Hi, I'm Dr Pam Brown,

Hi, I'm Dr Pam Brown,
I'm a GP in Swansea

and I also work in an osteoporosis
clinic in the hospital in Swansea.

Our bones grow
throughout the early part of life

and then later in life,
from about the mid-30s onwards,

we begin to lose bone,

so it's important that we've got lots
of bone in our skeleton at that stage.

Our bones are healthy
because they provide us with support

and allow us to protect
some of the organs within our body

that are really important,

and the main reason
for keeping our bones healthy

is so that we don't have fractures
or broken bones,

particularly later in life.

The way that we can protect them

is to lead a healthy lifestyle
throughout life,

really from the cradle to the grave.

That involves eating a healthy diet
which is rich in calcium,

having plenty of sunlight exposure
to make vitamin D in our skin

and ensuring that we take
vigorous exercise early in life

and more gentle exercise to stop us
from having falls later in life.

The ideal exercise is resistance-type
exercise that we can do in the gym,

or doing aerobics,

where we're actually stressing
the bones in our skeleton quite a lot.

Calcium is an important component
of bone,

along with protein
and other fibre-type structures

that make the bones strong.

We can get lots of calcium
particularly from dairy produce.

Skimmed milk contains more calcium
than full-fat milk,

so we can drink plenty of milk
and protect our bones

while still protecting our heart
and sticking to a low-fat diet.

We also can get calcium from other
sources like calcium-added soya milk

if we're not able to take dairy produce.

And a variety of green leafy vegetables
have got calcium as well,

although that's a little bit
more difficult to get large quantities.

The main health problems
associated with bones are osteoporosis,

where the bones become thinner
and much more fragile,

and this begins to happen from
about the 50s onwards in many people.

We also have problems with joints,
which are completely separate,

and it is important to differentiate
between osteoarthritis,

which affects our joints
and causes pain,

and osteoporosis,
which affects our bones, our skeleton.

In terms of symptoms for osteoporosis,

usually there aren't any
until someone has their first fracture,

and that silent nature
of the underlying disease

while the bones are getting thinner

is really a problem
and makes it hard for people to know

whether they've got the disease.

When somebody begins
to develop osteoporosis,

usually it starts off very mildly
and the progression can take many years,

although sometimes, particularly in men,

osteoporosis can progress very rapidly,

so that people start having one fracture

and then very quickly thereafter
have further fractures.

Even at the late stages,
where someone's had a lot of fractures,

much can still be done to treat the
condition and prevent further fractures.

There are four main groups of treatments
that we can use for osteoporosis.

The first of those
is calcium and vitamin D

taken in high dose as a supplement,

as opposed to getting calcium
from the diet

and vitamin D from sunlight exposure.

And really anybody that has osteoporosis

or needs treatment for their
osteoporosis to prevent fractures

should have calcium and vitamin D
along with another treatment.

The next category and the commonest
drugs that are used are bisphosphonates,

and these are a tablet that's taken
once a week, generally, or once a month,

but it has to be taken
in a very careful way

to make sure that the drug is absorbed
and has a benefit for protecting bones.

So in summary it's really important to
do the lifestyle advice throughout life,

healthy diet, good exercise,
avoiding smoking and moderating alcohol.

And the really good news is that we have
such a huge range of drug treatments

available for osteoporosis

that once you've had a fracture
and you seek the correct diagnosis

we can always do something
to reduce your risk of future fractures.

So it's really worth
seeing your doctor or your nurse

and talking about your individual risk.