Dr. Arvind
Dubey
Decreasing
bone density
is a very important and
very common health hazard of women after
forty-forty five years of age. It is painful and crippling. This is called,
"OSTEOPOROSIS" or "POROUS BONES" which is never considered a disease but a normal routine for women
or as a discredit of being a woman, especially in rural India .
Why should
you at all
fear osteoporosis?
Besides a painful and crippling condition, chances of bone
fractures increase considerably in osteoporosis. Even a minor fall or a
vigorous hug may Cause a fractured bone which heals very slowly or some times
not at all or with long term disability and accelerated death rate. It causes marked changes in posture as
humped back is considered a stereotype
of ageing especially in our country. Deformed skeletal framework pushes or
shifts various organs result into a spectrum of difficulties ranging from
constipation to breathing problems. There may be chronic low backache,
restlessness, arthritis, and leg cramps etcetera.
Cause of
the problem
What you are suffering
today is the culmination of slow process started decades back. We usually
visualize bone as a solid rigid inactive mass but in fact it is an active
living tissue, constantly being recycled. Inner part of bone always breaks down
and outer surface is always in the process of reformation. The delicate balance
of these two processes in response to the demand of the body, which is
maintained in the youth, becomes disturbed. More calcium is withdrawn from the
bones than deposited and these become soft and weak. Actual cause of this
misbalance is not known.
It may be hormones, a genetic predisposition, nutrition, physical activity,
life style factors or probably all in combination.
Bone loss wit advanced age occurs due to changes in a woman's hormone levels.
Image Courtsey- Wikipedia
Image Courtsey- Wikipedia
Female
hormone, oestrogen, may be cited as a cause because when its production stops
due to ovarian atrophy, the process enhances. In nutrition Calcium and vitamin
D,
C & E deficiencies
have been blamed as even in a healthy adult deficiency of these can cause
osteoporosis
Who is at
risk?
Any one who is having the
fo1lowing may be at the risk of developing speedy osteoporosis. Judge yourself
over these 1ines-
- Any member of your family had or
having bone disease?
- Are you short stature and thin
built?
- Are you fair skinned?
- Have your ovaries been removed
before 45 years
of age?
- Are you childless?
- Have you been confined to bed for
a longer period?
- Are you having diabetes, kidney or
liver disease?
- Are you having an under active
thyroid?
- Are you sedentary?
- Do you smoke?
- Do you diet or fast frequently?
If your answer for any one of the above questions is yes then you are
at the risk of developing osteoporosis.
What
to do?
However
you may sufficiently delay it and decrease its intensity but how? Read further
and follow it in your life.
Take extra calcium in your diet: Calcium is essential to bone health.
The daily allowance of calcium for a woman prior to menopause is 1000 milligrams per day and after
menopause is around 1,500 milligrams
per day. Take plenty of dairy products, turnips, fish (especially those which
are eaten with bone), dates etc. Ragi is
a very good source of calcium. This can be taken into CHAPATI or in some
other form. Calcium supplementation in the form of medicinal preparations may
be cheap and desirable alternative to many of the women. Take about 1 to 1.5 grams of elemental
calcium per day (according to your menopausal status) and at least 50,000
units of vitamin D per week. This vitamin D will help you in depositing this
calcium in the bone
properly. As proper ratio of calcium to phosphates affects the amount of
calcium absorbed by bones. So reduce your intake of high phosphate food
drastically, namely all processed or canned meat, processed cheese, instant
soups, puddings, pastries and soft drinks. For adequate absorption and
metabolism of calcium, you
will
need vitamin C and
magnesium. The whole business may look to you rather confusing, so it’s better
to consult your doctor for it.
Change your life style: The speed with which your bones break down
depends on the way you treat your body. These are few recommendations
for change in your life style-
·
Remain active as inactivity increases bone
breakdown. Even after fracture, start moving as early as permitted by your doctor.
·
Cut
down intake of meat in your diet as it has been seen that heavy meat eaters have
twice more chances of developing osteoporosis than vegetarians. Eat more
cereals, grains, beans, vegetables, nuts etc.
·
Avoid
foods containing excess fats (optimum amount of fat intake is necessary- beware
of slimming courses which
insist on non-fat milk). So avoid saturated fats which are solid at room
temperature viz. ghee, butter, lard and some vegetable oils such as coconut or
palm oil.
·
Minimize
your intake of concentrated sugars which produce acidity in the blood and
consequently more calcium Comes out of bones.
·
Reduce
intake of foods with high
phosphate concentration (see above)
·
Stop
smoking and boozing as both of these reduce amount of “Oestrogen” in blood so
enhances bone dissolution.
·
Limit
intake of coffee and tae.
Make exercise a routine: Like muscles bones grow stronger with
use. Bone density in
well nourished women depends directly on how much the bone is stressed. Though
exercise should be started earlier but it’s never too late. No matter how old
you are, exercise can strengthen your bones. The best exercise for bone
strengthening are those that put a load or stress on your bones such as
jogging, aerobic dances, skipping roaps or brisk walking. Simple dancing or
swimming can be a good exercise. To get full benefit exercise should be done for 20 to 30
minutes at a pace fast enough to accelerate your pulse rate moderately. While
exercising, beware it should not be over done because if overdone the exercise
may increase bone destruction at the place of
its formation.
Beware of self medication: Steroids (used erroneously for
increasing muscle bulk and almost always present in magic or so called “rapid
cure preparations” of nonqualified quacks) intake results in severe blood loss
bone loss. So please do not go for magic
pills. Drugs for acidity (antacid) which especially contain Aluminum in them,
may contribute to osteoporosis, when taken regularly. The drugs for
hypertension which increase amount of urine, increase bone
destruction or calcium removal in urine. So when you are on above said drugs take calcium and vit. D
supplementation and consult your doctor on this point too.
CAN HORMONAL THERAPY
BE AN ANSWER?
Bone
resorption hastens as your ovaries are nonfunctional and you do not have its
hormones. So it is very likely
to be concluded that these hormones, especially Oestrogen might be a protector
of the bone. But it is still debatable. It has been claimed that Oestrogen
though decreases bone dissolution but it does not increase bone formation, which eventually usually
decreases. As therapy is withdrawn
the bone loss resumes. Simultaneously it places a woman at the risk of Cancer of uterus, breast &
liver, high blood pressure, gall bladder disease, diabetes
etc. So this hormone replacement therapy is not a desirable alternative for
women with a family history
of uterine
or breast cancer, diabetes,
liver diseases, gall bladder stones,
migraine and uterine tumors.
It does not mean that no
women should take
Oesrogen even if she is a high risk candidate for osteoporosis. Current researches suggest that
when the Oestrogen is taken in combination with another hormone called
progesterone (this combination is found in almost all the faintly planning
pills); risk of the cancer is
reduced.
But in any case this
therapy should be started and
continued under strict medical
supervision.
So do not long for a magic
pill for your day to day aches and pains due to osteoporosis which you can take
at bedtime and on next fine morning find yourself cured. You have to Change a lot in your nutrition,
your life style etcetera
but choose the way you can pursue life long, not that which you can tolerate as
a discomfort for
a short period.
Good educative blog -please keep posting!
ReplyDeleteThanks
Delete