Specialist bone experts
The accurate interpretation of blood and urine tests, combined with the latest, multi-view DXA scans is complex. Therefore this requires experienced experts to assess bone balance, which should be viewed in relation to bone density changes and clinical condition.
Bone formation and breakdown
Bone is an amazing organ that is continually undergoing change in formation to accommodate the stresses and strains put on it by daily living. Old bone breaks down and new bone forms on a continuous basis.
There are three special types of cell that are only found in bone. These are osteoblasts, which are responsible for producing new bone, osteoclasts, which are cells that dissolve bone and osteocytes, which are cells within bone. These cells are responsible for making and maintaining bone and there is a constant balance between osteoblasts forming new bone and osteoclasts breaking down bone. During growth and development bone turnover favours the osteoblast. During subsequent years there is consolidation when bone formation is in balance with bone breakdown and most of the adult skeleton is replaced about every 10 years.
Hormones and bone health
A number of hormones are important to the maintenance of good bone health including calcium-regulating hormones and sex hormones. Both oestrogen and testosterone have an effect on bone. Oestrogen acts on both osteoblasts and osteoclasts to inhibit bone breakdown at all stages in life and it may also stimulate bone formation. As a consequence, the marked decrease in oestrogen that occurs during the menopause leads to rapid bone loss. Accelerated bone loss results in fragility and a predisposition to osteoporosis and fracturing.
Understanding the “cross-talk” between the forming and resorbing bone cells has led to the development of drug treatments to halt bone loss or to stimulate bone formation with the choice of specific medication depending on several factors.
Accelerated bone loss during menopause
Bone Turnover Marker Tests
The time of a woman’s life when her ovaries stop releasing an egg (ovum) on a monthly cycle, and her periods ceaseFull medical glossary