Osteoporosis

By Lauren P. Adey, MD

If you’re feeling good and staying active, you figure your body is nice and healthy, right? Unfortunately, we can’t take anything about our bodies for granted, especially as we age.

I’m an orthopaedic surgeon, which makes me very familiar with the mechanics of our bodies and I would like to share some information about our bones.

Your skeleton is the structure on which your body relies to stand, move, bend over, pick things up, and reach overhead. Over time, your bones change due to aging and wear-and-tear. This can cause conditions such as osteoarthritis, which can be uncomfortable or even painful.

However, your bones can suffer an even greater problem that can be “silent” right up to the point where a simple fall could cause a potentially deadly fracture.

This “silent” bone issue is osteoporosis — which may begin with a milder condition known as osteopenia.

What are osteopenia and osteoporosis?

Losing too much bone can lead to osteoporosis, which means bones are brittle and can break with little effort. Osteopenia means bones are slightly less dense than normal but not in the range of osteoporosis.

Most people’s bones are as strong and dense as they’ll ever be between the ages of 18 to 25. By the time you reach 35, bone density begins to gradually decrease until menopause. After menopause, bone loss happens more rapidly — as much as 20 percent in five to seven years.

Risk factors

Everyone suffers some loss of bone mass over the years. However, you may be at higher risk of osteopenia and osteoporosis if you:

  • Are a women
  • Are postmenopausal or have low estrogen levels
  • Have a thin, small body frame
  • Are a man older than 70
  • Are Asian or Caucasian
  • Have a family history of osteoporosis
  • Have a history of broken bones
  • Take certain medications, such as steroids
  • Have certain diseases, such as rheumatoid arthritis, lupus, diabetes or a thyroid condition
  • Don’t get enough calcium and/or vitamin D
  • Smoke
  • Are inactive
  • Have more than three alcoholic drinks a day
  • Drink more than three cups of coffee a day
  • Are shorter than you used to be

Diagnosing osteopenia and osteoporosis

If you have fit any of the categories listed below, talk with your physician about scheduling a test to measure your bone density.

  • Women over age 65
  • Men over age 70
  • Anyone with a broken bone who is over age 50
  • Postmenopausal women under age 65 if they have significant risk factors

The current best practices test is a DEXA scan (dual energy x-ray absorptiometry). It measures the amount of bone mass in the hip and spine and compares results to those of a healthy 30-year-old person of the same gender. The comparison — stated as a number — is called a T-score and can give a good indication of bone loss over the years. Below are some typical numbers.

T-SCORES

  • -1 and above = normal
  • Between -1 and -2.5 = osteopenia
  • -2.5 and below = osteoporosis

Preventing osteoporosis

Based on a T-score, your doctor can give you good advice about preventing additional bone loss — or even reversing some loss. The two best things you can do are to get enough (absorbed) calcium and exercise on a regular basis. It’s never to early or too late to take these two steps.

Bones need calcium

  • Calcium needs to be ingested; the body can’t make it on its own.
  • Women under age 50 and men under age 70 need 1000 mg a day.
  • Women over age 50 and men over age 70 need 1200 mg a day.
  • Calcium-rich foods include dairy, non-dairy beverages such as soy or almond milk, beans, soybeans, canned sardines and salmon and dark leafy green vegetables, such as kale, spinach and turnips. The list goes on and on. You can easily find more information on calcium-rich foods on the Internet or at your local library.
  • To reach your daily amount, fill any gap with a calcium supplement, such as calcium carbonate or calcium citrate.

Vitamin D helps bones absorb the calcium

  • People under age 50 need 400 to 800 IU a day.
  • People over age 50 need 800 to 1000 IU a day.
  • The best source of Vitamin D is sunlight. While you need to be careful, most doctors now recommend 10 to 20 minutes of sun exposure each day to boost your vitamin D.
  • You can get some Vitamin D in wild caught mackerel, salmon and tuna and some fortified milk and orange juice.
  • To reach your daily amount, fill the gap with a Vitamin D supplement. Most calcium supplements include Vitamin D.

Exercise helps build strong bones

Regular exercise is proven to slow, or even reverse, bone loss. For preventing osteopenia and osteoporosis, the most important type of exercise is weight bearing, which uses your own body weight to work against gravity.

Examples of weight bearing exercises:

  • Brisk walking
  • Hiking
  • Running
  • Dancing
  • Kickboxing
  • Housework
  • Yoga
  • Tai chi
  • Pilates
  • Golf
  • Racquet sports

Take steps to help yourself

Because of the high risk of bone fractures, especially hip fractures, osteoporosis is a disease that needs to be taken seriously.

The next step is up to you! I mean that quite literally. If you want to remain healthy, active, and self-sufficient in your later years, you need to add more calcium to your diet, more exercise to your day, and check in with your physician about testing your bone health.