Seven years, no improvement

Photo above: Dr Manju Chandran discovered that Mrs Agnes Lim's condition was caused by a tumour on her parathyroid gland.

SINGAPORE - Retired teacher Agnes Lim was on regular osteoporosis medication for seven years, but her bone density continued to worsen.

It was only after she saw endocrinologist Manju Chandran that the real cause of her condition was uncovered: unusually high levels of calcium in the blood.

She was losing calcium because of a benign tumour growing on her parathyroid gland - a relatively rare cause of secondary osteoporosis.

The pea-sized parathyroid glands, next to the thyroid gland in the neck, make parathyroid hormone, which helps the body keep the right balance of calcium and phosphorous.

Mrs Lim, who is in her early 70s, had surgery to remove the tumour in August, and the results were almost instantaneous - her calcium levels are back to normal, and her appetite has improved.

Her family had thought all along that her condition was an inevitable part of ageing. Her daughter Valerie, 48, said: "I thought that osteoporosis was just something she had to live with.

"We've learnt that the causes of osteoporosis are not all the same, and the condition shouldn't be treated as a single illness."

About the problem

Osteoporosis causes thinning and weakening of bones.

Brittle bones are more prone to fractures, which may happen even with very minimal trauma. Fractures typically occur in the hip, spine and wrist.

Worldwide, 200 million women suffer from osteoporosis and a woman's risk of hip fracture is the same as her combined risk of developing breast, uterine and ovarian cancer. Caucasian and Asian women, especially those past menopause, are at highest risk.

Medications, dietary calcium supplementation and weight-bearing exercise can help strengthen the bones.

Although women 50 years or older are most at risk, osteoporosis can also affect younger women and men.

In Singapore, around 40 per cent of women over 65 are believed to have osteoporosis.

One in three women and one in eight men over 50 will have an osteoporosis-related fracture in their lifetime.

Once diagnosed, patients should also be tested for:

  • Thyroid function - An overactive thyroid can accelerate bone loss
  • Calcium in the urine - Passing out too much calcium is a common cause of bone loss
  • Vitamin D levels - Having enough Vitamin D is critical for adequate calcium absorption and basic bone support.
  • Parathyroid function - High hormone levels from these small endocrine glands in the neck are associated with excessive bone loss
  • Kidney function - Kidney failure can be associated with bone loss and some anti-osteoporosis medications can cause kidney damage too.

Sources: SingHealth, Mayo Clinic

Forum on Osteoporosis

The Singapore General Hospital (SGH) is holding a public forum on osteoporosis on Oct 27, with talks by doctors, nutritionists and physiotherapists.

It will be held from 8.30am to noon at Deck on 9, Block 6, level 9 of SGH.

It is organised by the Osteoporosis and Bone Metabolism Unit of the SGH Department of Endocrinology, and coincides with World Osteoporosis Day Celebrations this month.

Registration costs $5.

To attend, call 6321-4071 during office hours, or e-mail your name, IC number and contact details to pgmi.

Get a copy of The Straits Times or go to for more stories.

Purchase this article for republication.
Your daily good stuff - AsiaOne stories delivered straight to your inbox
By signing up, you agree to our Privacy policy and Terms and Conditions.