THE attention-grabbing title was intentional if just to emphasize and to declare to all and sundry that it is not only women who would suffer from osteoporosis but also men. While it is true that osteoporosis occurs much earlier in women-usually post-menopausal or after they have stopped menstruating- meaning the ovarian production of the female hormone estrogen has stopped (55-years- old on the average) men when they go into their 60s run the risk of fractures from brittle bones, which is part and parcel of the so-called andropause stage, due to significant decrease in the male hormone testosterone.
At this juncture, it is important that a basic understanding of bone be established so that its abnormality can be more easily connected with its signs and symptoms. Bone is a dense connective tissue, composed of the so-called inorganic component- mostly calcium phosphate salts which give our bones its solidity, hardness, and strength. The organic component is made of complex carbohydrates called mucoplysaccharides and a lot of proteins mostly collagen which impart into the bone- especially among children and teens- its moldability, elasticity, which explains while falls among children do not usually lead to fractures and if fractures occur, healing and formation of scar tissue called callus is much faster among the young compared to adults.
The core of bone is due to activity of bone cells called osteoblast which secrete the substance and materials that make the bone strong as they mature into their adult form osteocyte. During active bone formation - childhood to adolescence- another bone cell called osteoclast participates in trimming off excess bone growths so that when the person steps into young adult - 20s - the finished product is a smooth-surfaced, strong and sturdy bone. Then hormones come into play. Parathormone from the parathyroid glands start mobilizing calcium from the bone to the blood making sure that at any time, the serum calcium level should be 9-11 mg to make sure that there is normal nerve impulse conduction, the blood clots after a cut is made and that the muscles contract effectively. Another hormone, calcitonin from the thyroid brings back whatever excess calcium in the blood into the bone. This process of calcium removal and calcium deposition is involved in the so-called remodeling process of the bone. However, by the time the person reaches 35 years and older, the resorptive process or demineralization or removal of calcium salts from the bone gets the upper hand but the signs and symptoms are not manifested yet because by then the woman's ovary still produces estrogen- which is bone-sustaining so to speak- and of course the testosterone production of the man is still at its peak.
As earlier said, 55-years-old women, 65-years-old men may now face the risk of osteoporosis, in which a simple slip can easily fracture a bone causing long standing pain, loss of independence, decreased quality of life and significant reduction in ADL or activity of daily life. Due to pain , a lot of patients are wheelchair bound or worse, in hospital beds with one arm or leg slung up to a Balkan frame, obviously interfering with their normal urination and defecation.
All over the world, we have more and more senior citizens and elderlies, thus osteoporosis is a reality and must be managed appropriately and aggressively. It's not enough that we take drink our milk, and take our calcium supplements. Standout against osteoporosis, and if we may add, standout with your back straight, against osteoporosis.
With bisphosponates. These are drugs which help maintain the integrity of adult bones by inhibiting the activity of osteoclast, thus decreasing the removal of mineral salts, calcium phosphate salts from the bones. There are several in the market, taken daily or weekly like Alendronate, Risedronate and there are also bisphosphonates taken monthly and even once a year. However, from the experience and observation of your columnist, the once-weekly dosing has become a more convenient and accepted frequency of drug intake.
For example, let's take Alendra, which is a popular trade name of Alendronate, taken once a week on the day chosen by the patient herself/himself. It comes in 70 mg strength taken at least 30 minute BEFORE the first food in the morning- breakfast with a glass of water after which the patient maintains upright position- either sitting straight or standing to allow the medicine to go straight to the stomach, thus reducing irritation of the esophagus. If for some reasons, the patient missed a dose, take the tablet the next day then resume on same weekly schedule. Do not take two tablets at the same time. By the ways, bisphosphonates are swallowed whole, not chewed.
So to our dear readers and friends who are already enjoying Senior citizens discounts and all because of our silver hairs, let’s take care of our bones and walk with straight backs into the glorious sunset of our lives.