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Osteoporosis. When you don’t nourish your bones, they break.

With ageing comes the ordeal of a progressive weakening of the body. It is a natural process that prepares you to wind up as you close the book of life. The bones are no exception: they begin thinning and lose mineral density: the process we term osteoporosis. During this, bones spontaneously become brittle and fragile: the hallmark is the increased propensity to fracture after a slight fall (minor trauma). However, ageing isn’t the only factor; several other conditions may weaken the bones.

Osteoporosis. When you don’t nourish your bones, they break.

Women develop osteoporosis at greater magnitudes than men – due to menopause – a state of reduced oestrogen levels, a hormone that naturally prevents bone weakening. However, men are likely to die earlier than women when they develop the disorder. People who do not get enough sun exposure are prone to osteoporosis. We believe that approximately 200 million people have osteoporosis. And about 9 million fractures annually are attributable to osteoporosis globally.


A sedentary lifestyle leads to poor health outcomes.

Osteoporosis may either be primary or secondary. Ageing, diseases and drugs cause primary and secondary osteoporosis, respectively.

Diseases include eating disorders (anorexia), chronic kidney disease, hyperthyroidism, hyperparathyroidism, malabsorption, and Cushing’s disease. Any condition that renders a person immobile will weaken the bones: osteoporosis may be the ultimate eventuality.

Excessive exercise, low body weight, and secondary amenorrhoea potentiate loss of bone mineral density. A sedentary lifestyle, smoking, and alcohol abuse also increase the risk.

Glucocorticoids (corticosteroids) and anti-seizure drugs cause secondary osteoporosis. Cancer drugs, antacids (proton pump inhibitors) are suspects, but the evidence is scanty.

As the bones weaken and collapse, you may lose height. You may assume a progressively stooped posture. You may complain of low back and neck pain. We often suspect the problem late because it has no overt symptoms. A fractured wrist, hip, or rib may be the sentinel finding. Osteoporosis involving the backbone (vertebrae) may lead to spine collapse or a fracture. One of the most grievous effects of osteoporosis is a hip fracture. It leads to substantial disability.

Osteoporosis. When you don’t nourish your bones, they break.
Low back pain is a common symptom.

Following a history and physical examination, we will take blood samples to check the levels of calcium and vitamin D. When available: we will measure bone mineral density at crucial points using dual-energy X-ray absorptiometry (DEXA) scans.

We recommend that once a woman reaches menopause, she should screen for osteoporosis. It should also apply to men who are chronically using glucocorticoids.

Drugs to reverse the risk of osteoporosis include bisphosphonates, monoclonal antibodies, and a few selective oestrogen receptor modulators. However, these drugs are not only costly but also carry an array of side effects.

The best shot at managing disorder resides in lifestyle modifications to prevent, slow down, or reverse osteoporosis. They include regular weight-bearing and muscle-strengthening exercises, consuming adequate dietary calcium and vitamin D: smoking cessation and curbing down on alcohol intake.  Minimise the risks of falling.

Detecting osteoporosis promptly – will culminate in the desired outcomes. When untreated, it will reduce the quality of life. A medical check-up will always suffice, especially among those at risk.

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MBChB (MUK), Graduate Fellow, Department of Physiology, Makerere University Founder and Content Creator Peer reviewer, Associate Editor

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