drinks
At least 20 minutes weight-bearing exercise per day (usually brisk walking)
In the summer, at least 20 minutes of exposure to sunlight every day (without sun cream).  I've been told by a consultant rheumatologist that if your shadow is taller than you are then the sun isn't strong enough to be doing the job Vit D-wise which contributes to why so many people at the latitude of UK are deficient in Vit D. 
Maintaining a BMI around 22

I realise I'm probably 'preaching to the converted' but I thought I'd share what's worked for me as I am living proof that despite being an 'oestrogen-free' zone for several years I have managed to have normal bone density scan results.   

[Rowan]

Its very interesting tiger74 that you had your ovaries removed and had 4 years of anti estrogen medication and your bones are fine, it make you wonder about the role of estrogen in bone density that we are always being told about.

Clearly something else is going on with bone health and density.

Would add magnesium to your excellent list.

[Dancinggirl]

I have a friend who has been diagnosed with advanced stage osteoporosis aged 55 following a fall that broke her sacrum - she was wheel chair bound for 3 months. These so called wonder drugs are far from ideal as they have some nasty side effects - she is having intravenous treatment which is causing problems in her jaw bones and teeth. Prevention should be the main line of defence and this should include routine DEXA scans - these scans should not be just for 'at risk' people.  My friend with the osteoporosis had been told at a routine health check only weeks before her fall that she was the healthiest women the doctor had met in ages - slim, fit, very low cholesterol etc.
I was a dancer so in my dancing years I was very slim (7.5 stone, sometimes less) was working so hard I got very little sunlight (no sunshine holidays at all) and had a low fat diet (so little dairy!!).  I probably didn't lay down much bone density in the first place and having an early menopause won't have helped.  I really had to push for the DEXA scan as according to the GPs list of 'at risk' people I shouldn't be at risk!!!!!!
I will be very interested to see how my bones are, especially as I am trying to maintain the right lifestyle to preserve my bones.  I'm afraid I am really worried about the drugs they offer for bone density - I'd rather go back on HRT.  Dg x

[Rowan]

My GP referred me for a bone scan years ago (when they were easier to come by) because I  was fine boned and small and very slim and I did not eat much cheese or much dairy, it came back normal, it was suggested that I had another one in about five years, when I suggested it to my GP she said it was not necessary and it would not have changed much anyway.

I still have the results that were sent to me.

I have also have had a heel and wrist bone density scan both were normal. Done privately.

I do think there is genetic component that can make you more susceptible to osteoporosis also medications e.g. proton pump inhibitors can contribute.

There should be more awareness about osteoporosis as it can start early in life especially due to fad dieting and excess exercise.

There is nothing stopping anyone getting a private bone scan even if they are not offered one on the NHS. 

[CLKD]

The pelvis is the densest bone area which is usually scanned.  If regular scans were performed it may well save the NHS in the long run when people develop thinning and sustain fractures.

[tiger74]

Dancinggirl - I do hope the results of your upcoming DEXA scan are good - fingers crossed.  I agree with what you say about the osteoporosis medication (I assume you're referring to bisphosphonates?) - I know several people who take it and it's a faff to take and osteo-necrosis of the jaw is a known, albeit uncommon, side-effect so dental treatment becomes more of a faff too.

Thanks Silverlady - I've just re-checked the list of ingredients in the 'Maxi-Hair' supplement I take every day and it contains a good amount of magnesium so perhaps that's been helping. 

Another health issue of which young people should be made more aware.     

[CLKD]

teaching our teens to eat healthy and exercise well - we had regular PT lessons including the dreaded cross-country, swimming; I danced from age 8 until 18; went horse riding occasionally, we had cycles or we walked because that was the choice - or stay at home.  Our grandparents were active through necessity too, but my Paternal Grandma had a Dowager's hump by the time she was 65+ and lost several inches in height whilst I was growing  - it was sort of accepted that old ladies shrunk  .

Remember hoola hoops, well I could, once  and French skipping …… all good exercise   

[Dancinggirl]

Update on my DEXA scan.  I've just got back having had the scan - it's rather relaxing having the scan!!!! The lovely man who did the scan said there was some bone loss but it's not too bad - Yippee.  All that power walking, calcium rich diet and the extra Vit D in winter is obviously paying off.  He said I should still discuss things with my GP - maybe I should take some extra calcium - I'll ask.
I have to say I am relieved.  All the pain I'm getting in my hips and lower back is probably just arthritis and as an ex dancer I expected to get problems at this age and stage. I  just have to keep moving or I'll sieze up!!!
I urge you all to push for a DEXA scan if you think you may have issues with bone density - a simple thing to have done and it may help you to prevent long term problems.
DG x

[CLKD]

  for the update.  OA can be managed with pain relief as necessary, I try to remember to swallow some Nurofen before I attempt chores in the garden or I tend to go 'ouch' in the evenings 

[Ju Ju]

Good news DG! 

[tiger74]

Hi Dancinggirl

Thank you for updating us.  That sounds like good news.  Presumably your GP can prescribe supplementary calcium if deemed appropriate.

Best wishes