Section 3 - Diagnosis & TreatmentNext Question

22.How can the risk of 'brittle bone disease' be reduced ?

You may remember from the answer to Question 12 that bones grow and strengthen under the influence of the sex hormones and that without them, the bones may become osteoporotic and brittle. The risk of "brittle bone disease" amongst the Kallmann's syndrome population is therefore greater for those sufferers who do not seek some form of hormone replacement therapy which would increase bone density and strength. In short, the sooner treatment is begun, preferably as close to the normal age of puberty as possible, the lower the risk of osteoporosis.

If it has already been established by your doctor that you have some degree of osteoporosis, you may be offered non-hormonal treatment (in addition to hormone replacement therapy) which works directly on the bones. This usually involves taking two different types of tablets for up to three or four years. The first kind of tablets help to slow down the destruction of bone tissue which occurs when you have osteoporosis. Typically, after two weeks and when the bones are sufficiently "prepared", the second stage of treatment begins. Tablets containing calcium, an important mineral responsible for bone strength, are taken for another 10 weeks. After 12 weeks of treatment, the process is repeated once again. Although it is unlikely that osteoporotic bones will ever become as strong as normal, healthy bones, this kind of treatment can help to increase bone mass by as much as 3% a year.

Along with medical treatment, the extent of osteoporosis can be minimised by taking vigorous physical exercise. This should ideally be a form of weight-bearing exercise. Weight-bearing exercise helps to build up muscle tissue around the weaker bones. The strengthened muscle tissue acts as a better "cushion" to a fall or strain which would otherwise result in bone fracture. Running, jogging and off-road mountain biking are ideal forms of exercise, whilst swimming, weightlifting and casual, day-to-day cycling are not. Of course, regular exercise has other benefits, as it can help you lose weight and improve the performance of your heart and lungs.

The treatment of osteoporosis can take several years. Osteoporosis takes a long time to develop and it takes a while to rebuild weakened bones. You are usually not aware of any changes straight away, but given time, your bones will calcify and harden and be better protected against painful fractures.