Health Risk: Osteoporosis

July 13, 2010

Roller skaters sitting in a park

Most people consider osteoporosis a condition of frail elderly women, but the damage from osteoporosis begins much earlier in life. This is why it's so important to build strong bones early and continue to take steps throughout life to keep them strong.

Don't wait. Now is the time to build strong bones and keep them strong Almost 10 million people in the US already have osteoporosis, and another 18 million have low bone mass putting them at increased risk for developing osteoporosis. Although the majority affected is women because of changes during menopause, men can still have osteoporosis. In those older than 50, statistics show that one in two women and one in eight men will have an osteoporosis-related fracture in their lifetime.

What is Osteoporosis?

Because bone is living tissue, it is constantly being renewed throughout your life in the two staged process of old bone being broken down and new bone being built to replace the old. During childhood and early adulthood, more bone is produced than removed. Maximum bone mass and strength is reached by the mid-30s. Although bone loss is a natural process, knowing your risk for developing osteoporosis and taking active steps through healthy behaviors will help to slow its progress and reduce your risk of complications.

Osteoporosis is caused by bone loss that happens at a rate faster than it can be replaced. Bones affected by osteoporosis are weakened due to the loss of density and can break even from minor injuries, sneezing, or sudden movement. Breaks or fractures, especially in women older than 50, are often a sign of osteoporosis.

The fractures can be either cracks in the bone as in a hip fracture or collapsing as in a compression fracture of the vertebrae of the spine. The spine, hips, ribs, and wrists are the most common areas where fractures from osteoporosis occur. However, osteoporosis-related fractures can happen in almost any skeletal bone in the body. Osteoporosis is responsible for over 1.5 million fractures each year.

What are the risk factors in developing osteoporosis?

Some risk factors can't be controlled:

Family history – if your mother, father, grandparents or sibling has/had osteoporosis
Gender – women are at greater risk than men
Age – women 65 and older and men 70 and older
Race – women who are white or Asian especially those with a family history
Thin, small body frame and low body weight
Past medical history of a fracture as an adult especially after the age of 50
Lack of hormones – Androgen in men and estrogen in women as with menopause
History of rheumatoid arthritis
Use of certain medications such as corticosteroids, anticonvulsants, thyroid medications or cancer treatments
Anorexia nervosa

Talk to your doctor about these factors that put you at higher risk What are the symptoms of osteoporosis? Osteoporosis can cause severe back pain, loss of height, and spinal deformity. Often, however, there are no symptoms – especially in its early stages. Because of the lack of symptoms, some people may have osteoporosis for several years without knowing, until they break a bone. By then, the disease may be in its advanced stages – with bones being so weak that even a simple bump can lead to a fracture. For this reason, getting screened for osteoporosis is so very important.

What screening tests are available?

A Bone Mineral Density (BMD) test uses a special machine to measure bone density. Most types of these tests are simple, quick, and non-invasive and can be performed in outpatient radiology centers, hospitals, and in some doctor's offices. Some screenings like the heel scan can even be done at health fairs. Some examples of screening are:

Dual-energy x-ray absorptiometry (DEXA) - scans the entire body and measures BMD.

Quantitative computed tomography (QC) - measures bone density in the hip and spine and produces a three-dimensional image.

Peripheral bone density testing - uses ultrasound to identify bone loss in a localized area such as the heel or hand.

If you think you have any risk factors for osteoporosis, are 65 years or older, or have experienced a recent fracture, talk to your doctor about getting a BMD test.

What can you do to prevent osteoporosis or keep it from getting worse?

Here are steps you can take to help keep your bones strong at any age:

Exercise regularly – your bones get stronger when you use them for either high- or low-impact weight-bearing exercise such as walking, hiking, running, dancing, or sports. These activities make your body work against gravity, helping it stay strong and fit. Strengthening exercises such as lifting weights or using exercise bands help by improving bone density, muscle tone and balance. Also, exercises such as Yoga and Pilates help with balance and reducing your risk of falling as you get older. Eat a well-balanced diet that is high in calcium and vitamin D – good sources of Calcium include dairy products, white or dried beans, salmon, sardines, and broccoli. About 300 milligrams (mg) of calcium are in a cup of milk or yogurt, two cups of broccoli, or i six or seven sardines. Consider adding a tablespoon of nonfat powdered milk to puddings, soups, and homemade bakery goods for an additional 50 mg. Good sources for vitamin D include salmon, tuna, egg yolk, fortified cereal, and sunlight. Most people don't get enough calcium or vitamin D in their diet, so supplements may be needed. According to the National Osteoporosis Foundation (NOF), most men and women 19-49 years of age need 1000 mg of calcium a day and 400-800 IU of Vitamin D. For people 50 and older 1,200 mg of calcium and 800 - 1000 IU of Vitamin D are recommended. Talk to your doctor and learn more at www.nof.org Stop smoking – Also, female smokers tend to produce less estrogen and have an earlier menopause. Research shows that the longer you smoke, the greater your risk, and the longer it takes to heal from a fracture. Limit your intake of alcohol – excessive alcohol use can interfere with the calcium balance in your body.

Your doctor can help in creating a plan that is best for you For some people, taking calcium and vitamin D and making lifestyle changes isn't enough. In that case, your doctor may prescribe a medication to help stop bone loss such as: Bisphosphonate – slows down bone loss and in some cases increases bone mineral density. When taking these drugs, it is important to stand or sit upright for 30 minutes after swallowing the medication to decrease the risk of heartburn and ulcers in the esophagus. Also, you must wait 30 minutes to eat or drink, except water, or take other medications, including vitamins and calcium Estrogen replacement therapy Other hormones that can help regulate calcium or phosphate levels in the body and prevent bone loss, such as calcitonin If you have been diagnosed with osteoporosis already, stay on your recommended treatment plan, which may include osteoporosis medicine to help stop bone loss, calcium and vitamin D supplements, exercise, and a diet high in calcium and vitamin D

You can find out more by visiting the National Osteoporosis Foundation at www.nof.org or go to MyHumana, scroll down to the Condition Centers located on the left side of the page, and select Bone and Joint.

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