Episode 1: October 4, 2010
by Sanaz Majd, MD
Today I want to talk about a condition every woman—regardless of her age—should be aware of: osteoporosis. So what is osteoporosis?
What Is Osteoporosis?
Osteoporosis is the loss of bone mass causing fragile bones. We all slowly lose some bone mass as we age, but those with osteoporosis tend to lose more than what is considered normal. Because the bone is not as dense, it becomes weaker and may more easily fracture. Bone density is closely related to the levels of estrogen hormone, the female hormone that declines as women age. Therefore, osteoporosis tends to be much more common in women who have already gone through menopause, because they are no longer producing as much estrogen. Yes, for you girls who aren’t there yet, it’s just another health problem to look forward to after your periods stop.
What Are the Symptoms of Osteoporosis?
Many patients erroneously believe that bone loss causes actual pain, but it doesn’t. With only one exception: if you break a bone. Osteoporosis wouldn’t be too big of a deal, if it wasn’t for the increased risk of bone fractures. Women with osteoporosis tend to break their bones a lot more easily with more minor traumas that come from things like hitting your leg against the coffee table or gently falling down after you trip. And the reason that fractures are a big deal is because they cause pain and suffering—and they may lead to other risky complications, like infections or blood clots. But let’s not get ahead of ourselves.
Who Gets Osteoporosis?
All of us lose bone mass as we age, but not everyone gets osteoporosis. We know there are certain risk factors that can contribute to developing osteoporosis. So what are these risk factors? Let’s “break” it down:
Family History of Osteoporosis: Did either one of your parents suffer from osteoporosis or a hip fracture? Forming strong bones is partly genetic. So if your parents passed on the poor bone-forming genes, it may place you at greater risk for developing osteoporosis later in life.
Sex/Race: Being female and being Caucasian also places you at a greater risk of developing osteoporosis.
Cigarette Smoking: Studies show that smoking causes bone loss, and is quite bad to the bone. Another great reason to think about quitting!
Excessive Alcohol Consumption: Studies show that bone loss increases with the amount alcohol consumed, and that those who consume more than 2 drinks a day have a higher risk of hip fractures.
Body Frame: Women who are thin, small-boned, and weigh less than 125 pounds are typically at greater risk. (This doesn’t give you permission to go and eat fast food every day so that you can exchange your risk of osteoporosis for heart disease, though!)
Hyperthyroidism: Excess thyroid hormones can cause a decrease in bone mass. Therefore, those who leave their hyperthyroidism (a condition where the body itself produces too much thyroid hormone) untreated, and those taking an inappropriate amount of thyroid hormone pills to treat their underactive thyroid condition are at increased risk.
Medications: Some medications can lead to osteoporosis as a side effect. Women who take too many steroids (not the kind that make you bulk up) and other medications used to treat certain health conditions, like rheumatoid arthritis or lupus are at greater risk. So are women taking an inappropriate amount of thyroid medications, anti-seizure medications, and some chemotherapy agents. Taking the anti-contraceptive injection, Depo-Provera, for longer than two years is also a risk.
Estrogen Deficiency: Estrogen builds bone. So if you have too little, it can do the opposite. There are many health conditions associated with low estrogen levels: menopause, eating disorders, excessive exercise, premature ovarian failure, and those with amenorrhea, disorders characterized by the lack of menstrual periods.
History of a Previous Fracture: Those with a prior low-trauma fracture as an adult are more likely to have osteoporosis without knowing it.
Medical Diseases: Various medical problems are associated with low bone density, such as rheumatoid arthritis, inflammatory bowel disease, celiac disease, cystic fibrosis, hyperthyroidism, diabetes, and kidney disease.
How Does Osteoporosis Get Diagnosed?
A special x-ray of the spine and hip called a DXA scan measures the amount of bone mineral density and is used to determine if someone has osteoporosis. All postmenopausal women age 65 or older should get routinely screened with a DXA scan. Some women younger than 65 years old with some of the previously mentioned risk factors may get screened earlier than age 65, however. If you are 65 years old or more, or if you are younger but have any of the above risk factors, you should consult your physician and discuss the need for getting screened.
How Do You Prevent Bone Loss?
It’s important to prevent bone loss now--there is no time like the present. You don’t want to wait until you’ve already been diagnosed with osteoporosis to start working on your bone health. Here are my three quick and dirty tips to help prevent bone loss:
Diet: Postmenopausal women all require about 1500 mg/day of calcium (in divided doses), in addition to 800 IU (International Units) of Vitamin D daily. So if you don’t consume enough dairy products, you’ll need to take some supplements to compensate for it. You should also limit your alcohol intake, and do not consume more than 1 or 2 drinks a day. Bone appétit!
Exercise: 30 minutes of exercise at least three times a week will help prevent bone loss in women. The exercise should preferably be weight-bearing, such as walking, running, or aerobics, in which you bear the weight of your body on your feet. And no, a walk around the mall does not constitute as exercise!
Smoking Cessation: You may not be able to change the fact that you are female, that you are thin-framed, or that you have a family history of osteoporosis. But there are certain factors you can change about yourself, and this is an important one to work on – quit smoking! No if’s, and’s, or bones about it!
How Do You Treat Osteoporosis?
Once you are diagnosed with osteoporosis, besides following the above advice on how to prevent further bone loss, your doctor may want to place you on medications to help prevent further loss as well. The medication that is prescribed most often for osteoporosis is in the group called the Bisphosphonates. This group of medicines help prevent further bone loss and reduce the risk of fractures. You may not gain the amount of bone you lost already, but it will help prevent even more bone loss occurring with the aging process.
Now that you know all about osteoporosis, let’s get cracking on preventing it!
Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.