Osteoporosis 

Treatment, Prevention & Risks

What Is Osteoporosis? What Puts Some Women At Risk For Losing Bone? Why Is Osteoporosis Such A Concern? How Can Osteoporosis Be Monitored? How Do I Prevent And Treat Osteoporosis? Keeping Strong And Healthy Bones Makes A Difference

Osteoporosis is a condition that many people associate with older women who have a broken hip or a hump in the spine. Yet this is a condition that all women, young and old, need to pay attention to. It can limit a woman's independence and quality of life, and put her at risk for serious health problems.

The good news is that osteoporosis is preventable. Taking stock of yourself and taking action can help you keep your bones strong and healthy.

Age, lifestyle, and certain medical conditions increase a woman's risk for developing osteoporosis. Women with type 1 diabetes are thought to be at higher risk for this condition as well.

Thanks to the advances in diabetes care, and the resulting reduction in complications, women with diabetes are living longer. But this good fortune has a negative side as well: women who live longer are at a higher risk for bone loss as a result of aging. It's also true that Graves' disease (excessive activity of the thyroid gland, hyperthyroidism) and hyperparathyroidism (excessive amounts of parathyroid hormone in the body) occur slightly more frequently in women with type 1 diabetes, and both of these conditions can cause osteoporosis.

Let's take a look at what osteoporosis is, how to monitor for it, and how to prevent and treat it.

What Is Osteoporosis?

Osteoporosis means porous bone. It is a silent disease that usually goes unnoticed until fractures in the spine or hip occur. It is characterized by low bone mass and thinning of the bone tissue. The bone can resemble thin lace; it becomes fragile and easily fractures.

Bone is living tissue. It is dynamic. It breaks down and rebuilds itself. This process is called "bone turnover." As we age, bone turnover changes. The rate of growth decreases while removal of old bone continues. This leads to bone loss.

What Puts Some Women At Risk For Losing Bone?

Women are more prone to osteoporosis when they are deficient in estrogen. To keep the bone strong and thick, the body needs estrogen. Estrogen is important for vitamin D absorption that is critical for calcium absorption. The body's ability to absorb vitamin D and calcium decreases with age. After menopause, our body loses one-third of our bone mass. Women who enter menopause with lower bone mass are at high risk for developing osteoporosis. Women who go through menopause at an early age (in their 40s) are more likely to lose more bone. If a woman doesn't take steps to reduce this rate of removal, the bone mass becomes thinner and weaker.

Lifestyles that put a woman at risk for losing bone include smoking and inactivity. Smoking interferes with the body's ability to absorb calcium. On the other hand, exercise keeps muscles strong and well-toned, thus keeping the body in balance. Weight-beating activity helps maintain existing bone. Also, if a woman is fit and flexible, she is less likely to be seriously hurt in minor falls or accidents.

Women taking steroids and too much or too little long-term thyroid medications may lose more bone. Steroids interfere with the architecture of the bone and contribute to bone loss. The thyroid hormone stimulates bone turnover. Women with untreated Graves' disease are at risk for losing bone mass. Women with hypothyroidism (deficient thyroid activity) who take too much medication can also lose bone. So it's important to have your thyroid function checked routinely and to take medications as prescribed. (Note: Women who are getting correct amounts of thyroid medication are not at increased risk for bone loss.)

Women with certain body types are at risk. Women who are thin tend to have lower bone density and, as a result, are more at risk for a fracture.

Women with nutritional deficiencies are at risk. Women who take in inadequate amounts of nutrients, women who have eating disorders, and those who consume too much alcohol are at heightened risk for losing bone. Over-restriction of fat can interfere with the body's ability to make its own estrogen.

Why Is Osteoporosis Such A Concern?

Untreated osteoporosis can lead to fractures of the spine, hip, and wrist. It can result in loss of height, back pain, and it can limit a woman's activity. Some women find it difficult to lift a bag of groceries or their grandchild. Osteoporosis and bone fractures can lead to loss of independence, disability, and depression. It can be difficult to get around and connect with others.

How Can Osteoporosis Be Monitored?

A bone scan is used to measure your bone density and determine your risk of developing a fracture. The bone density test called the DXA scan, is not painful and involves lying on a table as a machine scans your spine or hip The DXA Scan gives a score that used to compare the density of you bones to that of a young, healthy woman. This score is referred to a the "t-score." The lower the bone density, the lower the t-score and the higher the risk for fracture. A t-score of-2.5 usually indicates that you have osteoporosis.

How Do I Prevent And Treat Osteoporosis?

As long as you do not have any impairment of kidney function, you should follow a meal plan rich in calcium and vitamin D. (If you do have kidney disease, then you should ask for specific calcium and vitamin D requirements from your physician and dietitian.) If you are premenopausal or are taking hormone replacement therapy, you need 1,000 to 1,300 mg a day of calcium and 400 to 800 IU of vitamin D a day. If you are postmenopausal and not taking hormone replacement therapy (also known as HRT or estrogen replacement), you need about 1,500 mg a day of calcium and 400 to 800 IU of vitamin D a day. (If you are interested in receiving hormone replacement therapy, be sure to discuss the advantages and risks with your doctor.)

If you are unable to get the recommended amounts of these nutrients from the food that you eat, you will need to use supplements. If so, it's recommended that you get at least half of your calcium requirements from food and the other half from supplements. To maximize the absorption of calcium supplements, take half the dose (for example, 300 to 400 mg) in the morning and half (the other 300 to 400 mg) in the evening.

Taking medications as prescribed to treat thyroid or parathyroid conditions is also important. Ask your doctor about your thyroid function tests to ensure that you are taking the right amount of medication.

Be as active as possible. Alternating between weight-bearing exercises like brisk walking, tennis, or jogging, and less stressful exercises like biking or swimming, will help you to tone your muscles and keep your bones strong while keeping your heart healthy. In The Osteoporosis Book, Dr. Nancy Lane reports that women who start to exercise can increase their bone density by 3 to 4 percent in a few years by starting an exercise program that includes lifting weights and walking briskly for 30 minutes, three to four times a week. Activities like yoga are also helpful in increasing flexibility, strength, and balance.

Reduce your risk of losing more bone by stopping smoking and reducing your intake of alcohol. If you have an eating disorder, seek the help of a professional who can support you. If you have nerve damage, poor eyesight, or problems with your balance, you may be more at risk for falling. Talk with your health care team to explore ways to reduce your risk for falls, to strengthen your muscles, and protect your bones. Eliminate unnecessary clutter in your home and workplace.

There are many osteoporosis medications now available to prevent bone loss and treat osteoporosis. They all have side effects as well as benefits. Determining which one is best for you requires discussions with your doctor, consideration of your risk factors for experiencing the side effects, your overall health, and the extent of any bone loss that might have already occurred. The medications that are approved for preventing osteoporosis are Evista, Fosamax, and hormone replacement therapy. The osteoporosis medications that are approved for the treatment of osteoporosis are Calcitonin, Evista, Fosamax, and hormone replacement therapy.

Keeping Strong And Healthy Bones Makes A Difference

As women age, bone loss occurs. Too much bone loss leads to osteoporosis and potentially devastating effects on independence, mobility, and quality of life. You can make a difference for yourself. Take the time now to keep your bones strong so that you can enjoy the fruits of aging.

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