Preventing and Managing Osteoporosis

Osteoporosis is a disease of thinning, weakening bones. While the body constantly absorbs and replaces bone tissue, with osteoporosis, the creation of new bone doesn’t keep up with the daily loss of old bone. This condition can affect anyone but is most common in Caucasian or Asian women after menopause.

There are often no symptoms of osteoporosis prior to a broken or fractured bone; the breaks can range from the obvious (hip or wrist) to subtle fractures in the spine resulting in permanently stooped posture.

Aside from gender and race, osteoporosis risk factors include a diet low in calcium, a history of an eating disorder or weight loss surgery, or long term use of certain medications, including corticosteroids (prednisone,) some seizure medications, stomach acid medications (proton pump inhibitors), chemotherapy, or organ transplant medications. Lifestyle choices like smoking, heavy alcohol use, and a sedentary lifestyle are also risk factors.

The best way to diagnose osteoporosis is with a bone mineral density test (BMD) which uses a few X-ray beams to measure the thickness of the bones in the hips and lower spine. All women should be screened starting by age 65, sooner if they have risk factors.

Prevention of osteoporosis involves a diet adequate in calcium and vitamin D, weight-bearing exercise, and changes in lifestyle.

Getting enough calcium (1,200 mg per day for women 51 an older) is important. Foods high in calcium include low-fat dairy products, green leafy vegetables, canned salmon, soy products such as tofu, calcium-fortified cereals or juice. Calcium supplements taken by women over 50 years of age should not exceed 1500 mg daily.

Vitamin D improves the body’s ability to absorb calcium. You can increase your vitamin D intake by spending 10-15 minutes, two-three times a week in the sunlight; eating foods like fortified dairy products, salmon, tuna, sardines, egg yolks, mushrooms; and/or taking vitamin supplements. Women up to age 70 need 600 international units (IU) of vitamin D per day; 71+ need 800 IUs. Anyone taking a supplement shouldn’t take more than 3000 IUs daily unless specifically instructed by a physician, as too much Vitamin D can result in its own set of issues.

Getting regular exercise is another good prevention; make sure to include upper body and weigh-bearing exercises as well. Walking while holding some light hand weights will accomplish both goals. Remember, always check with your doctor before starting any new exercise routines.

Treatment for osteoporosis, aside from continuing the preventive measures, include medications that can help slow or stop bone loss.

There are several different classes of medications used in treatment and they vary in type and frequency of dosage, effectiveness, side effects, and cost. You and your doctor should decide which treatment is best for your condition.

The bottom line is osteoporosis is a significant medical condition that could put you on the sideline of your own life. Don’t be a victim. Get screened, and if needed, get treated.

Dr. Beth Hodges is a family practice and palliative care/hospice physician in Asheboro, N.C., as well as a part-time medical director for HealthTeam

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