Osteoporosis is a disease that affects ten million Americans of which 8 million are women. One in two women and one in eight men over age 50 will get osteoporosis related fractures.
It is a decrease in the density or thickness of your bones. The bones get thinner and weaker as we get older. Unfortunately, there are no obvious warning symptoms. It is therefore known as the “silent disease”. Having weak bones means they may break after a minor injury or fall. It may happen without any injury.
Osteoporosis is a preventable disease. The best way to prevent weakened bones is by having enough calcium and vitamin D in your diet and regular exercise.
1. Follow a diet with enough calcium and vitamin D.
a. Women need 1000 to 1500 mg/day of calcium.
b. It means at least three 8 ounces glasses of milk per day. You can also eat three ounces servings of yogurt. Other choices are dark leafy vegetables, orange juice and cereals. If you don’t have this much calcium in your diet, ask your doctor if you should take supplements.
c. A natural source of vitamin D is sunlight. In only 15 minutes each day, you can get enough sunlight to keep a healthy vitamin D level. However, sunlight exposure does increase your risk of skin cancer.
Try to do weight bearing exercises three times a week. It helps the uptake of calcium by your bones. Examples are walking, jogging, stair climbing and hiking.
a. Estrogen- oral estrogen can be combined with oral progestin to prevent osteoporosis. If a woman has had a hysterectomy, only estrogen is given. With the recent studies of Prempro having an increased risk of breast cancer, stroke and heart attacks, and other problems, you need to ask your doctor if estrogen is safe for you to take. You doctor might consider non-estrogen alternatives for prevention.
b. Evista (Raloxifene)- approved to be used for both prevention and treatment of postmenopausal osteoporosis. It is a “selective estrogen receptor modulator”. It can cause hot flashes or increase the risk of blood clots in some women.
a. Postmenopausal status
b. Premature menopause (before age 45)
c. Caucasian race or Asian ethnicity
d. Thin, small body build
e. Family history of osteoporosis
f. Certain medications, e.g., steroids
g. Use of tobacco, excessive alcohol or caffeine
Bone densitometry or DEXA scans can be ordered to check the thickness of your bones. It will tell you what your risk for a fracture is. Consult with your doctor to see if this test is indicated.
Some medications can stop bone loss of calcium. They will keep your osteoporosis from getting worst.
a. Biphosphanates- there are two medications called alendronate (Fosamax) and risedronate (Actonel). They can be used for treatment and prevention of osteoporosis. Consult with your doctor to see if treatment is indicated.
b. Calcitonin (Miacalcin)- This is a hormone that is given via a nasal spray. You do one “puff” every day.
c. Teriparatide (Forteo)- is an injectable hormone that stimulates new bone. Side effects are nausea, dizziness and leg cramps. Only approved to be used for 2 years.
1. National Osteoporosis Foundation offers a 22 page free booklet about osteoporosis (1-800-223-9994).
2. National Institute on Aging offers free facts sheet about menopause, osteoporosis and preventing falls (1-800-222-2225).
3. Public library and bookstores have books about osteoporosis.
4. Websites: www.ahrq.gov- Agency for Healthcare and
www.nof.org- National Osteoporosis Foundation.
www.nia.nih.gov- National Institute of Aging.