Bone Changes throughout Our Lifetime:

Bones are constantly changing throughout our life. Old bone is removed and new bone is built.  When we are young, our bones form faster than they are broken down. During early adulthood, the amount of bone formed is about equal to the amount of bone that is broken down. In midlife, the process begins to reverse and bone is broken down faster than it is made.

Osteoporosis:

Osteoporosis is when the outside walls of bone become thinner and the holes in spongy bone become larger.  This is often seen in the spine, hips and wrists. The bones become weaker and more fragile.  These changes lead to an increased risk of fractures (broken bones).  In the elderly, fractures greatly affect a person’s quality of life and can lead to disability and have been linked to an increased risk of death.

Risk Factors for Osteoporosis:

• Low Calcium Intake
• Low Vitamin D levels
• Excess Vitamin A
• High Caffeine intake
• Being thin
• Being Caucasian or Asian Arthritis
• Certain medications such as steroids
• Aging
• Aluminum intake (Antacids)
• Alcohol Intake (3 or more drinks per day)
• Inadequate physical activity (exercise)
• Smoking (Active or Passive)
• Falling
• Menopause
• Certain health conditions such as Rheumatoid
• Family history of Osteoporosis
• Female gender

Symptoms of Osteoporosis;

There may be no symptoms of osteoporosis for many years. There may be a loss of height or a curvature of the spine causing a Dowagers Hump in the upper back. Usually there is no pain until there is a fracture.

Diagnosis:

Diagnosis is made with a bone mineral density (BMD) test which is performed by lying on a table and a dose xray of the hip and spine is performed.  It is recommended that all women age 65 years old or older should have a BMD. Younger women with risk factors should also have a BMD performed earlier than age 65. The frequency of testing is based on test results and a FRAX score (which indicates the risk of a fracture within the next 10 years.

Prevention of Osteoporosis:

Lifestyle plays a key role in preventing osteoporosis. Exercise, a healthy diet, and not smoking can help keep your bones strong and healthy throughout your life. Diet should include low fat dairy products such as milk, cheese and yogurt or calcium fortified cereals or juice, sardines, canned salmon with bones, and leafy green vegetables. Also vitamin D is important for the absorption of calcium. Vitamin D is found in milk products egg yolks, beef liver, fatty fish such as salmon, mackerel or tuna. A little sunshine helps as well, but don’t overdo it as too much sun can lead to skin cancer.

Treatment for Osteoporosis:

Various medications are used to treat osteoporosis and help reduce the risk of fractures. Medications include Bisphosphonates, Denosumab, Calcitonin, Raloxifene or hormone therapy.  Your provider will discuss treatment options to help determine the best options for you.

References:

ACOG (August, 2013). Osteoporosis. APO48.

USPSTF (2011). Screening for Osteoporosis.

Blog written by Colette Blanchard, NP