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Did you know that May is National Osteoporosis Month? One in two women and up to one in four men over the age of 50 will break a bone due to osteoporosis. The disease, which is not a normal part of aging, is serious causing broken bones, pain, suffering, and life-altering loss of mobility- yet it is treatable and even preventable.

What is osteoporosis?

Osteoporosis is a bone weakness disease. A reduction in bone mass (tissue and calcium) with a weakened framework causes the bone to become brittle and break. Osteoporosis is a problem that increases your chance of breaking a hip, spinal vertebrae, or wrist. This is a silent disease, much like high blood pressure or high cholesterol levels. In other words, there are usually no symptoms until you break a bone due to the loss of bone mass. Osteopenia, low bone density, and brittle bone disease are other terms that experts will use to describe low bone mass before a bone actually breaks. More than 25 million Americans already have osteoporosis and each year more than 1.5 million bone fractures are related to the disease. The good news is osteoporosis is a preventable and treatable disease; however, there is, as of yet, no cure.

How does osteoporosis develop?

Bone is a living tissue that is constantly undergoing remodeling by bone-forming cells (osteoblasts) and bone-removing cells (osteoclasts).  When the reabsorbing cells remove the bone faster than the bone-forming cells, bone mass or density. Several risk factors assist in speeding up the bone loss process. After age 40, almost everyone gradually loses bone mass. Diets which are deficient in calcium, excessive loss of calcium on urine, a sedentary lifestyle, cigarette smoking, being underweight, early menopause, and over-treatment with thyroid hormone and/or cortisone are also risk factors. Alcohol consumption is now not considered a risk factor on most experts’ lists. Osteoporosis is a complex disease and not all of its causes are known.

Why are women diagnosed with osteoporosis more often than men?

Women lose their natural protection from bone loss during and after menopause, when their estrogen levels fall. Estrogen, which starts to decline around age 38, helps the bone remodeling process stay in favor of maintaining bone mass. When estrogen levels decline, the speed of bone loss rapidly increases. Men and women both begin losing bone mass after the age of 40, however, menopause rapidly increases the speed of bone loss in women. In men, osteoporosis usually becomes a problem in their seventies.

Diagnosing osteoporosis

First, start with a good history and physical examination with your doctor. Several new techniques are available to measure bone mineral density. A relatively new, painless, and safe technique to measure the strength of bone is the DXA Test, or Dual-Energy X-ray Absorptiometry. A double x-ray beam is passed through the hip or spine and a computer measures and calculates the bone mineral density. This is a good test method which gives accurate results and takes only 10 to 20 minutes with minimal radiation exposure. Only a bone densitometry test can measure the density of bones. If the bone densitometry test indicates a low bone density, you have an increased risk of breaking a bone due to osteoporosis.

Should I worry about osteoporosis?

Simply put, the disease can be prevented with early, appropriate treatment, thereby limiting your chances for pain and disability from broken spinal vertebrae, ribs, wrists, and even death from complications of a hip fracture. Eighty percent of the 25 million Americans with reduced bone mass are women and are at risk for fractures. Approximately 500,000  vertebral spine fractures and 250,000 hip fractures occur annually.

Do children get osteoporosis?

A rare form of juvenile osteoporosis can occur in teenagers. The developmental years and teen years through the early twenties are important to build a peak bone mass with proper nutrition and exercise.

Is osteoporosis preventable?

You can prevent or slow the process of bone mass loss through lifestyle changes, nutrition, exercise, and medication when appropriate, including hormone replacement therapy. The good news is you can start today! You must get adequate calcium, (either by your diet and/or by calcium supplementation), vitamin D, weight-bearing exercise, and estrogen replacement therapy if you are at or beyond menopause. Estrogen replacement therapy remains the main treatment, along with adequate calcium and vitamin D, and exercise, to slow bone loss and maintain strength in menopausal women. Only a few women, for medical reasons, are unable to take estrogen replacement therapy. Remember, adequate calcium intake and exercise alone are not enough to prevent osteoporosis.

What if I already have significant osteoporosis?

There are medications available that help to prevent bone reabsorption and therefore prevent bone loss. Some studies suggest an increase in bone mass after using these medications. A prescription is required for these medication treatments, which are available in injection, nasal spray, and tablet form.

Which supplement is the best?

Calcium in any form probably works well. Calcium citrate and calcium carbonate are available, though calcium citrate has better absorption in the stomach. Which supplement is the best? Well, probably the least expensive. 

How much calcium should I be taking daily?

Recommendations from the National Institute of Health are 1000 mg of calcium daily for women ages 25 to 50 and men ages 25 to 65; postmenopausal women 1500 mg daily. Calcium can come from your diet and calcium supplements if your diet is inadequate.

How much vitamin D is needed daily?

If you are young and healthy, you probably get enough vitamin D from your diet and sun exposure. Everyone should get 400 to 800 units daily. If you are over age 70, have low bone density, have a chronic illness, or are on medications such as cortisone or prednisone, you should probably take a standard multivitamin supplement. many supplements are available and, once again, the least expensive will probably be just fine.

How much and what kind of exercise should I be doing?

Most individuals would benefit from brisk walking 20 to 30 minutes daily. Muscle action on bone helps maintain bone strength and the structure of bone is maintained. The best activity is weight-bearing such as walking. If you have been inactive, start slowly (about five minutes daily) and increase your time over the next four to six weeks. If you have a history of heart disease or circulatory problems, check with your primary care physician or cardiologist before starting any exercise program. If you have difficulty walking, pool aerobic exercise is better than no exercise at all. Do the best you can and remember to be careful not to injure yourself. While exercise does not prevent osteoporosis, studies have shown that bone strength does improve and therefore reduces your risk for broken bones. For help and support, see the National Osteoporosis Foundation. You can follow them on Facebook, Instagram, and Twitter:

The NOF even has weekly prizes throughout May for those who participate in the 10,000 Steps a Day in May Challenge!

Are there other diseases that mimic osteoporosis?

Yes. Your doctor will most likely order some screening blood work to check for other medical causes of bone loss. A few diseases causing bone loss include hyperparathyroidism, hyperthyroidism, Cushing’s disease (excess cortisone), intestinal malabsorption diseases, and some kidney diseases. If you have already had a vertebral compression fracture, further testing to exclude a bone tumor may be necessary.

What is a bone biopsy?

A bone biopsy is a means to directly look at the bone structure and content. A small core of bone is taken after numbing the back of the hip bone (iliac crest). The only way your doctor can diagnose a disease called osteomalacia, or soft bones. Most patients tolerate the procedure well. This test is not routinely recommended in patients with osteoporosis, but should be done in patients who have osteoporosis with no apparent cause, as well as in patients who are not responding to treatment.

 

 

 

 

 

 

 

This website may contain general information relating to various medical conditions and their treatment. Such information is provided for informational purposes only and is not meant to be a substitute for advice provided by a doctor or other qualified healthcare professional. Patients should not use the information contained herein for diagnosing a health or fitness problem or disease. Patients should always consult with a  doctor or other healthcare professional for medical advice or information about diagnosing and treatment. 

 

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