Osteoporosis Risks: No Bones About ItIt can happen without warning – you bend over to pull a weed from your garden and suddenly suffer an intense pain in your side. The emergency room physician informs you that you’ve fractured a rib. The cause, he tells you, is osteoporosis. The effects of osteoporosis often manifest just as this scenario suggests – completely out of the blue. Patients with this condition have bones that become extremely porous and brittle, so much so that they are subject to fracture with even the slightest stresses, such as bending over to pull a weed from the ground. Unfortunately, symptoms often times fail to surface until it’s too late, leaving a person to discover that they have the disease only after suffering a fracture.
Osteoporosis primarily strikes postmenopausal women, with more than 28 million women affected in the US alone. It causes more than 1.5 million fractures every year and it is estimated that one in two women will experience a bone fracture due to osteoporosis in her lifetime. But women aren’t the only ones dealing with this disease; approximately five million American men also suffer, with millions more at risk. Each year, approximately 80,000 men endure a hip fracture, and one third of these men die within a year. As America ages, the ranks of people with osteoporosisrelated fractures will continue to swell, resulting in an enormous increase in pain, suffering, and economic costs. Taking the proper steps to prevent osteoporosis from silently robbing your bones’ strength is essential. Sure, some women are genetically predisposed to the condition, but when equipped with the proper tools, everyone can do their part in combating this debilitating disease. The elusive symptoms of osteoporosis often go unnoticed by many women. In patients with this silent disease, two types of risk factors may present themselves: those that can be controlled and those that cannot. The latter lead to a greater risk for developing osteoporosis — women genetically susceptible to osteoporosis (ie — their mother or grandmother has the disease) have a 60-80% chance of developing the disease. Women make up 80% of current sufferers; losing bone mass due to age and chronic medical problems such as asthma, diabetes, hyperthyroidism, liver disease, or rheumatoid arthritis, as well as hormone deficiencies, all fall into the category of risk factors that women cannot manage to avoid. But there are factors you can control; in managing them, you are proactively taking measures to prevent this crippling disease. Although early detection and timely treatment of this disease can decrease the risk of a future fracture, none the current treatments for osteoporosis are complete cures. This is precisely why prevention is so important, and it’s never too late to start. Lifestyle changes, which include quitting cigarette smoking, curbing alcohol and caffeine intake, exercising regularly, and consuming a balanced, nutritious diet with adequate amounts of calcium and vitamin D, all contribute to the prevention of bone thinning and promotion of strength. Taking the aforementioned precautions is the first step in maintaining strong, healthy bones. Smoking one pack of cigarettes per day throughout one’s adult life can itself lead to the loss of five-to-10% of bone mass. This is because smoking decreases estrogen levels and can lead to bone loss in premenopausal women. Similarly, more than two drinks of alcohol a day may contribute to bone loss, and more than two cups of coffee daily can do the same. The sooner you quit smoking and curb both your alcohol and caffeine intake, the faster you will be on the road to strong bones. The benefit of exercise for osteoporosis lies in its ability to decrease the risk of falls, due to improved balance and muscle strength. Most doctors recommend weight-bearing exercises, such as walking, preferably daily, as a healthy and safe way to maintain healthy bones. Although regular exercise promotes a wide variety of health benefits, it alone does not bring about substantial increases in bone density. Building strong and healthy bones requires an adequate intake of calcium beginning in childhood and adolescence for both sexes. Children ages one through 10 should consume 800 mg/day; men, premenopausal women, and postmenopausal women also taking estrogen should consume 1000 mg/day; teenagers and young adults ages 11 to 24 are capped at 1200 mg/day; postmenopausal women not taking estrogen should receive at least 1500 mg/day; and pregnant and nursing mothers should include 1200mg to 1500 mg/day of calcium into their diets. When vitamin D is lacking, however, the body cannot absorb adequate amounts of calcium to keep bones strong and healthy and therefore prevent osteoporosis. Be sure to consume enough vitamin D as well. CALCIUM = IMPORTANT
• Increase your intake of dairy products, especially
low fat products that simultaneously reduce calories and maintain
calcium levels.
• Take a daily multivitamin or get 15 minutes of direct exposure to the sun every day; each provides adequate vitamin D for the average adult. • Add a tablespoon or two of nonfat dry milk when cooking. Doing so adds 50 mg of calcium per tablespoon. • Drink orange juice with calcium added, which contains as much calcium as the same amount of milk. • Lactose intolerant individuals should use a lactase enzyme replacement in a tablet or liquid form to take in a sufficient amount of dairy products. • Consume green leafy vegetables like broccoli and kale. • If you don’t like vegetables, give almonds or legumes a try; each provide sufficient amounts of calcium. (Source: www.learn-about-osteoporosis.com) Along with making lifestyle changes, there are several medication choices available to patients that can ease suffering, curtail bone loss, and increase bone strength. Estrogen hormone replacement therapies, such as the drugs Premarin, Estrace, Prempro, Estraderm, and Estratab, have been shown to prevent bone loss, increase bone density, and prevent bone fractures by making up for the lower amounts of the hormone present in postmenopausal women and women with other low estrogen conditions. Similarly, Selective Estrogen Receptor Modules SERMs) can help prevent osteoporosis by decreasing bone loss. SERMs also double as cholesterol moderators; they reduce the blood concentration of total and LDL, or bad cholesterol, in the bloodstream. Bisphosphonates are another option – they prevent the hip and spine fractures brought on by osteoporosis by increasing the amount of bone present. Patients currently suffering from severe kidney disease, with low calcium levels, with certain stomach disorders or who have trouble swallowing, and who have difficulty standing or sitting upright for 30 minutes after taking a morning dosage should avoid this treatment. Another alternative are calcitonins, which also slow bone loss and curb the risk of fracture. These are used alongside calcium and vitamin D to treat bone loss. For more information on medications, visit: www.netwellness.org/ healthtopics/osteoporosis/osteoporosis.cfm. Prevention, however, remains the best way to avoid the rigors of osteoporosis. Taking the necessary steps in combating the disease early on allows you to keep osteoporosis at bay as well as maintain a healthy lifestyle. With a well-balanced and nutritious diet, regular exercise, and appropriate dietary supplements you will be on the path to strong, healthy bones. RISK FACTORS OF OSTEOPOROSIS
EDUCATE YOURSELFAnswers
to Common Questions About Osteoporosis and Bone Density Testing Bone
Density Testing Endocrinology
and Osteoporosis: Patient Information Healthology:
Focus on Osteoporosis Osteoporosis
Evaluation SCORE Sheet Osteoporosis:
Should You Be Tested? Osteoporosis
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