A Doctor's Take on Osteoporosis

    Dr. Becca Hopper, Deaconess Clinic Internist and Pediatrician


    Osteoporosis is a disease in which the density and quality of bone are reduced—bones actually become weaker. As bones become more porous and fragile, the risk of fracture is greatly increased. The loss of bone occurs silently and progressively. Often there are no symptoms until the first fracture occurs.

    The causes of osteoporosis are many, but some of the major risk factors include:
    • Inadequate calcium and vitamin D consumption throughout life. 
    • Being a postmenopausal woman or senior-aged male
    • Low estrogen from other causes, such as ovary removal
    • Sedentary lifestyle
    • Chronic steroid use
    • Small, thin frame
    • Family history of osteoporosis (such as older relatives who had severe breaks, or maybe an older woman who had a significant “stooped” or “hunched” back)
    • In males, low testosterone can be a risk factor.

    While you may not be able to completely prevent osteoporosis, you can lower your risk substantially through several lifestyle modifications and possibly taking certain medications. Some of the most important things you can do for your bones include:
    • Staying active, particularly with weight bearing exercise. When you put a strain on your bones (such as by walking, lifting weights, etc.) it causes the bone to strengthen itself by rebuilding bone mass.
    • Maintain a good diet, particularly high in calcium-containing foods. These include low-fat/skim milk, cheeses, yogurt, and other dairy. Green leafy vegetables also contain calcium. Everyone needs about 1,000 mg of calcium per day; however, if you are pregnant, have low estrogen or are post-menopausal, you need 1,500 mg per day. It’s important to note that your body can only absorb about 600 mg of calcium at a time. So if you were to drink a glass of milk and take a calcium supplement at the same time, you wouldn’t absorb all of that calcium.
    • Vitamin D is also important because it’s the vitamin that allows your body to absorb calcium and converts it for its uses in the body. Our bodies make vitamin D in response to sunlight. However, this is NOT a reason or excuse to spend too much time in the sun! If your face and hands are exposed to 15-20 minutes of sunlight per day, this will make adequate vitamin D. You can also supplement vitamin D in your diet (which may be a good idea, especially in the winter). Vitamin D3 is the preferred type for absorption. If you are under age 50, you need at least 400 IUs (international units). If you are over age 50, 800 IUs are recommended. However, 1,000 IUs is a maximum level for a preventive dose.

    How is osteoporosis diagnosed?
    • We always hope to learn that a patient has osteoporosis BEFORE a bone break. Unfortunately, sometimes the first sign of weakened bones is a fracture. However, if I know if a patient is at risk, I will screen them to help treat the disease before a fracture occurs. The standard for osteoporosis diagnosis is the DexaScan, which is an x-ray of certain parts of the skeleton, such as the femur and spine to if see bone mass is normal. If you have a reading of -2.5 or less on one of your bones, that indicates osteoporosis. This test is only available through a physician’s order.  If you would like to learn more about DexaScan, be sure to talk to your doctor.

    How is osteoporosis treated?
    • Medication is a common treatment. The first-line medication is usually a bisphosphonate (Fosamax, Boniva, etc.) They reduce fracture risk and prevent further bone loss. Some newer medications may actually help build bone mass. There are other medications that work to help manage osteoporosis by modifying hormone levels. These medications aren’t without risks and side effects, and the benefit must be determined by you and your doctor together.
    • Specific exercises and nutrition can also help build bone mass.  FrameWorks, an exercise program offered by The Women’s Hospital and High Pointe (therapy at The Women’s Hospital), teaches women how to exercise safely and effectively.  The focus is placed on appropriate and weight-bearing exercise, minimizing the risk for injury while increasing bone mass.  For more information about FrameWorks, contact Jackie Spring at 812-842-4511.
    Posted: June 20, 2014 by Jessica Gerlach

    Tags: bones, calcium, joint, Osteoporosis

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