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Well Being: Who suffers from weak bones?

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By Dr Yash Gulati

Osteoporosis is believed to be a disease of the aged. How big a myth is this?
It is a common problem for people above the age of 50 years. The risk of getting the disease increases as the person gets older because bone mass is lost faster than it is created. These days, the disease has been seen in children and adults, too, due to a sedentary lifestyle.

Who are at risk for the disease?
Women and men above the age of 50 years, people who have a family history of the disease and people who are overweight.

How to recognise early signs of the disease?
Some common symptoms are cramps and pain in bone, brittle fingernails and frequent fractures.

Do Vitamin D and calcium supplements work for everyone? What is the general dosage advised?
In a survey carried out in India , about 70% of population was found to be deficient in vitamin D. Vitamin D is very important for the calcium to be carried to the bone for its deposition so that the bones can become strong.

Vitamin D has also been shown to be important in the treatment of osteoporosis. So, while treating osteopenia or osteoporosis, specific drugs for osteoporosis are usually coupled with vitamin D and calcium for better response.

Generally speaking, vitamin D 60,000 units once a week and calcium 500 mg once a day is sufficient for people who are deficient in vitamin D. It is also a myth to say that injectable vitamin D works better than oral vitamin D therapy. Injectable vitamin D is used only when there is some absorption problem in a patient. After a course of vitamin D for three to four months, a maintenance dose of once a month—60,000 units of vitamin D—will suffice.

What kind of screening is advised to check the disease and at what age is this recommended?
Bone mineral density scan or dual-energy X-ray absorptiometry (DXA) is advised to check the disease for all older age women above 65 years of age.

Dr Yash Gulati is senior consultant, orthopaedics, joint replacement & spine, Indraprastha Apollo Hospitals, New Delhi

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