Osteoporosis: Our Silent Bone Disease

Imagine a disorder that silently eats away at the body’s hardest substance—our bone—causing fractures or breaks without any warning. Osteoporosis is the most common bone disease and is a silent process that steals bone strength by thinning and weakening them as we age. It can lead to permanent disability, loss of independence and even death. Osteoporosis threatens 34 million Americans—mostly older women, but men can get it too. It leads to 1.5 million fractures each year, and the cost to treat this disease is as high as $17 billion and rising. The good news is that it easily can be prevented and reversed with early treatment.

What are Osteoporosis Risk Factors?

• Women are more likely to get osteoporosis as a result of their thinner, lighter bones and frame and a decrease in estrogen after menopause.
• White and Asian women are at highest risk. African-American and Hispanic women have a lower but still significant risk.
• A small-boned frame and low body weight especially combined with early menopause.
• Long-term use of steroids, Depo Provera, heparin, some anti-seizure and thyroid medications increases risk.
• Lifestyles that include diets low in calcium and vitamin D, little or no exercise, smoking, excessive alcohol and caffeine use contribute significantly to this disease.
• Age increases the risk of osteoporosis.
• A pattern of fractures and family members who have a stooped appearance or have lost height as they have aged.

How Will I Know if I Have this Bone Disease?

The only way to know for sure is to have a bone mineral density test (BMD), also called a DEXA scan. This painless test measures the thickness of the bone by using a special X-ray machine with very low doses of radiation. It takes approximately 15 minutes. The results tell your doctor how high your risk for fracture is and your rate of bone loss. The hips, spine and wrist most often are tested because they are at highest risk for weakening and fracture. DEXA most often is done for post menopausal women over the age of 50 or younger women with high risk factors.

What Can I Do to Prevent or Treat Osteoporosis?

• Get adequate calcium and vitamin D from diet or supplements
• Do not smoke.
• Limit alcohol and caffeine drinks to no more than two per day.
• Exercise three to five times a week such as walking, jogging, dancing or tennis.
• Talk to your doctor about special medications.

Why are Calcium and Vitamin D Important?

Your body needs calcium for your heart, muscles and nerves to function properly. It assists your blood to clot normally and is particularly important for new bone formation, which prevents osteoporosis. Vitamin D helps your body to absorb calcium. It is formed naturally after exposure to sunlight.

The National Institute of Health recommends that men and women have adequate daily intake of calcium and vitamin D as follows.

• Calcium
  • Ages 25 to 50 pre-menopause 1,000 mg/day
  • Ages 51 to 64 post-menopause 1,500 mg/day (if not on hormones)
  • Ages 65 or older 1,500 mg/day
  • Pregnant or Breastfeeding 1,200-1,500 mg/
    
• Vitamin D
  • 400-800 IU daily

Which Foods are Best?

• Milk: One 8 ounce cup = 300 mg of calcium
• Dairy products: Low fat is best
• Fish and Shellfish
• Green, leafy vegetables
• Tofu
• Breads and Cereals
• Nuts
• Navy or refried beans

What Should I Know About Supplements?

• Stick to name brands with proven reliability that have the USP symbol.
• Take 500 to 600 mg of calcium with vitamin D at one time.
• Space each dose several times throughout the day for better absorption.
• Take supplements at the same time every day.
• Do not take calcium with your multivitamin or iron supplements.
• Calcium carbonate (Caltrate, Viactiv): take during or near meals.
• Calcium citrate (Citrical): take with meals or an empty stomach.
• Use antacids that are high in calcium but do not contain aluminum.
• Avoid calcium from oyster shell or bone meal as it is high in lead content.
• Coral calcium is not recommended for osteoporosis or other diseases.
• Added magnesium is not necessary for calcium absorption.

References

National Osteoporosis Foundation; National Institute of Health, 2003, Printed 2005.

4/20/2006