Osteoporosis

 
Osteoporosis is the thinning and weakening of bones, usually with age. It is much more common in women than in men, especially after menopause, when there is less estrogen in your body to keep bones strong. Weaker bones are more likely to break and lead to other complications. The good news is that there are steps you can take to prevent osteoporosis, and there are treatments available if you already have it.
 
 
There are some risk factors for osteoporosis that you can't do anything about, and some that you can. Some known risk factors are:
  • being a woman
  • over 65
  • family history of osteoporosis
  • personal history of broken bones and/or falls
  • Caucasian (white)
  • low body weight (under 127 lbs)
  • menopause earlier than age 45 (for example, due to surgical removal of ovaries)
  • some medications (such as steroids)  
Bone weakening actually begins long before menopause - usually after about age 30. A lot of bone loss has already occurred before you start to show the symptoms of osteoporosis. So if you are young, now is the best time to do what you can to slow this process down and prevent osteoporosis in the future. There is a lot you can do to help keep your bones strong:
  • get good nutrition, including good sources of calcium (1000-1500 mg/day)
  • get adequate vitamin D, from sunlight exposure, diet, and/or supplements (10-15 micrograms/day)
  • maintain a healthy weight
  • get regular exercise, including a lot of walking (which not only helps bone strength, but increases muscle strength and balance, which reduces your likelihood of falling)
  • keep alcohol use at a moderate level - 1 drink per day for women
  • don't smoke  
By the time you show symptoms of osteoporosis, such as a fracture or humped spine, there is less you can do to treat it. It is best to get a bone density test before you notice any symptoms, so that you have more time to prevent osteoporosis before it starts. In general, if you are a woman over 65 you should have a bone density test, and if you are over 40 you should consider it if:
  • you have a lot of risk factors
  • you were told you have lower bone density than average based on a health screening ultrasound heel test
  • you have been losing height when measured at an annual physical exam  
Talk to your doctor about whether and when you should be tested.
 
If osteoporosis is becoming a problem for you, you can still reduce your risk of fracture with certain osteoporosis drugs:
  • Bisphosphonates (such as Fosamax and Reclast) help prevent further bone loss, and can sometimes increase bone strength. They are available in various forms, from a weekly tablet taken by mouth to an annual intravenous drip.
  • Hormone therapy (supplemental estrogen) can be given after menopause to help reverse the effects of natural low estrogen.
  • Selective estrogen receptor modulators (SERMs, such as tamoxifen or Evista) imitate estrogen molecules in some body tissues, including bones. They can have the same effect as estrogen in keeping bones strong, and are often a good choice if you are a postmenopausal woman who should not take supplemental estrogen (for example if you have or are at high risk for breast cancer).
  • Calcitonin is a thyroid hormone that helps to regulate calcium in the body.
  • Parathyroid hormone (Forteo) treats severe osteoporosis in postmenopausal women, especially in the spine. It is given by a daily injection for two years.  
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