What is Osteoporosis?

Osteoporosis is a condition in which the bones lose density, becoming fragile and brittle. This increases the risk of fracture. There are no obvious symptoms of osteoporosis until a fracture occurs.

Bone density increases through childhood, teenage and young adult years, until peak bone density is reached. Bone is a dynamic substance which is continually being remodelled by bone formation and bone resorption. From the age of about 30, bones start to deteriorate in strength as bone resorption exceeds bone formation. This is a natural part of the ageing process. Women are at greater risk of developing osteoporosis than men. The hormone oestrogen is important for maintaining healthy bones, and when oestrogen levels suddenly decline after menopause, bone resorption occurs at a much faster rate resulting in a decrease in bone density and eventually osteoporosis. Although men lose bone strength at a more gradual rate, they are also at risk of developing osteoporosis.

Other risk factors contributing to osteoporosis are certain medications, smoking, heavy alcohol consumption, a poor diet, a family history of osteoporosis, a lack of exercise, small stature and certain diseases (including coeliac disease).

What is an Osteoporotic Fracture?

A fracture simply means a broken bone. An osteoporotic fracture is a broken bone which occurs after minimal force. Any bone can be affected by osteoporosis, but the most common sites of osteoporotic fracture are bones in the ribs, wrist, spine, pelvis, upper arm and hip. Osteoporotic fractures are commonly caused by falling, coughing, sneezing and lifting. Once a person has one osteoporotic fracture, the risk of having future fractures rises significantly.

How is Osteoporosis Related to Coeliac Disease?

Inflammation of the small bowel lining in untreated coeliac disease causes malabsorption of nutrients, including calcium. Calcium plays a vital role at a cellular level within the body’s tissues and fluids. This requires a stable blood level of calcium. If insufficient dietary calcium is absorbed from the diet to maintain the required level of calcium in the blood, more is taken from the bones than can be replaced (increased bone resorption). This causes the bones to become weaker. If a child is malabsorbing calcium due to untreated coeliac disease, their bones may not form properly during the growing years.

How do I find out how strong my bones are?

Bone strength can be measured using a Dual-energy X-ray Absorptiometry (DXA) scan, commonly known as a bone density test.

It is recommended that all adults diagnosed with coeliac disease should have a bone density test regardless of age, gender or menopausal status.

Your GP or specialist can give you a referral to a hospital or a clinic, which perform bone density tests.

A person medically diagnosed with coeliac disease is entitled to a Medicare rebate for a bone density measurement under item number 12315, “a proven malabsorptive disorder”. This rebate is available every two years.

How often should I have a Bone Density Test done?

Usually no more frequently than every two years, unless recommended by your doctor. Where possible, it is important to have your bone density test repeated on the same bone densitometer at the clinic or hospital you attended for your initial visit. There can be slight differences in results obtained on different machines.

What is the Treatment for Osteoporosis?

An adequate calcium intake and weight bearing exercise are important. Additional treatments are often recommended. Specific medications are now available which have been shown to be very effective for the treatment of osteoporosis. Speak to your doctor about the different treatments. Smoking and a high intake of alcohol should be avoided. It is never too late to treat osteoporosis.

How much Calcium should I have?

Different amounts of calcium are needed throughout a person’s life, depending on gender, menopausal status and age. In women, it also changes if you are pregnant or breastfeeding. Your doctor or dietitian can advise you on your requirements.