Mitzi Krockover, M.D., Answers Your Questions about Osteoporosis

Q: What is osteoporosis?

A: This age-related disease generally develops after age 40. It is a gradual process, escalating just before menopause. Your bones grow thinner, losing density and strength. The cause is still unknown.

While osteoporosis itself is not life-threatening, it puts you at increased risk for breaking a hip, vertebra (spine), wrist or leg bone. Because there are no early symptoms, you might not realize you have osteoporosis until you break a bone.

Q: Who gets osteoporosis?

A: There are several risk factors for osteoporosis, including age (being past menopause); gender (women are at higher risk); family history; and race (Asian and Caucasian women have the greatest risk).

Your lifestyle also affects your risk of developing osteoporosis. Your risk is greater if you don't get enough vitamin D. A diet high in protein, fat, sodium or caffeine is risky, as is smoking cigarettes or drinking too much alcohol. Not getting enough exercise can also contribute to the problem.

Other risk factors include early menopause, problems with calcium absorption, or a disease that affects your thyroid, blood or joints. Taking steroids (to treat asthma or arthritis), certain epilepsy drugs or blood thinners also increases your chance of getting osteoporosis.

Q: How do you prevent osteoporosis?

A: The keys to prevention are calcium, exercise, vitamin D and estrogen.

Calcium keeps your bones strong. If your body doesn't get the calcium it needs from your diet, it will take calcium out of your bones. To get enough calcium, you should eat calcium-rich foods such as dairy products (for example, skim milk and yogurt); high calcium vegetables, including broccoli, collard greens and kale; salmon; tofu. You can also take antacids containing calcium.

The National Academy of Sciences Food and Nutrition Board recently increased the recommended daily calcium intake for most adults over age 50 to 1,200 milligrams (mg.) per day. Talk to your doctor before taking any supplements, including calcium.

If you don't get enough exercise, your bones can grow weak. Aim for weight-bearing exercise (where bones and muscles work against gravity) such as walking three times a week for 30 minutes or more. Exercise is also good for your flexibility and sense of balance, which can protect you against dangerous falls.

Your body produces vitamin D when you are exposed to as little as 10 minutes of sunlight a day or eat foods containing vitamin D. The recommended daily allowance of vitamin D is 400 International Units (IUs). If it's hard for you to get enough vitamin D from your diet or sunlight, supplements can make up the difference. Do not take a supplement of more than 400 IUs of vitamin D each day without speaking with your doctor first, however.

Your bone loss speeds up around menopause. Experts believe this is due partly to the fact that your body no longer produces the hormone estrogen, which is good for bones. Some medicines have been proven to help prevent the bone loss associated with osteoporosis. The most effective is estrogen-replacement therapy (ERT).

If you are at high risk for osteoporosis, speak with your doctor about whether ERT would be a good choice for you. If you cannot take ERT, your doctor can suggest other options.

Q: How is osteoporosis treated?

A: ERT remains the gold standard for preventing or slowing down bone loss. There are other drug therapies being tested today, but most have not been proven as effective in reducing the risk of bone fractures.

If you develop osteoporosis, you will need to work with your doctor to decide which lifestyle changes and therapies will be the best for you.