Facts About Osteoporosis

(April 2009) - If you are osteoporotic you could suffer a fracture simply pushing a grocery cart. How strong are your bones? By the age of 50, white women have a 40 percent lifetime risk of fracturing a bone (men only have a 13 percent chance at that point). Asian and white women have the greatest risk. Women who weigh less than 127 pounds or have a body mass index of less than 21 are at greater risk.

Fractures due to thin bones are sometimes called fragility fractures. About half of these are vertebral fractures and most of the rest are arm- or hip-related fractures. Vertebral fractures can occur very easily with simple movements like bending over. Hip fractures are usually due to falls and can result in nursing home care or even death.

Bones become more fragile with age. They can also be affected by the use of some medications, such as steroids. It has also been suggested that life’s everyday stresses can increase our body’s own production of steroid (cortisol), which can contribute to bone loss.

Testing for Bone Loss
Depending on your age and risk factors, your doctor may want to order a test to see how much bone loss you have. This test is called a DEXA (bone) scan and it is painless. The results of this test help your doctor decide if you should be on prescription medication for
your bone loss. The DEXA scan gives a number called a “T-score.” The lower your T-score, the thinner your bones have become and the greater your risk of fracture.

What You Can Do

800 IU of vitamin D3 (cholecalciferol) daily
Vitamin D is made in the skin when we are in the sun, but many people are deficient. This “sunshine vitamin” is necessary for your body to absorb calcium. If your body does not get enough calcium from diet or supplements, it will take it from your bones. Low vitamin D levels have also been associated with death due to cardiovascular disease, less favorable outcomes for patients with breast cancer, and greater rates of depression.

1,000-1,200 mg of calcium per day in two divided doses
Your body cannot absorb much more than 500 mg of calcium at a time so it is best to divide the dose to ensure you absorb as much as possible. There are several forms of calcium. Calcium citrate can be taken anytime but may exacerbate symptoms of heartburn and only about 200 mg of the 500 mg tablet is actually absorbed as elemental calcium. Calcium carbonate is another form of calcium (the kind in Tums) and is best taken after a meal. I do not recommend the other types of calcium supplements.

Exercise
Weight bearing (walking, aerobics) exercise helps to strengthen your bones by stressing them and causing increased bone cell activity. Resistance exercise causes your muscles to stress your bones and also stimulates them and helps to keep them strong. Additionally, exercise helps to prevent falls that may lead to hip fractures.

Stop smoking
Women who smoke have greater bone loss and they reach menopause a couple of years sooner. Menopause is associated with an increased rate of bone loss.

Talk to your doctor about your risks and always discuss supplements and exercise programs with your doctor before starting anything new.

Written by Shauna Zaren, M.D., a physician with Memorial Health University Physicians – Family Medicine Center. Dr. Zaren is accepting new patients. Please call 912-350-8404 to schedule an appointment. This article first appeared in Savannah Health Perspectives magazine, volume 5, number 2, 2009.