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Keep Your Bones Strong

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As children we were told to drink milk to keep your bones strong throughout your life. But when your bones weaken later in life, you could be suffering from osteoporosis, a condition resulting from a loss of bone mass and a change in bone structure.

Osteoporosis is a serious health problem in the United States, as it affects 28 million people, with more than 1.5 million fractures of the back, wrist and hip bones each year. Over 80% of people with osteoporosis are women.

Osteoporosis and its conditions don’t just have an impact on people and their bones; it also impacts the health of our communities. Pain and disability in people suffering from bone fractures result in lost work time or the inability to return to performing daily routine activities. Long-term medical care expenses cost billions of dollars, with that number only expected to increase over the next two decades.

How does osteoporosis occur?

Bone is a living tissue with calcium and other mineral deposits. It is broken down and built up with new strong bone over and over. From birth to age 25, calcium from food helps bone to rebuild faster than it is broken down, with persons between the ages of 25 to 30 having reached their peak bone mass.

What are the symptoms of osteoporosis?

Bone loss occurs without any symptoms that you can see. It is a painless disorder and is often called a “silent disease.” Tooth loss may be a warning sign that osteoporosis has started to affect the jawbone.

There are two types of risk factors in people – those that are genetic or hereditary and those that your lifestyle choices can change.

Risk Factors You Can't Change

  • Older age (starting in the mid-30s but more likely with advancing age)
  • Non-Hispanic white or Asian ethnic background
  • Small bone structure
  • Family history of osteoporosis or an osteoporosis-related fracture in a parent or sibling
  • Prior fracture due to a low-level injury, particularly after age 50

Risk Factors You Can Change

  • Low levels of sex hormone, mainly estrogen in women (e.g., menopause)
  • The eating disorders anorexia nervosa and bulimia
  • Cigarette smoking
  • Alcohol use
  • Low calcium and vitamin D, from low intake in your diet or inadequate absorption in your gut
  • Sedentary (inactive) lifestyle or immobility
  • Certain medications, including the following:
    • Steroids
    • Excess thyroid hormone replacement
    • Heparin, a commonly-used blood thinner
    • Anti-seizure medicine: phenytoin (Dilantin)
  • Treatments that deplete sex hormones: anastrozole (Arimidex) and letrozole (Femara) to treat breast cancer or leuprorelin (Lupron) to treat prostate cancer
  • Diseases that can affect bones
  • Endocrine (hormone) diseases
  • Hyperthyroidism
  • Hyperparathyroidism
  • Cushing's disease
  • Diabetes (Type 2)
  • Inflammatory arthritis
  • Rheumatoid arthritis
  • Lupus

What Can You Do?

To know if you are at risk for osteoporosis, you can speak with your doctor about screenings that are available to help identify the density of your bones, including a dual-energy X-ray absortiometry (DXA).

There are also several lifestyle changes that can help to lower your risk and prevent osteoporosis from affecting your bones:

  • Avoid smoking
  • Avoid heavy alcohol use
  • Exercise and stay active
  • Adequate calcium and vitamin D intake

There are also several treatment options that your doctor can evaluate to determine what the best fit is for you and your condition:

  • Bisphosphonates
  • Denosumab (Prolia)
  • Hormone replacement (estrogen)
  • SERM (selective estrogen receptor modulator
  • Teriparatide (Forteo)
  • Calcitonin

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