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osteoporosis

Bone Density

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The older you get the greater your risk of osteoporosis. Osteoporosis is a bone disease in which bones are brittle, weak and more likely to break. People with osteoporosis most often break bones in the hip, spine, and wrist. There are no signs or symptoms of osteoporosis. You might not know you have the disease until you break a bone. That’s why it’s so important to get a bone density test to measure your bone strength.
A bone mineral density (BMD) test is like an x-ray or scan of your body. A bone density test estimates the true mass of the bone. It doesn’t hurt, and you don’t need to do anything to prepare for it. It only takes about 15 minutes. By measuring BMD, it is possible to predict fracture risk. A BMD test is recommended for all women between the ages of 50 and 65 with risk factors such as family history, bone structure and body weight, and ethnicity, to name a few. The test is recommended for all women over the age of 65. Men and women who take certain medications or have certain diseases should talk to their doctor about having a bone density test, too. Men over 65 who have concerns about osteoporosis, should talk to their doctor about a bone density test.

  • About 40% of postmenopausal women in the U.S. have osteopenia (low bone density). An additional 7% have osteoporosis (substantially low bone density).
  • One in three women and one of five men over the age of 50 will experience a bone fracture related to osteoporosis.
  • About 33% of people who suffer a hip fracture are totally dependent or in a nursing home in the year following the fracture, stressing the importance of early detection and appropriate therapy.
  • Osteoporosis has many available prescription and nonprescription treatment options once the diagnosis is made.

These things can also increase your risk for osteoporosis:

  • Hormone changes (especially for women who have gone through menopause)
  • Not getting enough calcium and Vitamin D
  • Taking certain medicines
  • Smoking cigarettes or drinking too much alcohol
  • Not getting enough physical activity

If you have osteoporosis, you can still slow down bone loss. Finding and treating this disease early can keep you healthier and more active, lowering your chances of breaking a bone.
Get enough calcium.
Calcium helps keep your bones strong. Good sources of calcium include:

  • Low-fat or fat-free milk, cheese, and yogurt
  • Almonds
  • Broccoli and greens
  • Tofu with added calcium
  • Orange juice with added calcium
  • Calcium pills

Get enough vitamin D.
Vitamin D helps your body absorb calcium. Your body makes vitamin D when you are out in the sun. You can also get vitamin D from:

  • Salmon or tuna
  • Fat-free or low-fat milk and yogurt with added vitamin D
  • Breakfast cereals and juices with added vitamin D
  • Vitamin D pills

Get active.
Physical activity can help slow down bone loss. Weight-bearing activities (like running or doing jumping jacks) help keep your bones strong.

  • Aim for 2 hours and 30 minutes a week of moderate aerobic activity. If you are new to exercise, start with 10 minutes of activity at a time.
  • Do strengthening activities at least 2 days a week. These include lifting weights or using resistance bands (long rubber strips that stretch).
  • Find an exercise buddy or go walking with friends. You will be more likely to stick with it if you exercise with other people.

You don’t need special equipment or a gym membership to stay active. Check with your local community center or senior center to find fun, low-cost, or free exercise options.
If you have a health condition or a disability, be as active as you can be. Your doctor can help you choose activities that are right for you.
Stay away from cigarettes and alcohol.
Smoking cigarettes and drinking too much alcohol can weaken your bones. Find ways to stop smoking. If you drink alcohol, drink only in moderation. This means no more than one drink a day for women and no more than two drinks a day for men.

Take steps to prevent falls.
Falls can be especially serious for people with weak bones. You can make small changes to lower your risk of falling, like doing exercises that improve your balance. For example, try walking backwards or standing up from a sitting position without using your hands.
It’s never too late to get on the right track to being and staying healthy!

Preventing and Treating Osteoporosis

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Osteoporosis is a disease marked by reduced bone strength due to bone mass and bone quality. It is often called a “silent disease” because it usually progresses without any symptoms until a bone fracture occurs or one or more vertebrae collapses.
Osteoporosis is the major underlying cause of fractures in postmenopausal women and the elderly. Fractures occur most often in bones of the hip, spine, and wrist, but any bone can be affected. Some fractures can be permanently disabling, especially when they occur in the hip. Bones affected by osteoporosis may become so fragile that fractures occur spontaneously or as the result of minor bumps, falls, or normal stresses and strains such as bending, lifting, or even coughing.
Collapsed vertebrae may first be felt or seen when a person develops severe back pain, loss of height, or spine malformations such as a stooped or hunched posture.
In the United States today, more than 53 million people either already have osteoporosis or are at high risk due to low bone mass. Osteoporosis can occur at any age, although the risk for developing the disease increases as you get older. In general, osteoporosis is more common in women, and they often develop it at a younger age.
Many people think that osteoporosis is a natural and unavoidable part of aging. However, medical experts now believe that osteoporosis is largely preventable. People who already have osteoporosis can take steps to prevent or slow further progress of the disease and reduce their risk of future fractures. Although osteoporosis was once viewed mainly as a disease of old age, it is now recognized as a disease that can stem from less than optimal bone growth during childhood and adolescence, as well as from bone loss later in life.
In addition to a healthy diet, a healthy lifestyle is important for optimizing bone health. You should avoid smoking and, if you drink alcohol, do so in moderation (no more than one drink per day is a good general guideline). It is also important to recognize that some prescription medications can cause bone loss or increase your risk of falling and breaking a bone. Talk to your doctor if you have concerns about any medications you are taking.
What are some of the causes of osteoporosis?
A major contributor to bone loss in women during later life is the reduction in estrogen production that occurs with menopause. Estrogen is a sex hormone that plays a critical role in building and maintaining bone. Decreased estrogen, whether due to natural menopause, surgical removal of the ovaries, or chemotherapy or radiation treatments for cancer, can lead to bone loss and eventually osteoporosis. After menopause, the rate of bone loss speeds up as the amount of estrogen produced by a woman’s ovaries drops dramatically. Bone loss is most rapid in the first few years after menopause but continues into the postmenopausal years.
In men, sex hormone levels also decline after middle age, but the decline is more gradual. These declines probably also contribute to bone loss in men after around age 50.
Osteoporosis can also result from bone loss that may accompany a wide range of disease conditions, eating disorders, and certain medications and medical treatments. For instance, osteoporosis may be caused by long-term use of some antiseizure medications (anticonvulsants) and glucocorticoid medications such as prednisone and cortisone. Glucocorticoids are anti-inflammatory drugs used to treat many diseases, including rheumatoid arthritis, lupus, asthma, and Crohn’s disease. Other causes of osteoporosis include alcoholism, anorexia nervosa, abnormally low levels of sex hormones, hyperthyroidism, kidney disease, and certain gastrointestinal disorders. Sometimes osteoporosis results from a combination of causes.
When should you talk to your doctor about osteoporosis?

  • You are a man or woman over age 50 or a postmenopausal woman and you break a bone.
  • You are a woman age 65 or older.
  • You are a woman younger than age 65 and at high risk for fractures.
  • You are a man age 65 or older and at high risk for fractures.
  • You have lost height, developed a stooped or hunched posture, or experienced sudden back pain with no apparent cause.
  • You have been taking glucocorticoid medications such as prednisone, cortisone, or dexamethasone for 2 months or longer or are taking other medications known to cause bone loss.
  • You have a chronic illness or are taking a medication that is known to cause bone loss.
  • You have anorexia nervosa or a history of this eating disorder.
  • You are a premenopausal woman, not pregnant, and your menstrual periods have stopped, are irregular, or never started when you reached puberty.
  • What are some types of medications for the treatment of osteoporosis?

Bisphosphonates are approved for the prevention or treatment of osteoporosis. These medications reduce the activity of cells that cause bone loss.
Parathyroid hormone: A form of human parathyroid hormone (PTH) is approved for postmenopausal women and men with osteoporosis who are at high risk for having a fracture. Use of the drug for more than 2 years is not recommended.
RANK ligand (RANKL) inhibitor  is approved for postmenopausal women with osteoporosis and men who are at high risk for fracture.
Estrogen agonists/antagonists (also called a selective estrogen receptor modulator or SERM) is approved for the prevention and treatment of osteoporosis in postmenopausal women. SERMs are not estrogens, but they have estrogen-like effects on some tissues and estrogen-blocking effects on other tissues.
Calcitonin is approved for the treatment of osteoporosis in women who are at least 5 years beyond menopause. Calcitonin is a hormone involved in calcium regulation and bone metabolism.
Estrogen and hormone therapy are approved for the prevention of postmenopausal osteoporosis as well as the treatment of moderate to severe hot flashes and vaginal dryness that may accompany menopause. Estrogen without an added progestin is recommended only for women who have had a hysterectomy because estrogen increases the risk of developing cancer of the uterine lining and progestin reduces that risk.
The Food and Drug Administration has recommended that women use hormone therapy at the lowest dose and for the shortest time, and carefully consider and discuss with their doctor other approved osteoporosis treatments.

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