MEDICAL INSIDER
DR CORA LIM
FOR SEPT 17, 2027

OSTEOPOROSIS
(Part 1)

What is Osteoporosis?
It is a condition that makes the bones fragile. There are
usually no symptoms, and it’s often only discovered when
you break a bone in a minor accident or fall.
Bone is a living tissue, but as we get older, it’s not able to
renew itself as well and our bones start to thin.
This happens to everybody to some degree, and when the
bones become fragile it’s called osteoporosis.
Who is at risk?
Osteoporosis is more common in women, particularly after
the menopause period.
You are at greater risk of developing osteoporosis if you:

  • Have steroid treatment for more than three months
    • Have a family history of osteoporosis
  • Don’t do much weight-bearing exercise
  • Are a heavy drinker or smoker
  • Have a low body weight
  • Have an early menopause (before the age of 45)
  • Had your ovaries removed/surgery
    How can I help myself ?
    The following will help to reduce your risk of developing
    osteoporosis:
  • Plenty of calcium and vitamin D as part of a well-
    balanced diet dairy products such as milk, cheese and
    yogurt
  • Exercise regularly, especially activities that involve
    walking or running
  • Stop smoking
  • Don’t drink too much alcohol
    Who is the right person to treat you?
    A RHEUMATOLOGIST IS THE RIGHT PERSON TO TREAT
    YOU. Your rheumatologist would advise you a special test
    “DEXA or DXA SCAN” (Dual Energy X-ray Absorptiometry)
    for diagnosis. This test measures bone density. The possible
    results are:
  • Normal-risk of a low-impact fracture is low
    • Osteopenia – Your bone is weaker but your risk of a low-
    impact fracture is relatively small
    • Osteoporosis- You have a greater risk of low-impact
    fractures and you may need treatment – discuss this with
    your doctor
    This test is done before starting treatment and later at 2-5
    years intervals as per your doctor’s advice. (To be continued)

MEDICAL INSIDER

DR CORA LIM
FOR SEPT 23, 2027

OSTEOPOROSIS
(Part 2)

We started last week our discussion on What Osteoporosis
is.
We included in that discussion the following topics: Who is at
risk; How one can help himself/herself if he/she has
osteoporosis; and Who is the right person to treat
someone who has osteoporosis;
Today, as we tackle Part 2 of this subject matter, it is
important to know What treatments are there for those who
are having osteoporosis.
There are a number of treatments available, including the
following:
 Calcium and vitamin D
 Bisphosphonates (e.g alendronate, risedronate,
ibandronate or zolendronate)
 Teriparatide
 Raloxifene
 Denosumab

Usually bisphosphonates are advised along with calcium and
vitamin D supplements.
Let us now discuss the question: How do I take
bisphosphonates?
This treatment is available in an intravenous form or in an
oral tablet form with these guidelines:
 take it on an empty stomach with a glass or two of plain
tap water
 Don’t eat anything or drink anything other than tap water
for at least 30 minutes afterwards (for effective
absorption) 
 Stay upright (sitting, standing or walking) for up to an
hour
Are there Side effects to the treatment? Inform your doctor if
your have: Gastritis (the most common), skin rashes, a sore
mouth, flu-like symptoms, jaw pain, bone pain/muscle pain,
headaches.
What are we supposed to remember with this treatment:
Your bone density should start to improve after 6-12 months.
Bone renewal is a slow process so it is important to continue
treatment.