OCTOBER 29, 2020
As a primary care physician, I have a responsibility to educate patients about the importance of healthy strong bones. If you can develop healthy habits early in life, then oftentimes you can avoid developing osteoporosis or experiencing a fracture.
What does the term “osteoporosis” mean?
Osteoporosis is a condition characterized by low bone mass and loss of bone structure, leading to fragile bones and increased risk of fracture. It is considered a “silent” disease, because bone loss occurs without symptoms. One in 2 women in the United States over the age of 50 will break a bone in their lifetime due to osteoporosis.
What sites are most susceptible to fracture?
Your wrists, hips, and lumbar spine are all sites at risk for fracture and can lead to significant pain and loss of function.
What are risk factors for osteoporosis?
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Being a woman older than 60 years of age, or a man older than 70
Estrogen and testosterone levels both wane with age, and are critical to bone health. -
Having a body mass index (or BMI) less than 19
Increased fragility leads to increased fracture risk AND lower BMIs are associated with lower estrogen levels in women. -
Loss of height of more than 1.5 inch as an adult
This loss of height indicates the possibility of an asymptomatic compression fracture. -
Family history of osteoporosis, significant stooped back or hip fracture.
Did either of your parents sustain a hip fracture or have significant loss of height? -
Having a medical condition that reduces bone density
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Having a medical condition that puts you at risk for falling
Parkinson’s disease and spinal stenosis both can lead to instability with ambulation, thereby increasing fall risk. -
Taking certain medications which lower bone density
Steroids, antidepressants, anticonvulsants, immunosuppressant medications, medications such as aromatase inhibitors used to treat breast cancer, and medications such as pioglitazone used to treat diabetes all will reduce bone density over time. -
Drinking alcohol excessively or smoking
Which medical conditions put you at increased risk of osteoporosis?
You might be surprised to learn that many common medical conditions will increase your personal risk of osteoporosis. For example, if you have a current or past history of anorexia, then your risk for low bone density is higher. This is because anorexia is associated with the absence of ovulation and low estrogen levels, and estrogen is critical to bone health. If you have celiac disease, which is a disease of the small intestine, then your absorption of calcium is affected and this can lead to osteopenia and osteoporosis. Given the underlying malabsorption associated with celiac disease, even if you take enough dietary or supplemental calcium, you still may not be able to absorb the calcium in order for it to be beneficial to your bones.
If you are a man and have low testosterone, you are also at risk for reduced bone density. Not every man with “low T” has symptoms, so if you are obese, have diabetes, take opioid medications regularly, or have sleep apnea, you should talk to your doctor about your risk for “low T” and osteoporosis.
What can you do NOW to prevent osteoporosis?
• Get the right amount of calcium in your diet
• Do not forget to take vitamin D
• You need protein for healthy bones
• Exercise is essential
• Maintain a healthy weight
Building healthy life habits is vital to future bone health. Are you ready to take charge of your bones?
To determine your personal risk for osteoporosis, check out https://riskcheck.osteoporosis.foundation//
In our next blog series: Preventing Osteoporosis: Part 2, Diet
