Dr. Sagen Zac-Varghese

to make sure that we have the calcium and vitamin D to build the bones, the building blocks.

Second thing is definitely exercise.

So even my patients in their 90s go to three exercise classes a week and do Tai Chi and dancing.

So exercise definitely.

And the third thing is exercise.

assessing your fracture risk, which is looking at your risk of having a fracture in the next 10 years.

And there's an online calculator from the University of Sheffield.

And if you have a high fracture risk, then taking a medication to reduce that fracture risk and reduce your risk of fractures and protect your bones.

There's a lot of medications.

We use bisphosphonates.

Bisphosphonates are basically like a hook that sit on your bone surface and then the osteoclasts come along and they try and engulf them and they kill the osteoclasts.

They lift up from the bone surface and stop the osteoclasts working.

So bisphosphonates are great and they still keep working even after you've stopped taking them.

So bisphosphonates are a key drug for osteoporosis.

They reduce the risk of fractures by between 50% of their tablets to 70%.

Wow.

So they're really, really good medications.

And we take them from between 5 to 10 years if they're tablets or 3 to 6 years if they're infusions.

Amazing.

So that's an anti-resorptive agent.