According to a study in the United States, there are about one million people over the age of 50 suffering from osteoporosis. Among them, the number of women is more. The theme of this day is 'Say No to Brittle Bones'.

Why is that?
From birth to the age of 20 to 30 years, the bones of the human body become well-formed and strong. After that, the process of bone loss begins naturally at a rate of 1-1.5 percent per year. However, in women, bone loss begins at a rate of 3 to 5 percent in the first five years after the cessation of the menstrual cycle or menopause. So it can be said that bone loss is a normal process.

With increasing age, if no action is taken against this bone loss, in addition, some conditions that are at an increased risk of bone loss continue in the body for a long time, then it gradually moves to the stage of osteoporosis.

As we age, this process can be slowed down by increasing the amount of calcium in our bodies as well as taking vitamin D supplements.

Who is at Risk for Osteoporosis
The risk of osteoporosis increases for men and women of all ages as they age. But it is more risky in women than in men.

For women who end their menstrual cycle quickly or are in menopause.

Those who suffer from long-term abdominal IBS problems.
Those who have kidney and liver disease.
Those suffering from cancer.
Those who consume excessive alcohol for a long time.
Those who work most of the time sitting or do less physical work.
Those who smoke for a long time.
Certain medications carry a risk of osteoporosis with long-term use. For example, steroid medications, prostate cancer medications, long-term omeprazole or gas medications.

What happens when you have osteoporosis?
Osteoporosis is mostly invisible from the outside. As a result, the internal structure of the bones of the body becomes weak. It can break bones with minor injuries. A simple fall or minor injury can lead to a major fracture. Which can lead to long-term pain later on. Fractures of the legs and spine are especially painful.

When osteoporosis occurs, the patient experiences pain. This pain is slightly different from other pains. For example, their pain increases if they stand for a long time. The pain eases slightly with walking or work, but pain is felt later on after long walks or heavy work. Many patients say that at the end of the day, when they go to sleep at night, they feel pain in their body. The pain is usually felt all over the body, but pain in the back and legs can be felt more.

If someone has diabetes or thyroid problems along with osteoporosis, the nature of the pain may increase. Because the pain in this disease is from inside the body or due to bone structure. That's why taking many powerful painkillers will reduce the pain temporarily, but the pain will return. Complete pain relief is not possible unless treated according to the nature of the pain.

What tests can diagnose osteoporosis?

Bone structure analysis of our body can be easily understood through Dexa scan or BMD test. Anyone can take this test. But many people do not do it because the cost of this test is a bit high. In women, if this test is done after 40 years, the risk of osteoporosis can be easily understood. However, a normal X-ray can often give an initial idea of ​​the painful process.

How to get better from osteoporosis

By staying active or exercising regularly, osteoporosis can be slowed and you can stay well in the long term. Studies have shown that exercise can increase bone density in the spine by 5 percent.

Avoiding long-term smoking, not taking long-term gas medicine but taking a break of one or two months in between. For those who take long-term steroid-like drugs, a break from taking the drug also plays an important role.

Taking vitamin D supplements is very important as we age. Vitamin D mainly plays an important role in the incorporation of calcium into bones in our body. But it is said that there is no source of vitamin D in our normal food. Many people think that vitamin D is obtained from sunlight, but we cannot follow the exact process by which vitamin D is obtained from sunlight. For this, with increasing age, especially in women after the age of 40 years, 800 to 1000 IU per day or 20000 IU per week of vitamin D can be taken in the form of supplements with the advice of a doctor.

Vitamin D levels can be checked in women after age 40. If testing is not possible, there is no harm in taking vitamin D regularly. Because vitamin D in excess in the body, it usually does not cause side effects.

Is there a need for extra calcium as we age?

This question is asked by many people who are getting older, should they eat extra calcium or not? Many people take extra calcium in the form of medicine at will. Basically the food we eat contains calcium in various forms. Because of this, calcium needs are met with normal food. However, there are some foods that are rich in calcium, mainly milk or milk-based foods are high in calcium. These foods can be consumed as you get older. It is possible to fulfill the requirement of calcium.

Taking calcium in the form of medicine or supplements can be done on the advice of a doctor. The doctor can determine whether supplemental calcium is needed or not by looking at the X-ray or if necessary by looking at the amount of calcium in the blood. But vitamin D is needed to convert the calcium we take into the body into action or to be incorporated into the bones. Vitamin D is not found in normal foods. For this, vitamin D can be taken in the form of supplements with the advice of a doctor.

Does taking calcium supplements increase the risk of kidney stones?

Many people don't take calcium despite doctors recommending it. They think that eating too much calcium can lead to kidney stones. They have the correct interpretation of this concept. Basically, we eat calcium-rich foods to meet our calcium needs. After calcium enters the body, it has to bind with oxalate to reach the kidneys. So if we consume oxalate-free foods among the calcium-rich foods we eat, there is no risk of kidney stones.

It is best to avoid excessive consumption of foods rich in calcium oxalate such as nuts, beets, chocolate soymilk etc. However, it is not the case that they cannot be eaten at all. There is no harm in playing with moderate intervals. And the calcium that doctors give in the form of supplements usually does not contain calcium rich in calcium oxalate. Because of this, the risk of kidney stones is greatly reduced. Therefore, if you refrain from taking calcium as you wish from the store without the doctor's advice, the fear of kidney stones due to excess calcium intake will decrease.

Foods rich in calcium
Calcium is an essential element for bones. Under normal circumstances, adults need 800 mg of calcium per day. For this, experts recommend eating a balanced diet every day. Milk, cheese and other dairy products, yogurt, soymilk, green leafy vegetables such as broccoli, cabbage and okra, soybeans, various types of fish and oranges are excellent sources of calcium.

Important Advice
As bone loss is a normal process in our body, it is not unusual for many people to suffer from this bone loss problem as they age. But a few things are very important if someone is suffering from excessive bone loss or osteoporosis.

Shoes or sneakers should be used for normal walking.
To be safe from falling, the bathroom should be kept clean and the movement areas in the house should be kept clean and non-slippery.
Avoid moving in high and low places.
Abnormally leaning or bending the body should be avoided.
A comfortable vehicle should be used for long distance travel. It is better to have a helper with the patient when using public transport.
Author : MBBS, BCS, MD, FIPM (India)
Consultant & Pain Specialist
Bangabandhu Sheikh Mujib Medical College & Hospital, Faridpur