Osteoporosis

You hug your beloved grandmother and she seems shorter than she did a few years ago. No, it's not the incredible shrinking woman but osteoporosis, and vertebral fractures are reducing her stature. Osteoporosis is a decrease in bone density resulting in weak, brittle bones that fracture easily.

Normally bone metabolism is a delicate balance of calcium, vitamin D, phosphorus and hormones. The bone is constantly being broken down and replaced by special bone cells called osteoblasts and osteoclasts. This remodeling is essential to repair weak areas of the bone due to stress or fracture. Bone density peaks around age 30, but when an imbalance occurs, osteopenia or osteoporosis is the result. Osteopenia is bone thinning but not as severe as osteoporosis.

Osteoporosis is caused by either accelerated bone loss or inefficient bone replacement which has several etiologies. Osteoporosis causes include increased age, hyperthyroidism, hyperparathyroidism, menopause and some medications like steroids.

Unfortunately, osteoporosis is often diagnosed after a fracture, but there are risk factors that indicate the need for screening. Risk factors include elderly age, cigarette smoking, chronic steroid use, low body weight (less than 127 pounds), excessive alcohol use, or a history of a non-traumatic bone fracture.

Screening requires a bone density measurement (BMD) which can be done a in few ways but the most common is the dual x-ray absorptiometry or DXA scan. It is very useful because it uses minimal radiation, and gives bone density results in specific areas such as the hip and spine. It is a quick and painless procedure, taking only about 10 minutes. The BMD results are then compared to the average healthy adult. The further away from the average person's values, the greater the risk for osteopenia and osteoporosis.

Treatment includes a healthy diet high in calcium (1200 to 1500 mg daily), vitamin D (800 IU daily), and exercise. Smokers should give up their habits. Treatment also can include medications that decrease the bone breakdown process, help to regulate calcium concentrations in the body, or stimulate new bone growth. Your doctor will decide which option is best for you.

Prevention starts early with encouraging kids, teens and young adults to eat healthy diets, as this is when the bone density is still increasing. After 30, diet, exercise and healthy habits will be paramount. Certain medications, such as steroids, that can cause bone loss should be monitored by a health care provider. Care should also be taken to prevent falls. Fixing loose rugs, improving light in hallways and stairwells, and avoiding walking on uneven grounds could prevent a devastating fractures.

Overall, osteoporosis is a disease that must be kept at the forefront of our minds as we age. If you or your loved ones have risk factors, please contact your health care provider, because prevention is key. For more information please see the National Osteoporosis Foundation at www.nof.org.