Bone loss is a concern, because frail bones can fracture easily. A hip fracture can rob a patient of independence and can even be life threatening. There are lifestyle choices and medications that can stop bone loss and in some cases even rebuild bone. However, there are many factors to take into consideration before deciding on using just diet and exercise or hormone replacement therapy, HRT, to rebuild bone.
Identification
Throughout life, the bones are constantly being broken down and replaced with new bone. By the thirties, bone starts to be broken down faster than it is replaced, warns the American College of Rheumatology. This can lead to frail bones and osteoporosis.
Osteoporosis can exist without causing symptoms, and a bone density test may be the only way to detect it. Bone density is considered normal if the T-score is between 1.0 and -1.0. A T-score between -1.0 and -2.5 is diagnosed as osteopenia, or the beginning stages of osteoporosis. A T-score of -2.5 or lower indicates osteoporosis and a high risk for a fracture.
Osteoporosis is not just an older woman's disease. It can occur in men and even in younger individuals whose diet is deficient in calcium and vitamin D or in young women who overexercise to the point where menstruation stops.
Hormone Replacement Therapy
Osteoporosis occurs when the body produces less estrogen due to menopause or as the result of surgery or restrictive diet. In these cases, hormone replacement therapy may be required; however, there can be side effects. HRT is reserved for cases where osteoporosis is severe -- a low T score -- and when there is a high risk of fracture. HRT may also be taken to manage severe menopausal symptoms such as hot flashes. However, HRT can increase the risk of blood clots, heart disease, stroke and some forms of cancer, states MayoClinic.com. A physician can determine individual risks, based on a patient's health history, before starting HRT.
Exercise
According to the National Osteoporosis Foundation, bone responds to exercise by becoming stronger. Weight-bearing exercise that loads the bones with a force are the most important for building and strengthening bone. Lower body weight-bearing exercises include walking, dancing and tai chi. Push-ups and yoga postures that place weight on the arms, are examples of upper body weight-bearing exercises.
If osteoporosis is severe, avoid high-impact exercises, twisting and rounding the back. For bone loss, current recommendations are 30 minutes of weight-bearing exercise on most days of the week.
Diet
Diet can also help maintain bone health. The National Institute of Arthritis and Musculoskeletal and Skin Diseases advises that adequate intake of calcium and vitamin D can help to preserve bone mass, support bone growth and prevent fractures. If the diet is inadequate in calcium and vitamin D, supplements may be required. The severity of osteoporosis and the risk of fracture will determine whether dietary changes alone are enough.
Considerations
The decision to treat bone loss through diet and exercise alone or in combination with HRT is a complicated one. Bone density tests along with any risk factors for osteoporosis and risks with HRT all need to be considered. During treatment, bone density tests can be performed at regular intervals to monitor the condition of the bones and determine if changes in therapy need to be made.
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