Osteoporosis

There are many degenerative processes that happen with age in the body, with no symptoms at all in the initial stages - osteoporosis is one of them, progressive bone loss. Correct intervention in the early stages could help you avoid pain and fractures later. Therefore sharing this information. 😊

If  you are a woman past 45, OR have a family history of multiple fractures, you may want to talk to your GP and consider getting a bone density scan done, if they advise it for you. This is a non-invasive easy procedure that most  labs do, takes 10-15 mins. 

Post Covid/the Covid vaccine, many women seem to be hitting menopause earlier, in their early 40s - so bone loss is also happening earlier. 

Note: You may have great Calcium and Vit D levels, you may be super-active, super-healthy, into sports and fitness, all your health checkup numbers may be fantastic, and no aches or pains - but you could STILL have osteopenia (the first stage of bone loss) or osteoporosis itself.  Because of menopause (see below for explanation) or other reasons. Genetics also plays a huge part - if your mother/women in your family have had bone issues, that is an indicator. This raises your risk of fractures. 

Long term used of medicines like steroids are also known to cause bone density loss.

Bone density peaks in your mid-30s. After that you start losing it. So the earlier you start on good load-bearing exercises, the better. Walking alone is not enough. The best gift you could give your adult daughters could be a gym membership, for strength training.😃 Could save them from pain and fractures later. 

Note: You cannot get back bone that is lost. You can only try and reduce the possibility of fracture by stimulating bone growth or reducing bone loss. Some of them are habits that you could build up, like the correct exercise. 

Things that could help delay bone loss/ prevent fractures

• Strength Training: This is the most important thing for your bones, not just for your muscles. Specific training targeted towards loading the bones could stimulate bone growth. Exercises that help improve balance could prevent falls. A good trainer should be able to design this for you. Just regular exercises may not be enough - they need to be targeted for bone loss and balance. 
• These do not need fancy equipment - you can learn simple body-weight or resistance band exercises.
• Walking and yoga may not be enough to build muscle and bone in the right places, especially after 40.
• Balance Training: Calling this out separately because this is super-critical. There are loads of simple exercises for this. Preventing falls as much as possible is important.
• Note: Show your bone density scan reports to your trainer BEFORE you start training if you already have bone loss. So they know what to avoid and where to focus on. (See section below). For example, if you have bone loss in your lumbar spine, you need  to strengthen the area, while avoiding certain exercises. And also make lifestyle changes - ensuring you don't bend forward and pick up heavy weights, for example. 
• Do not try to do online exercises without supervision if you already have bone loss - you could break something. Always get a trainer. Places like SPARRC will insist on medical reports after a certain age. 
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• Diet: A diet rich in natural sources of Calcium, Vit D, Magnesium, Protein, fiber etc. (speak to a nutritionist to see what your body needs - with your blood reports). 
• Protein is very important to prevent muscle loss, and fibre for gut health. 
• Keep in mind that if your gut is not balanced and absorption is poor, whatever you are eating/whatever supplements you are having, will not help. So you may want to fix that first. Gut resets/ayurvedic treatments etc are known to help.  
• Fix issues like inflammation, with a good nutritionist.
• Supplements: May or may not help. If a doctor sees the beginning of bone loss, they may put you on supplements for a year, and then decide on medication if the bone loss is still very rapid. 
• Reducing Stress: Stress can also make things worse, accelerate bone loss and other types of damage in the body. All diseases should be treated holistically - the body is an interconnected system. 
• Medicines: If your bone loss is sufficiently advanced the doctor will advise medication. It is entirely up to you to do your own research and decide whether you want to take it. Medication won't help you get back lost bone mass. It is supposed to only reduce further bone loss and lower your fracture risk. 
• IF you decide to take medication, they help you choose between the available types of treatment, based on your age and general health. 
• Ask about the side effects - and choose what you can live with. 
• All of these medicines will have side effects - therefore the earlier you catch bone loss, the better. You could get away with medicines that have fewer side effects. If you wait too long you no longer have that option.

How does targeted exercise help reduce bone loss? (from MetaAI, confirmed with a doctor)

"Modifying exercise routines based on bone mineral density (BMD) reports can indeed lead to better outcomes for older adults, especially those with bone loss in the lumbar spine area.

Studies suggest that tailored exercise programs can improve BMD, reduce fracture risk, and enhance overall quality of life. For instance, research shows that progressive loading exercises, such as resistance training and impact exercises, can stimulate bone growth and improve BMD in individuals with osteoporosis or osteopenia.

Weight-bearing exercises, like walking, stair climbing, and squats, are also beneficial as they apply mechanical loads that stimulate bone remodeling. Additionally, exercises that improve balance, flexibility, and posture, such as mind-body exercises (e.g., tai chi), can reduce fall risk and fractures.

The American College of Sports Medicine (ACSM) recommends exercise interventions with high adherence to guidelines for optimal BMD improvements. A systematic review found that exercises with high ACSM adherence led to greater improvements in lumbar spine and femoral neck BMD." 

Tip: ChatGPT does provide very good advice on the kind of exercises you could do to increase bone growth in the areas where you have maximum bone loss. And it will also tell you what you should not do - IF you provide it the numbers from your scan report, trends in bone loss (previous and latest scans, in a table, with dates) and also give details of your age, gender, other illnesses, family history of fractures etc - basically everything a doctor would consider. My doctor was pretty impressed with its recommendations.

ALWAYS run this past a doctor before you give it to your trainer. And do the exercises under supervision. Find a good reliable place in your neighbourhood. I highly recommend SPARRC, have been going there for years. And they have doctors who decide what exercises you should do. There should be other similar places also in other cities, do ask around. 

Why does bone loss happen?

Bone Resorption (from ChatGPT, confirmed with a doctor)

Bone resorption is the process by which the body breaks down existing bone tissue and releases its minerals (mainly calcium and phosphorus) into the bloodstream.

It is a normal, essential biological process—but it becomes a problem when it outpaces bone formation.

Your bones are not static. They are constantly being renewed through a process called bone remodeling, which has two coordinated phases:

Bone resorption: Specialized cells called osteoclasts dissolve old or damaged bone. Minerals are released into the blood

Bone formation: Different cells called osteoblasts lay down new bone to replace what was removed

Why bone resorption increases after menopause

After menopause, several things shift at once: 

Estrogen normally suppresses osteoclast activity. 

• When estrogen falls, osteoclasts live longer, they remove more bone
• Bone formation cannot keep up

This is why spinal bone loss can accelerate rapidly, even in women who exercise and eat well.