STRONG BONES, STRONGER LIVES
Dr Tanya van der Made, a specialist endocrinologist based in Ballito, explains the importance of bone health and its connection to the endocrine system.
An endocrinologist’s training allows us to “connect the dots” of numerous investigations to arrive at a diagnosis. It’s a time-intensive process but rewarding, as it allows us to track changes over time and intervene, when necessary, while preserving the body’s natural, healthy endocrine system.
Bone health is a prime example of this intricate balance. Bone is a dynamic organ, continuously breaking down and rebuilding itself at a microscopic level. It’s not static, and it needs to be respected. Neglecting this can lead to dire consequences, such as atypical fractures that occur when bone density improves without corresponding strength. This often happens when patients on oral bisphosphonate medications are not adequately monitored.
What is osteoporosis?
Osteoporosis, a silent yet debilitating condition, affects millions worldwide, compromising bone strength and significantly increasing the risk of fractures. When the balance of bone formation is disrupted, bones lose their density and strength, becoming susceptible to fractures.
Osteoporosis is not restricted to older women, as is often assumed. Men and younger individuals are also at risk, particularly those with underlying chronic conditions, hormonal imbalances, or specific lifestyle factors.
The primary causes of osteoporosis are multifaceted. Aging and hormonal changes, especially reduced oestrogen levels after menopause, are well-recognised contributors. However, other conditions, including diabetes, thyroid dysfunction, and long-term corticosteroid use for conditions like asthma or rheumatoid arthritis, can also accelerate bone loss. A condition called hyperparathyroidism is often missed and it is caused by overactivity of the parathyroid gland causing calcium to leach out of your bones and increased calcium levels in the blood. This is an important secondary cause to exclude as a cause of osteoporosis. Family history, smoking, excessive alcohol consumption, and insufficient physical activity further exacerbate the risk and ongoing deterioration
of bone.
Identifying risk factors early and conducting regular screenings can help prevent fractures and even save lives.
Preventing and treating osteoporosis
Prevention starts with a healthy lifestyle. Adequate calcium and vitamin D intake, regular weight-bearing exercise, and avoiding smoking and excessive alcohol consumption are key. For those already diagnosed, there are numerous treatments available. These range from medications that slow bone loss, to those that actively rebuild bone. It’s a misconception that osteoporosis cannot be treated – there are many effective options to discuss with your doctor.
I advocate for proactive community care and early diagnosis. Anyone over the age of 50 should consider a bone density scan and, if at risk, follow up every 18–24 months. Persistent back or hip pain should also be a red flag for potential bone health issues and warrants investigation.
Treatment options for osteoporosis have advanced significantly in recent years. Medications such as bisphosphonates and denosumab work to slow bone loss, while anabolic agents like teriparatide stimulate bone formation. Hormonal therapies may also be appropriate in select cases. However, these treatments must be tailored to the individual, taking into account their medical history, risk factors, and overall health.
As an endocrinologist, my role in managing osteoporosis extends beyond prescribing medications.
Community engagement and success stories
My favourite success story recently has been organising the “Wiggle Your Bones” run, which had over 66 participants, including some four-legged furry friends. The event aimed to raise awareness about bone health while encouraging physical activity – a key component of osteoporosis prevention.
Community engagement is crucial because too often, people suffer in silence. By sharing knowledge and fostering open conversations, we can empower individuals to take charge of their health and ensure that osteoporosis is detected and managed effectively.
My aim was simply to get people to talk about osteoporosis and raise awareness. This was done with support from NOFSA (National Osteoporosis Foundation of South Africa) who have their main event in Cape Town.
Let’s challenge the misconceptions and work together to prevent fractures and improve bone health across all ages. Remember, it’s never too early – or too late – to take care of your bones.
Details: www.kznendo.co.za; 087 354 9024; endoInbox@gmail.com
