Mood-altering medications such as antidepressants, antipsychotics and benzodiazepines (for example, Clozapine and Diazepam) can also contribute to bone problems. Elderly patients taking these medications are more likely to have falls and fractures’. The medications may add blood pressure changes and physical instability to existing vision problems, poor flexibility, and depleted muscle mass and strength.
As mentioned briefly, osteoporosis is more likely in women who have an early surgical removal of their ovaries, a hysterectomy without removal of the ovaries or a premature natural menopause (before the age of forty). In addition, you may be more likely to get osteoporosis if you have had anorexia nervosa, exercised so much at some time that your menstrual periods stopped for six or more months (known as amenor-rhoea), used steroids over a long period (for example, to treat asthma or arthritis) or been confined to bed for some months, perhaps because of a serious accident.
Bobbi was in her early fifties when she fractured her wrist after slipping on some wet grass. Her medical history included a three-year period of anorexia nervosa in her twenties, together with smoking throughout her adult years, so a DEXA investigation was ordered. This revealed a worryingly low bone density, which prompted Bobbi to quit smoking, improve her diet and start treatment with HRT. A bone density measurement two years later indicated that the deterioration of Bobbi’s bones had been arrested.
The most important factor of all in determining your risk of osteoporosis is the genes that control the way your body functions, and that may conspire with neglect of weight-bearing exercise, smoking, or a low calcium intake. If genetic vulnerability is combined with any other risk factor, the likelihood of osteoporosis multiplies. Attempts to put figures on these risks have proved controversial.
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