Osteoporosis: Symptoms, Calcium Needs and Treatment

Many people only learn they have weak bones when they break one. A woman slips on a wet floor and fractures her wrist, or an older man cracks a bone in his back just by lifting a bucket. Osteoporosis builds up silently over years, but it is preventable and treatable, and what you do in your thirties and forties matters as much as what you do later.

What is osteoporosis?

Bones are living tissue that is constantly broken down and rebuilt. Until around the age of 30 you build more bone than you lose. After that the balance slowly shifts, and in women it speeds up after menopause when oestrogen falls. In osteoporosis the bones become thin and porous and break easily, most often in the hip, spine and wrist.

Osteoporosis symptoms

There are usually no symptoms until a fracture happens. Warning signs that come later include:

• A fracture after a minor fall or bump
• Gradual loss of height
• A stooped or rounded upper back
• Sudden back pain from a small crack in a spine bone

Who is at risk?

• Women after menopause, and anyone with early menopause
• Age above 50, and a family history of hip fracture
• Low calcium and vitamin D deficiency, which is very common in Pakistan, even in sunny cities, because of covered clothing, indoor lifestyles and diet
• A small, thin body build
• Smoking, and heavy tea, cola or alcohol intake
• Long-term steroid use, and conditions such as an overactive or underactive thyroid, diabetes and kidney disease
• Little physical activity

How is it diagnosed?

The standard test is a bone density scan, called DEXA. It gives a T-score. A score of -2.5 or lower means osteoporosis, and scores between -1 and -2.5 mean low bone mass. Your doctor may also check calcium, vitamin D, thyroid and kidney tests.

How to keep your bones strong

• Calcium: adults need roughly 1,000 mg a day, and women over 50 about 1,200 mg, from food first. Good sources are milk, yoghurt (dahi), paneer, cheese, sesame seeds (til), almonds, daal and leafy greens. A glass of milk has about 300 mg.
• Vitamin D: get some safe sun exposure on your arms and face, and ask your doctor to check your level. Many people need a supplement.
• Exercise: weight-bearing activity such as brisk walking, stair climbing and light strength training builds bone.
• Protein: include eggs, daal, chicken, fish and dairy at meals.
• Quit smoking and keep tea, cola and alcohol moderate.
• Prevent falls: remove loose rugs, keep floors dry, use good lighting, wear non-slip footwear, and have your eyes tested.

Medicines for osteoporosis

If the scan shows osteoporosis, or your fracture risk is high, your doctor may prescribe a bone-strengthening medicine along with calcium and vitamin D:

• Bisphosphonates such as alendronate and risedronate, taken by mouth, or zoledronic acid given as a yearly drip. They slow bone loss.
• Raloxifene, which acts like oestrogen on bones in postmenopausal women.
• Injectable medicines for severe osteoporosis, chosen by a specialist.

Oral bisphosphonates must be taken exactly as instructed: first thing in the morning on an empty stomach with a full glass of plain water, staying upright for at least 30 minutes, to protect the food pipe. Treatment usually continues for several years, and your doctor will review it. Tell your dentist you are taking them before dental surgery.

When to see a doctor

• You have broken a bone after a minor fall
• You are a woman over 50 or a man over 65 with risk factors
• You are losing height or developing a stooped back
• You take steroid tablets for a long time

Key takeaways

• Osteoporosis causes no symptoms until a bone breaks, so prevention and testing matter.
• Calcium, vitamin D, exercise and not smoking protect your bones at every age.
• A DEXA scan diagnoses it, and medicines can reduce fracture risk.
• Take bisphosphonates exactly as directed.

Related medicines on Medimart

These are commonly used to build and protect bones:

• Calcium with vitamin D3: supports bone strength
• Vitamin D3: corrects low vitamin D
• Alendronate: a bisphosphonate that slows bone loss
• Risedronate: another bisphosphonate
• Raloxifene: a bone-protecting medicine for postmenopausal women
• Zoledronic acid: given as an infusion, usually once a year

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Browse osteoporosis medicines and supplements on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from a doctor. Please discuss a bone density test with your doctor if you are at risk.