Q: My mother, who died at 88, had osteoporosis and was quite frail. I’m 69 and a recent bone scan showed I have mild osteopenia and my GP wants to prescribe medicines for it. But I’m worried about side-effects. Would sport (I’m a keen tennis player) and vitamin D and calcium supplements be enough for the time being?
Amanda Thomas, Cornwall
A: Osteopenia is the medical term for low bone-mineral density. In your case, the loss of bone mineral is not yet considered serious and most doctors would agree you do not require medication at this stage.
(Like all drugs, those for bone loss can also potentially cause side-effects – severe heartburn due to stomach-acid reflux and, much more rarely, cells in the jaw bone dying off.)
What matters is the rate of decline, so you should be re-scanned in two years.
Osteoporosis can run in families, so the fact that your mother had it does put you at greater risk. But the truth is that in all post-menopausal women, a decline in bone density is inevitable owing to the loss of the hormone oestrogen.
Oestrogen helps bones by inhibiting the effect of cells called osteoclasts, which break down old bone, while also promoting the activity of osteoblasts that build new bone.
While you are unlikely to be able to reverse osteopenia at this age, you can slow it down.
‘While you are unlikely to be able to reverse osteopenia at this age, you can slow it down’
Weight-bearing and muscle-strengthening exercises are crucial for maintaining bone density, so your regular tennis playing will go a long way to support this and I recommend playing at least once a week.
Other preventative steps include quitting smoking and limiting alcohol intake – both can affect bone mass: the former by reducing oestrogen levels further, and effectively lowering calcium absorptionin the gut, while alcohol increases osteoclast activity and suppresses osteoblasts, a double whammy.
And yes, calcium (1,200mg) and vitamin D (800IU) are vital.
Q: I was diagnosed with non-Hodgkin lymphoma 17 years ago and one of my sisters was diagnosed a few years later. We’re the only ones in our family (of 11) who have to wear hearing aids and I wonder if this is connected to the lymphoma?
Irene O’Hara, Edinburgh
A: It is good news to hear that your disease was now some years past – and you ask a fascinating question.
From what I understand there is no direct relationship between lymphoma and the onset of deafness, but a connection might exist for many reasons.
First, lymphoma can often occur in, or near, the head and neck, or the base of the skull. If the tumour grows near the auditory nerve or the inner ear, it could impact hearing.
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Another possibility is that some types of chemotherapy or radiation therapy – if the cancer is in the head or neck – can damage the inner ear.
Separately, lymphoma can occasionally cause what are called paraneoplastic syndromes – essentially the immune system attacks healthy tissues in the body, which might affect the inner ear or auditory nerve.
More rarely, lymphomas may be linked to autoimmune disorders – and there is a type that affects the inner ear and that is a potential cause of hearing loss, which might have affected you and your sister.
It’s also worth noting that hearing loss is common with age – and in 11 siblings, it does not surprise me that two of you have it and it is possible that the lymphoma diagnosis in each of you is simply a coincidence.
IN MY VIEW… New drug hope for women’s disorder
I’m happy to report some good news for patients with polycystic ovary syndrome (PCOS): the condition, which affects around 10 per cent of women, is characterised by abnormally high levels of testosterone – a result of too much being produced in the ovaries and via body fat.
This triggers a range of symptoms, including irregular periods, weight gain, excess hair growth and fertility problems.
The current treatment is oral contraceptives but, while this can regulate periods, testosterone levels can remain high.
Now research has revealed that artemisinins, drugs derived from the sweet wormwood plant and used to treat malaria, can block the production of male hormones by interfering with a particular enzyme.
This is a dramatic discovery and initial studies using ‘malaria’ drugs in women with PCOS show great promise. Larger studies are under way.
These drugs have a long history of use in people so, should these trials be successful, they could be rolled out quickly. Artificial intelligence is busy working on finding more drugs that may be ‘repurposed’ like this.
One strong argument in its favour!
- Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email drmartin@ dailymail.co.uk – include your contact details. Dr Scurr cannot enter into personal correspondence. Always consult your own GP with any health concerns