A stitch in time saves nine



Osteoporosis is a silent disease that causes weaker bones, leading to fractures. The word ‘osteoporosis’ means ‘porous bone’.

Generally, we do not find out that we have a health problem till irreversible damage is done to human body, and the same is true for osteoporosis, the silent bone disease affecting millions of people in the world, and leading to an estimated nine million fractures in a year. It is unfortunate that a fracture that can lead to disability and suffering, could have been prevented by a simple test and preventative measures.

Young women, who make half the population of the world, give birth, nurture and work hard in their lives to be a role model for their families. Sadly, when they get older, they are generally left behind, specially in the society like ours which is patriarchal, and where men take precedence over most of the things, including healthcare.

We have heard all our lives that, “prevention is better than cure”, and that is why we stress on improving our cholesterol and eat healthy so we do not get diabetes, but nobody has made us aware of what we can do to maintain healthy bones. Creating mass awareness of issues like breast cancer and osteoporosis is a challenge as these conditions mostly affect women, and takes a more persistent voice to be heard in society.

Bones – at all times – are in a state of forming new bone and removing old and fragile bone. This process remains in balance and bone strength is maintained till both men and women reach a certain age when the hormones like estrogen and testosterone drops in the body leading to less bone formation and more destruction of bone, resulting in fragile bones. Fragile bones are not capable of sustaining any stress and sometimes even a small stress like excessive coughing or sneezing can lead to a compression fracture of the vertebra. There is no cure for osteoporosis, but with treatment, we can help slow the breakdown of bone in your body, and some treatments can spur the growth of new bone.

According to recent statistics from the International Osteoporosis Foundation, worldwide, approximately, one out of every three women will experience an osteoporotic fracture in her lifetime after the age of 50 and one of the five men will have the same level of threat of experiencing a fragility fracture secondary to osteoporosis.

Life expectancy is increasing in the world and same is true for Pakistan; we are seeing more and more 70- and 80-years old people in our society. It is our responsibility that we should be able to maintain not only the number of years of human life but also maintain a good quality of life.

Most osteoporosis fractures come as a surprise; frequent places to get an osteoporotic fracture are wrist, hip and backbone. Research has shown that 25 percent of people with hip fractures, especially in men, lose their lives due to medical and surgical complications.

Women tend to have more vertebral fractures, leading to deformities in the back, shortening of the height and disabling posture with chronic pain. Patients get a bent-over posture. It sometimes gets difficult even to change clothes and have proper digestion of food, due to stomach being pressed by crushed vertebra.

So what can be done to prevent all this?

Do you know that 80 percent of the fractures could have been prevented only if you knew more about proper nutrition, bone health, testing done at the right time and getting appropriate treatment by a qualified rheumatologist/clinician? Your rheumatologist/clinician plan to prevent or to treat osteoporosis; novel treatments are available which can be taken on weekly, monthly, half-yearly or yearly basis, depending on the patient’s disease condition.

So let us all promise ourselves to take care of ourselves and our families and not be totally lost in our daily race of making a living and our daily routines. Remember, getting weaker bones is a part of aging process just like getting gray hair on your scalp; men and women both suffer from this disease, so both need to take care of their bone health.


Women under the age of 50 require 1000 mg calcium daily

Women 50 or older require 1200 mg of calcium daily.

Diet rich in sufficient amount of calcium should be taken; one cup of milk or yogurt has about 300 mg of calcium.

Remember you need enough vitamin D in the body to absorb calcium from your stomach, vitamin D levels should be checked as recommended by your rheumatologist/clinician and treated accordingly.


Regular weight bearing exercises should be done like walking or swimming for healthy bones; if you already have osteoporosis, you need to consult your rheumatologist/clinician before starting any exercise. Walking as little as three to five miles a week can help build your bone health. Sedentary life style is a risk factor.

If you have a family history of osteoporosis, check with your rheumatologist/clinician for testing. Avoid smoking and alcohol consumption, avoid carbonated drinks.

All the woman and men above the age of 65 and 70 years respectively should get a bone mineral density test. It is recommended by national osteoporosis foundation that even if you’re of younger age but at high risk due to some diseases or some medications that you have taken in the past, check with your rheumatologist/clinician if you require a bone mineral density test.

Health is the biggest gift of God; it provides us with a sense of security and independence. We need to maintain our bodies so that we do not become dependent on others to take care of us and, to do that, we have to take care of our mental, physical and spiritual health.

Advice for youth

Osteoporosis is most common in older people but it can affect young people, including premenopausal women in their 20s, 30s and 40s. This is generally seen in young people with some medical problems like thyroid disease, Celiac disease or Rheumatoid arthritis, etc.

Young people should take care of their health early so they can attain a peak bone mass. The stronger your bones are in younger age, the slower they will get weaker as a person gets old.

Useful tips for our youth

-Make sure you get enough calcium and Vitamin D

Exercise regularly and choose weight-bearing activities like walking and running.

Do not smoke. Cigarette smoking often starts in adolescence and has a harmful effect on reaching peak bone mass.

Don’t drink alcohol; it has plenty of unhealthy effects on our bones and our body.

Live a healthy life when you are young, do good for others and good will come to you

Stay happy and stay well.

Dr. Saliha Ishaq is:

Diplomate American Board of Internal Medicine

Diplomate American Board of Rheumatology

Consultant Rheumatologist


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