Osteoporosis is a disease that weakens bones to the point where they break easily-most often bones in the hip, backbone (spine), and wrist. It’s called the “silent disease”-you may not notice any changes until a bone breaks-but your bones have been losing strength for many years.
Bone is living tissue. To keep bones strong, your body continually breaks down old bone and replaces it with new bone tissue. As people enter their forties and fifties, more bone is broken down than is replaced. A close look at the inside of bone shows something like a honeycomb. When you have osteoporosis, the spaces in this honeycomb grow larger and the bone that forms the honeycomb gets smaller. The outer shell of your bones also gets thinner. All this loss makes your bones weaker.
Millions of Americans have osteoporosis-mostly women, but more than 2 million men also have this disease. White and Asian women are most likely to have osteoporosis. Other women at great risk include those who:
The risk of osteoporosis increases as you get older. At the time of menopause women may lose bone quickly for several years, after which the process slows down but continues. In men the loss of bone mass is slower. But, by age 65 or 70 men and women are losing bone at the same rate.
Millions more Americans have osteopenia. Whether your doctor calls it osteopenia or just says you have low bone mass, consider it a warning. Bone loss has started, but you can still take action to keep your bones strong and maybe prevent osteoporosis later in life. That way you will be less likely to break a wrist, hip, or vertebrae (bone in your spine) when you are older.
For some people the first sign of osteoporosis is to realize they are getting shorter or to break a bone easily. Don’t wait until that happens to see if you or your loved one has osteoporosis. Your doctor may suggest a type of bone density test called a DEXA-scan (dual-energy x-ray absorptiometry) if you are age 65 or older or if he or she thinks you are at risk for osteoporosis. This test shows how solid your bones are and assesses your risk for a fracture or broken bone. It could show that you have normal bone density. Or, it could show that you have low bone mass or even osteoporosis.
There are things you should do at any age to prevent weakened bones and keep them strong and healthy. Eating foods that are rich in calcium and vitamin D is important, as is including regular weight-bearing exercise in your lifestyle.
Calcium. Getting enough calcium all through your life helps to build and keep strong bones. People over age 50 need 1200 mg of calcium every day. Foods that are high in calcium are the best source, such as low-fat dairy foods, canned fish with soft bones such as salmon, dark green leafy vegetables, and calcium-fortified foods like orange juice, breads, and cereals.
If you think you aren’t getting enough calcium in your diet, check with your doctor first. He or she may tell you to try a calcium supplement, the most common of which are calcium carbonate and calcium citrate. However, too much calcium can cause problems for some people. On most days you should not get more than 2500 mg of total calcium from all sources, including foods, drinks, and supplements.
Vitamin D. Your body uses vitamin D to absorb calcium. Most people’s bodies are able to make enough vitamin D if they are out in the sun for a total of 20 minutes every day. You can also get vitamin D from eggs, fatty fish, and cereal and milk fortified with vitamin D. If you think you are not getting enough vitamin D, check with your doctor. Each day you should have:
As with calcium, be careful. More than 2000 IU of vitamin D each day may cause side effects.
Exercise. Your bones and muscles will be stronger if you are physically active. Weight-bearing exercises, done three to four times a week, are best for preventing osteoporosis. These include walking, jogging, playing tennis, and dancing. Strengthening and balance exercises can also be effective, as they may help you avoid falls that might cause a broken bone.
Medicines. Some common medicines can make bones weaker. These include a type of steroid drug called glucocorticoids used for arthritis and asthma, some antiseizure drugs, certain sleeping pills, treatments for endometriosis, and some cancer drugs. An overactive thyroid gland or using too much thyroid hormone for an underactive thyroid can also be a problem. If you are taking these medicines, talk to your doctor about what you can do to help protect your bones.
Lifestyle. Smoking increases the loss of bone mass; for this and many other serious health reasons, stop smoking. Limit how much alcohol you drink, as too much alcohol can put you at risk for falling and breaking a bone.
Treating osteoporosis means stopping the bone loss and rebuilding bone to prevent breaks. Diet and exercise can help make your bones stronger, but they may not be enough if you have already lost a lot of bone density. There are also several medicines to think about. Some will slow your bone loss, and others can help rebuild bone. Talk with your doctor to see if one of these might work for you:
When your bones are weak, a simple fall can cause a broken bone. This can mean a trip to the hospital and maybe surgery. It might also mean being laid up for a long time, especially in the case of a hip fracture, so it’s important to prevent falls. Some things you can do are:
Osteoporosis is not just a woman’s disease. Not as many men have it as women do, but men need to worry about it as well. This may be because most men start with more bone density than women and lose it more slowly as they grow older.
Experts don’t know as much about this disease in men as they do in women. However, many of the things that put men at risk are the same as those for women:
Older men who break a bone easily or are at risk for osteoporosis should talk with their doctors about testing and treatment. Men can use alendronate, risedronate, or parathyroid hormone to increase bone density. Testosterone supplements may also help for some men with low levels of testosterone.
National Osteoporosis Foundation
1232 22nd Street, NW
Washington, DC 20037-1292
National Institutes of Health
Osteoporosis and Related Bone Diseases~National Resource Center
2 AMS Circle
Bethesda, MD 20892-3676
Source: National Institute on Aging, www.nia.nih.gov (Original title:Osteoporosis)