Today we will spend a little time on an oft forgotten, largely neglected,yet critical bodily organ. It is so critical to our humanity, in fact, that in it's absence we would be blobs.... jelly fish, if you like. You've guessed it...we are getting down to the bare bones! The skeleton is a dynamic organ...admittedly not quite as dynamic as the heart, liver, brain,'or just about anything else, but dynamic none the less! Bone comprises 4 major components: osteocytes (long suffering bone cells), osteoclasts (the ultimate scavengers) and osteoblasts (the working class).They all reside, work and play in a mineral matrix.

The skeleton is not just a clothes-hanger, it is also a a factory (for blood cells) , a ware-house (for minerals) and a body guard for sensitive spots (like the brain). Bone health and good health are thus synonymous.

Our bones are at their prime between 25 an 30 years of age...and our mission in later years is to keep the numbers as close to prime as we possibly can. We call bone failure,'fracture'. Even primetime bone is prone to failure under certain circumstances (like paragliding in storm or meeting up with Mike Tyson on a bad day),'but as we age, and particularly if we have not been bone conscious in our youth, failure may occur quite spontaneously.

Spontaneous fracture, or fracture with minimal trauma is called osteoporosis, severe osteoporosis to be correct. Quite literally, osteoporosis means porous bone and a cross section is very scary sight indeed! Normal bone is virtually solid. There are small cavities (called remodeling units) where osteoclasts dig and osteoblasts fill at more or less the same rate. It's when this process unhinges (as in poor choice of parents, menopause, prolonged bedrest or a trip to Mars) that the osteoclasts gain the upper hand. This may be due to excessive stimulation or to osteoblastic strike action or suppression. The result is see-through bone ...with a laticework of frail and fractured bony arches and huge open spaces.

Clinical suspicion, fracture,'plain X-Ray and quantitative ultrasound are all helpful in establishing the diagnosis, but as the condition is systemic,'a Dual Energy Xray Absorbtiometry DXA test, is required before pharmacological treatment for the condition can be commenced.

Not that medicine is the answer, nor even supplements. Awareness is the key. That and consideration...for your humble, hard working skeleton!

It's about nutrition, exercise, fresh air and a positive outlook.

All is not as it seems. There is more calcium in 100g of sesame seeds than in a glass of milk...green leafy veg, in fact most farm fresh veg is perfect. Eggs, butter, salmon and Shiitake mushrooms are great sources of vit D (great breakfast idea !) Impact exercise out in the sunlight ...or a walk on the beach ...perfect! Good clean air! ...sorry!...the no smoking zone is even smaller now.... As far as a wee doch and doris in the evening is concerned .....well, as long as it's a wee one!!

Important Downloads

South African Osteoporosis Guidelines


Dr Douglas Seton, Obestetrician & Gynaecologist Knysna © 2021

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