Linzi Smith and her family.
Linzi Smith and her family. Supplied

Osteoporosis can strike at any age

SUNSHINE Coast mother Linzi Smith was diagnosed with osteoporosis at 39 years of age after she coughed and fractured her back.

Linzi had no idea anything was wrong with her bone health.

"At the time, it felt like I had just pulled a muscle," she said.

"My GP agreed and prescribed pain and cough medication, but the pain eventually became so unbearable that my husband insisted I go to the emergency department and have another doctor investigate."

"After an examination, the doctor said he thought it stemmed from post-natal depression, and that I was imagining it to be worse than it actually was. He prescribed Valium and strong pain relief and recommended lots of rest."

Linzi knew something wasn't right though so she booked an MRI scan two days later. The results revealed Linzi had fractured her back.

A subsequent BMD scan revealed Linzi had the bones of an 80 year old, and she was diagnosed with osteoporosis at just 39 years of age.

"When I was diagnosed with osteoporosis I was in disbelief. The results were shocking. I couldn't 'feel' or 'see' osteoporosis, and I didn't think it was something I would have to worry about until I was much older. Coming to terms with it, I felt lucky I had found out before fracturing any more bones," Linzi said.

Linzi's doctors recommended an immediate course of medication to prevent her condition deteriorating.

"I was breastfeeding my 10-week-old daughter at the time. So I had to weigh up whether it was worth ceasing breastfeeding and the potential detrimental effects that this would cause my baby, or to just delay treatment," she said.

"In the end, I delayed treatment and breastfed for another few months to give my baby the best possible start in life.

"I have to take medication for the rest of my life. I also have to be careful not to fall, and avoid playing certain games and sports with my children in case I have an accident and break any bones.

"There are so many things I would love to try with my kids, but I can't because I'm scared I'll injure myself. I know they would love to go skiing and horse riding like I did as a child, so it really upsets me that they won't get to experience that with me."

Sadly, Linzi's story is becoming far too common.

Leading experts are today delivering a startling wake-up that our nation's bone health is worse than expected, with almost one-in-three (29.2 per cent) Australian adults living with brittle bones, and many unaware of the contributing risk factors.

New findings from the Geelong Osteoporosis Study, just published in the Medical Journal of Australia, for the first time provide a wake-up call on the magnitude of osteoporosis and osteopaenia in Australia.

The study reveals the disease is more widespread than previously thought with 1.2 million affected by osteoporosis and a startling 5.4 million people with low bone density also known as 'osteopaenia' (a potential precursor to osteoporosis).

A separate GP and Consumer Tracking Study, commissioned by Osteoporosis Australia, also reveals GPs are not always investigating at-risk patients and patients are not fully aware of the risks to their bone health.

According to Associate Professor Julie Pasco, Geelong Osteoporosis Study co-author, from the School of Medicine, Deakin University, and Barwon Health, Geelong, the study re-enforces what we know about osteoporosis - it's a disease which needs greater awareness.

"Almost six per cent of men and 23 per cent of women over the age of 50 are living with osteoporosis," said A/Prof Pasco.

"While osteopaenia is more prevalent than osteoporosis among women aged 55-to-79 years, osteoporosis dominates among those over 80 years of age (51 per cent vs 43 per cent, respectively). We also found about one-in-two (56 per cent) men aged over 50 years is living with osteopenia, while 18.5 per cent of men aged over 80 years have osteoporosis. In both groups osteoporosis increased with age," A/Prof Pasco said.

"Fortunately preventative measures can be taken to reduce the risk of further bone loss and its associated health risks," said Geelong Osteoporosis Study lead investigator, Associate Professor Mark Kotowicz.

"Regrettably, bone health ranks very poorly on the public's agenda, and receives insufficient attention from healthcare professionals in general practice," said A/Prof Kotowicz.

Osteoporosis Australia Chief Executive Officer, Ms Shelley Evans said the GP and Consumer Tracking Study, which surveyed over 200 GPs and 1,200 consumers nation-wide, provides vital insights into their understanding of the risk factors for brittle bones.

"Our study revealed that GPs are only referring a very small percentage of eligible patients for a bone mineral density (BMD) scan," said Ms Evans.

The study also found that while the Australian public has a reasonable understanding of calcium's role in promoting good bone health (49 per cent); only one-in-three people surveyed recognised the need for regular exercise, and just seven per cent cited vitamin D/sunshine as being important. Worryingly, one-in-five respondents could not nominate a single risk factor for osteoporosis.

According to Professor Peter Ebeling, Medical Director of OA and Head of Endocrinology, Western Health, Melbourne, the findings demonstrate there is significant room for improvement in the perceived importance of osteoporosis prevention among both the average Australian and their GP.

"People need to find out if they have low bone density, or are in fact suffering from osteoporosis. With early identification of the risk of low bone density, simple steps can be taken to help improve bone health. Adequate dietary calcium, adequate Vitamin D intake from sunshine or supplements, and regular weight-bearing exercise can make a positive impact for most people.

"The serious side of the disease is fractures and we need to work with GPs and the public to identify people properly, and then we can prevent these fractures," Prof Ebeling said.

"Unfortunately the studies today reveal that a large number of Australians have low bone density, and not enough is being done to prevent osteoporosis. The important message is there is a lot a GP and an individual can do if osteoporosis is detected.

"People who have sustained a spinal fracture are four times more likely to experience another fracture within 12 months, compared with someone who has never sustained an osteoporotic fracture," said Prof Ebeling.                                        

"Women who have had two or more osteoporotic fractures are up to nine times more likely to have another fracture, rising to an 11 times greater risk for women who have had three or more fractures, compared with someone who has not broken a bone.

"This new research collectively reinforces the consequences of sustaining an osteoporotic fracture, which places a significant burden not only on those living with the disease, but on their family, friends and the community, and the need for increased education and awareness about the importance of maintaining strong, healthy bone," Prof Ebeling said.

"Not only does the general community need to be aware of how they can prevent the onset of osteoporosis, but doctors should be encouraging more patients to undergo BMD testing/DXA (dual X-ray absorptiometry) prior to developing an osteoporotic fracture."

Six years after her diagnosis, Linzi wants others to realise that osteoporosis isn't just an old person's disease.

"A lot of women don't realise that there are options to strengthen your bones and prevent the onset of osteoporosis," Linzi said.

"If I had known then what I know now, I would have cared for myself differently and ensured I got plenty of calcium, lots of strength training and vitamin D.

"Osteoporosis is not an obvious disease, because you can't see it or feel it until a fracture occurs. It's not something that you can readily or obviously measure without a BMD scan. And then once diagnosed, unfortunately there's no magic cure for the disease."

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