Protecting Your Bones Before They Break
Osteoporosis is a silent disease – you cannot feel your bones getting thinner. The first sign is often a fracture from a minor fall or even a cough. In Switzerland, one in three women and one in five men over 50 will suffer an osteoporotic fracture. At our practice in Zürich Seefeld, I believe in identifying and addressing bone loss early, before fractures occur.
What Is Osteoporosis?
Osteoporosis means “porous bones.” It occurs when bone resorption (breakdown) outpaces bone formation, leading to reduced bone density and deteriorated bone microarchitecture. The result is bones that are fragile and prone to fracture – particularly the hip, spine, and wrist.
Risk Factors
Post-menopausal women are at highest risk due to oestrogen decline, which accelerates bone loss. Other risk factors include age over 50, family history of osteoporosis or hip fracture, low body weight, smoking, excessive alcohol, sedentary lifestyle, long-term corticosteroid use, vitamin D and calcium deficiency, hyperthyroidism, early menopause, and certain medications (PPIs, aromatase inhibitors, anti-androgen therapy).
Diagnosis
DEXA (Dual-Energy X-ray Absorptiometry) scanning measures bone mineral density at the hip and spine. Results are reported as T-scores: above -1 is normal, -1 to -2.5 is osteopenia (low bone mass), and below -2.5 is osteoporosis. I also calculate the FRAX score – a 10-year fracture risk assessment that incorporates clinical risk factors alongside bone density. Blood work evaluates calcium, phosphate, vitamin D, PTH, thyroid function, and bone turnover markers.
What We Do: Building and Protecting Your Bones
Resistance and weight-bearing exercise: The most powerful non-pharmacological intervention. Bones strengthen in response to mechanical loading – resistance training, walking, hiking, and impact activities stimulate bone formation.
Calcium and vitamin D: Ensuring adequate calcium intake (1000-1200 mg/day from diet and supplements) and vitamin D levels (40-60 ng/mL) provides the building blocks for bone.
Hormonal optimisation: In post-menopausal women, HRT preserves bone density. Testosterone optimisation in men with low levels supports bone health.
Pharmacological treatment: When fracture risk is significant, medications like bisphosphonates, denosumab, or teriparatide can reduce fracture risk by 50-70%. I prescribe these when indicated and monitor for side effects.
Fall prevention: For older patients, reducing fall risk through balance training, home safety modifications, and medication review is as important as strengthening bones.
Lifestyle factors: Smoking cessation, moderate alcohol intake, and adequate protein consumption all support bone health.
Conclusion
Osteoporosis is preventable and treatable – but only if you know where you stand. If you have risk factors or are post-menopausal, a bone density assessment can guide proactive intervention. Book an evaluation at our practice in Zürich Seefeld.
