What is osteoporosis?
Osteoporosis, which means “porous bones,” is a condition that causes bones to become weak and brittle, leading to fractures. Osteoporosis usually progresses painlessly until a fracture occurs, usually in the hip, spine or wrist. The condition can cause pain, difficulty breathing, a loss of independence and even death when complications occur from some fractures.
Osteoporosis is a major public health threat for Americans aged 50 years of age and older. In the United States, 10 million individuals are estimated to already have the disease and almost 34 million more are estimated to have low bone mass, placing them at increased risk for osteoporosis. More than 80 percent of those affected are women. In fact, because of the loss of estrogen after menopause that blocks or slows down bone loss, women are four times more likely than men to develop this condition. One out of every two women will develop osteoporosis over the course of her lifetime. These numbers are predicted to rise as the population ages in the coming decades. Though many elderly people have osteoporosis, it is not a normal part of aging and can be prevented.
What are the risk factors for osteoporosis?
Factors that can increase your chances of developing osteoporosis include being female; a small, thin body frame; family history of osteoporosis; early menopause; a diet low in dairy products or other sources of calcium and vitamin D; inactive lifestyle; Caucasian or Asian race; use of certain medications to treat conditions like asthma, arthritis, gastrointestinal diseases, hypothyroidism and seizure disorders; smoking; excessive use of alcohol; and increasing age.
How would I know if I have osteoporosis?
The only sure way to find out if you have osteoporosis or low bone density that puts you at risk for osteoporosis (osteopenia), is to have a bone mass measurement which is also called bone mineral density or BMD test. Bone density tests are useful for confirming a diagnosis of osteoporosis if a person has already had a suspicious fracture, or for detecting low bone density so that treatment or preventative steps can be taken. In order to assess who should have a bone density test, doctors consider a patient’s medical history and risk factors.
The Federal Drug Administration's (FDA) approved method for diagnosing osteoporosis is the DXA or DEXA (dual energy X-ray absorptiometry), which measures bone density at the spine, hip or total body. Other methods that measure bone density at peripheral sites, such as the heel, wrist or finger are usually inexpensive and quick, but are considered screening methods that may indicate if you are at high, moderate or low risk for osteoporosis. Those who have been screened and are at moderate or high risk should then have a DXA test to make a final diagnosis. All of the methods to test bone density are painless, noninvasive, safe and are becoming increasingly available. Medicare covers the cost of having a DXA test once every two years.
How can I protect myself from osteoporosis?
Osteoporosis is usually preventable. Females need to take steps to protect the health of their bones while they are still children and throughout their teenage and young adult years, since peak bone mass is usually obtained by age 30 or before. Building strong bones at a young age lessens the effect of the natural bone loss that occurs after menopause.
Getting enough calcium throughout life is important because it helps to build and maintain strong bones. Children 5 to 10 years of age need 800 to 1,200 milligrams (mg) of calcium every day, while teens need 1,200 to 1,500 mg per day. Women 25 to 50 years of age should have 1,000 mg of calcium each day, while women near or past menopause should have 1,200 mg of calcium daily if they are taking estrogen replacement therapy; otherwise, 1,500 mg per day is recommended. Women older than age 65 years of age should have 1,500 mg per day. Make foods that are high in calcium part of your diet, including low-fat dairy products such as milk, yogurt and cheese; canned fish with bones, such as salmon and sardines; and dark-green leafy vegetables, such as kale, collard and broccoli. If you do not get enough calcium from your food, you might think about taking a calcium supplement. (Always check with your doctor before taking any dietary supplement.)
In addition, your body needs vitamin D to absorb calcium. An intake of 400 to 800 I.U. (I.U. is the standard measurement listed on any bottle of vitamins) is recommended per day; however, scientists are continuing to study Vitamin D to determine the optimal daily dose. Being out in the sun without sunscreen for 15 minutes a day gives most people enough vitamin D. This essential vitamin also can be obtained from supplements or vitamin-D rich foods such as egg yolks, saltwater fish, liver, and fortified milk.
Maintaining a healthy weight and being physically active at least 30 minutes a day for adults or 60 minutes for children can help decrease one’s risk for developing osteoporosis. Weight-bearing and resistance exercises build bone and muscle strength and help prevent bone loss, as well as improve coordination to prevent falls. Walking, jogging and playing tennis are all good weight-bearing exercises to build bone mass in the lower torso and extremities. Resistance exercises, including lifting weights, build bone mass in the upper torso and extremities. Always check with your doctor before starting an exercise program.
Additional important preventive measures include considering not smoking or quitting if you already do; and limiting consumption of alcoholic beverages. Good posture and prevention of falls are important in reducing the chance of injury.
How is osteoporosis treated?
Under Federal Drug Administration (FDA) guidelines, drugs to treat osteoporosis must be shown to preserve or increase bone mass and maintain bone quality in order to reduce the risk of fractures. Drugs currently approved for the prevention and/or treatment of osteoporosis include bisphosphonates, calcitonin, estrogens, raloxifene and teriparatide. The following is a brief description of each drug:
More information about osteoporosis can be obtained by contacting:
National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases
The National Women’s Health Information Center, Office on Women’s Health, U.S. Department of Health and Human Services
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