To think osteoporosis is shockingly sidelined by healthcare professionals in the UK

[Pavementworrier]

My mum was recently diagnosed. That in itself isn't such a shock - the bigger shock was that the treatments available are pretty limited with potentially significant side effects. And now I think about it there are things we should all be thinking about to try to limit our own risks. It's easy to forget when young that strength starts with our bones.

More than half of women in the UK will have an osteoporotic fracture and there is risk even if you never have vitamin d deficiency (which almost all of us will at some point). Some medication and food/drinks can put you more at risk but this is never taken into account in prescribing.

Reading today about the plan to give puberty blockers to 200 kids and then follow them for four years. Four years is not enough - osteoporosis is a huge risk of adjusting adolescent hormones and the people conducting the study have a duty to the children for the rest of their lives. What measures will be taken to monitor and protect their future skeletons? I bet none.

Anyway if you are reading this, however old you are, please think about vitamin d supplements, regular exercise and strength training and taking a dexa scan in your forties.

HRT supposedly offers great protection - I am 44 now and not sure when to start for best effect. My periods are irregular but otherwise I feel fine. Would be great if someone would start taking this disease seriously and work out the optimal starting moment!

K2 can be brutal on the stomach. I tried it and ended up with severe gastritis.

Ha ha, yes. I lost five stone of muscle and bone on Mounjaro, and now I'm just a puddle.

OP, I think osteoporosis is quite well known about for women? Ask a thirty year old about the benefits of load bearing exercise.

I only did 10 months of meds (alendronic acid) as I then started to get side effects and couldn't take the other prescriptions offered by the GP. I was referred to the hospital presumably for other options but by the time I got my appointment I had had another Dexa which showed improvement so haven't had to go back on medication (for now).

When i got my diagnosis I started strength training twice a week, focusing on weighted squats and lunges and other moves using dumbells. Have done this for nearly 4 years now - I definitely ignored the advice of the osteo nurse to only use resistance bands (if I had done this I am sure I wouldn't have improved my scores so much).

I haven't really done much diet wise apart from taking vit d, making sure I get enough calcium and protein. Haven't heard anything about reducing protein- surely that's not good for developing muscles?

There are lots of good fb sites about osteoporosis- I like Strong Bones and Brickhouse Bones - lots of inspiration about exercises . And the Liftmor study which has been mentioned here has also been a source of inspiration.

@Greenship Haven't heard anything about reducing protein- surely that's not good for developing muscles?

Increasing protein! I was told that a woman with osteoporosis should increase protein intake compared with someone without.

Yes that's what I thought- I was referring to the poster I quoted who had mentioned reducing protein, but maybe that was a typo. I have tried to increase protein where possible.

Not a typo. It is super complex. Proteins get a free pass, worse, proteins do not get a safe limit when talking about anything. Right now there is a trend of more and more proteins to the point people are taking shakes to reach a protein goal made up based on an internet page or post.
Excess protein without the minerals or without the proper exercise will increase bone loss, not bone formation.

"Data suggested that, at high levels of dietary protein, at least a portion of the increase in urinary calcium reflected increased bone resorption [10]. Additionally, subjects on a low-carbohydrate high-protein (LCHP) diet for 6 weeks had increased urinary calcium levels, decreased calcium balance, and decreased serum osteocalcin concentrations [11]. In a prospective study, protein was associated with an increased risk of forearm fracture for women who consumed more than 95 g per day compared with those who consumed less than 68 g per day. Women who consumed five or more servings of red meat per week also had a significantly increased risk of forearm fracture compared with women who ate red meat less than once per week [12] … n another study the relationship of animal protein rich diet to calcium metabolism was investigated during a 12-day dietary period. An increase in urinary calcium excretion was found indicating that the animal protein-induced calciuric response could be a risk factor for the development of osteoporosis [16]. ”
https://pmc.ncbi.nlm.nih.gov/articles/PMC4045293/

I am talking about excess.

thanks @Greenship!

I read an article that talked about high protein diets causing calcium to be lost in urine because amino acids are metabolized into acids that the body buffers with calcium. It was linked to a book that discussed the highest rates of hip fractures are in western countries were our diets are higher in calcium and protein than countries such as asia that as less protein and dairy heavy and where there is not an osteoporosis epidemic that we are facing here .. I imagine it is a lot more nuanced than that but it was interesting read ..

I have been weight training and taking Vit D for years and have a high protein diet so was wondering this this had caused my Osteo but I think more likely an unmedicated menopause and sedentary youth ,,

Edited to say thanks to ILoveDuckDuckGo for the additional info

@W0tnowthanks that makes sense

Reading all this with interest, I have been given a terrible T score and I suppose I remain partly in denial of how serious it might be....
Im hoping that fish (tinned sardines bones and all) is better overall than red meat, which I don't eat all that much of. Though I alao consume a lot of dairy (mainly low fat yoghurt) and now worrying about that 😬. It's so hard to retain a sense of proportion isn't it? 😭

I take a drug post-bc that can cause osteoporosis, but I was informed of that fact as soon as I started taking it. I was advised to eat 30 different fruit & veg a week and to take four hours of vigorous exercise a week (I run, swim & cycle), to ensure I promote healthy bone growth.

I've taken responsibility for that, and recently had a four-yearly scan that showed no bone deterioration.

None of the advice is a secret. There is plenty of material detailing what is needed. As the NHS is stretched thinner, we have to take ownership of our health more.

The swimming and cycling won’t promote bone growth, because they are non-weight bearing.

None of the advice is a secret. There is plenty of material detailing what is needed. As the NHS is stretched thinner, we have to take ownership of our health more.

I've taken ownership of my own health all my life. Good diet, lots of weight bearing and strength exercise. But I was born tall with bones so thin I could fasten a child's watch around my ankle and have to cut the excess off the strap to wear one on my wrist, I had an easy menopause with no justification for an HRT prescription and I have an autoimmune condition that causes osteoporosis that is none of my own fault.

People like me with known risk factors should be being offered scans automatically, yet I was refused one when I asked for it.

It's really a no brainer for the NHS, a scan will cost them a few tens of pounds. A broken hip will cost a lot more even if they don't result in a hip replacement, which many do. It has to be cost effective over time, surely?

But running and certainly not swimming will not be anywhere near as effective (I’m not sure about cycling, but I don’t think so). It’s great that there is no bone deterioration, but there are other much more effective exercises that you should have been advised to do.

I was also refused a bone scan when I asked. Lots of known risk factors including auto immune condition, steroids, history of breast cancer and a massive family history.
I got the dexa scan eventually and it revealed osteoporosis.
I live in a bit of a backwater as far as NHS services go. Postcode lottery.

Also, eat your prunes!

https://pubmed.ncbi.nlm.nih.gov/35798020/

yeah fair enough maybe hasn't a clue.
Just sounded like OP knew a place osteoP wasn't sidelined in way OP deplores.

I was diagnosed at your age. I take alendronic acid, which is a necessary evil. Apart from dexa scans every three years there is no mention of it from any of the consultants I see..

"None of the advice is a secret. There is plenty of material detailing what is needed. As the NHS is stretched thinner, we have to take ownership of our health more."

Utter nonsense! There is plenty of material about a variety of conditions. The data changes all the time as more scientific proof becomes available.
We are not medically trained, the vast majority of population.
I like to think I'm not an idiot but I don't know there is a potential issue from thin air. It would take me a long time to understand what I need to find out and what is a reliable source of information.
There has to be a point where we actually expect good reliable regularly updated information available through official channels.
Plenty of posts on here showing PPs have been dismissed by GPs, consultants and nurses.
Clearly there is an issue with training some of these professionals and making sure their knowledge is up to date. If they don't know, who do we ask?
We might as well go back to the olden days when the village 'wise woman' treated everyone.
It would benefit the NHS if the population at large were better informed about preventive care. Starting in your 20s. This when you can actively take ownership and start looking after your bones health and you apply that knowledge to raising your children and the cycle continues.
There is a big problem in this country with knowledge about health. Signposting as a minimum. Sharing knowledge. That sort of thing. Anyone can google but what do we need to google and how do we know if the answers are correct? That's no way to become well informed.

Oh I had a dexa scan and was told I was top 5. I’m on hrt - I wondered if you are too? I really do fear about oesteoporisis as 1 in 2 women over 50 will have a oesteoporisis related fracture at some point. That’s a terrifying statistic…

I have severe osteoporosis caused by a disease called primary hyperparathyroidism. It's the third most common endocrine disease after diabetes and thyroid dysfunction. A simple blood test to check your blood calcium level can detect it. It is the only disease which can be cured by having the overactive parathyroid gland or glands removed. Then the osteoporosis starts reversing as the calcium is no longer being pulled out of the bones into the blood.

@Branster
I completely agree.

I had no idea about this disease. Why would I? Same way no one ever mentioned menopause until I heard about it in my 40s.

I had two children by forceps and no one ever said the word 'prolapse' to me, it's only when I was diagnosed with three prolapses age 44 did I learn about them. No one ever said, don't get constipated, don't push your wee out too fast. Don't hold your breath when you lift heavy things.

And this thread is enlightening and I've learned so much.

When I asked the asthma GP (my post is up thread) after she finished laughing at me, she said do you take vitamin D and I said I had just started taking it - age 46, and that I lift weights. She said 'oh you'll be fine then'.

I also discovered I'm hypermobile last year. And yesterday, googling showed me that hypermobility has a greater risk of osteoperosis. So now I really do need to find the money for a dexa scan!

Has anyone managed to get one via private healthcare?

My blood calcium levels are totally normal, tested for other reasons twice this year, but I still have severe osteoporosis in my spine.

any medication that reduces inflammation (including over the counter painkillers) and reduces nutrition absobtion (anti reflux medication) should have the long term risk to bones advised.

not everyone can avoid taking these medicines though.

exercise exercise exercise
weight training is something everyone should do in some form.

You can find lots of weight routines on YouTube. I set up my iPad, and just follow what they’re doing on screen.

The OP makes good points, both about osteoporosis and the long term effects of medications or the lack of them. In the UK everyone would benefit from vit D3 daily for at least the six darker months.