Understanding osteoporosis

What is osteoporosis?

Osteoporosis is a disease of the bones caused by loss of bone mass (also called bone density) and weakening of bone tissue, making bones more likely to break.

Causes of osteoporosis

Osteoporosis is caused by a change in the normal process of bone breakdown and formation. Throughout your lifetime, old bone is broken down and replaced by new bone. When bone breaks down faster than new bone is formed, bones become fragile, less dense and more likely to break.

Until about age 30, bones are usually larger, stronger and denser because new bone is formed faster than old bone is broken down. Bone breakdown increases during the first few years after menopause and happens faster throughout the postmenopausal years. When breakdown happens faster than formation, bones become fragile and weak.

There are many risk factors for osteoporosis. Some risks you cannot change, and others you can.

Risk factors you cannot change

  • Gender: Women get osteoporosis more often than men.
  • Age: The older you are, the greater your risk.
  • Body size: Small, thin women are at greater risk.
  • Ethnicity: Caucasian and Asian women are at higher risk than black or Hispanic women.
  • Family history: Osteoporosis tends to run in families.

Risk factors you can change

  • Calcium and vitamin D intake: Appropriate amounts of calcium and vitamin D are necessary for the body to form new bone. Not enough calcium and vitamin D contribute to weak, fragile bones.
  • Physical activity: Activity that strengthens bones will aid in bone formation, because bone responds to the stress of physical activity. Lack of exercise or long-term bed rest can cause weak bones. Activities that build bone include weight-bearing (strengthening) exercises and aerobic exercise, like walking and biking.
  • Medication use: Steroids, thyroid medications and seizure medications may contribute to a decrease in bone mass.
  • Sex hormones: Low estrogen levels, especially after menopause, can contribute to osteoporosis.
  • Smoking: Smoking can slow bone formation.
  • Excessive alcohol intake: Drinking large amounts of alcohol contributes to the development of osteoporosis.
  • Poor diet: Eating disorders and poor eating habits can cause development of weak, unhealthy bones.

Symptoms of osteoporosis

Osteoporosis is called the “silent disease” because bone loss has no symptoms. Often, the first sign of osteoporosis is a bone that breaks easily from a strain, bump or fall.

Diagnosing Osteoporosis

A bone mineral density test (such as a DEXA scan) is the best way to check bone health. The test is painless, like an X-ray, and is done on the hip and spine. The DEXA scan can be used to estimate bone density and strength, diagnose osteoporosis, determine the rate of bone loss and whether prescribed treatments are making bones stronger.

Preventing osteoporosis

Take these steps to keep your bones strong and healthy:

  • Eat a balanced diet rich in calcium and vitamin D: Eat plenty of low-fat milk, yogurt and cheese, as well as foods fortified with calcium, such as cereals, bread and orange juice.
  • The best source of vitamin D is skin exposure to the sun. Get at least 30 minutes of sun between 10 a.m. and 3 p.m. at least twice a week. Some foods also contain vitamin D, and calcium and vitamin D supplements are available. Talk with your physician about your calcium and vitamin D needs. In general:
    • Ages 50 and younger need 1,000 mg of calcium and 200 IU of vitamin D per day
    • Ages 51 to 70 need 1,200 mg of calcium and 400 IU of vitamin D per day
    • Those older than 70 need 1,200 mg of calcium and 600 IU of vitamin D per day
  • Exercise: Increase bone strength by walking, hiking, jogging, climbing stairs, lifting weights, dancing or playing sports such as tennis. Activities that improve balance, such as yoga and tai chi, also are good sources of exercise.
  • Stop smoking: Smoking cessation classes and support are available through Norton Healthcare. [add link]
  • Limit alcohol: Drink alcoholic beverages only in moderation.
  • Prevent falls: Take steps to prevent falling, which will help prevent broken bones. Try these tips:
    • Use a cane or walker, especially if you have poor vision or balance
    • Wear rubber-soled shoes, and avoid walking indoors in socks or stockings
    • Keep rooms free of clutter
    • Use a plastic or carpet runner on slippery floors
    • Be sure carpets or rugs have skid-proof backs
    • Be sure stairs are well-lit, and always hold onto the railing
    • Have grab bars installed next to toilets and in bathtubs and showers
    • Keep a cordless phone nearby to avoid getting up and rushing to answer the phone
  • Talk with your doctor about medications to prevent osteoporosis: Several medications are available to help prevent postmenopausal osteoporosis. Speak with your physician about what medications may be right for you.

Treating osteoporosis

A diagnosis of osteoporosis can mean making significant lifestyle and dietary changes. It is important to follow the treatment plan prescribed by your primary care provider. Your primary care provider will determine the best treatment for osteoporosis. Regular bone density tests can evaluate the effectiveness of your treatment. Ask your primary care provider for your specific bone density test requirements.

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