Strong Body Needs Strong Bones
Strong healthy bones are important for good posture and to reduce your risk of fracture from falls. This is especially true if you have balance problems. In addition, your bones and skeletal system change as you get older, are immobile from injury, recovery from surgery or illness or if you are less physically active.
What is osteoporosis and osteopenia?
In osteoporosis which means ‘porous bones’ there is loss of bone density and bone strength. Osteopenia or bone thinning is a milder form of bone thinning. Both of these problems can cause a fracture- most common in the hips, spine or wrist. Fractures can occur after a fall but even after simple tasks that put strain on your skeletal system such as leaning over to pick up a heavy object. Symptoms of osteoporosis are bone pain, loss of height with stooped posture and fractures.
How does osteoporosis develop?
Bone is continuously changing or remodeling- old bone breaks down and new bone forming. Bone mass is at its peak in the mid-30s and declines thereafter. Bone loss increases after menopause when estrogen is reduced. Therefore the risk of developing osteoporosis increases with age. Women are at greater risk than men, however, men over the age of 75 y.o. and with low testosterone levels are at risk. Calcium deficiency, certain intestinal malabsorption syndromes such as Celiac disease, hormone deficiencies, and vegetarians are also at risk.
Risk Factors for Osteoporosis (Adapted from the Mayoclinic.org)
- Women- fractures are twice as common in women as men.
- Age- the older you are the greater the risk.
- Reduced physical activity due to sedentary lifestyle, ’out of commission’ recovering from surgery or illness, limit your activity or unable to move due to arthritis, and neurologic diseases affecting mobility such as stroke, Parkinsons, MS. Low calcium- This can be due to low intake, interference with medicines or reduced absorption such as with gastrointestinal disorders.
- Reduced exposure to sunshine- Due to low vitamin D levels. Especially important to people in Northern climates. Increasing factor with increased use of sunscreen to prevent skin cancer.
- Family history- Increased risk if parent or sibling has osteoporosis. People of white and Southeast Asian descent have higher risk.
- Body build- slender people may have less bone mass to begin with place them at greater risk.
- Excessive alcohol use is the leading cause in men.
- Corticosteroid use- treatments for asthma, inflammatory diseases.
- Thyroid medicine- too much can be a risk.
- Women with breast cancer treated with certain chemotherapeutic medicines that block estrogen.
- Aluminum containing antacids
- Soda (carbonated beverages) - It is not known why drinking a lot of soda increases your risk. Caffeine, phosphorous, and lack of calcium (if you substitute soda for milk).
- Depression- How this is a risk is not known. One study showed people on SSRI antidepressants were also at risk. The risk could be related to other factors such as changes in diet and physical activity in depressed people.
How is osteoporosis diagnosed?
Osteoporosis can be diagnosed by simple radiograph procedures such as CT scanning, ultrasound and dual energy X-ray absorptiometry (DEXA). DEXA, measures bone density in your hip, pelvis, wrist and spine. It is a simple, painless X-ray procedure requiring no invasive procedures or injections.
When should I get a bone density scan?
The National Osteoporosis Foundation, www.nof.org, recommends a bone density scan if:
Men and Women
- Break a bone after the age of 65 yrs
- Bone loss or fracture of vertebra in spine
- Loss of height by 1.5 inches compared to original height
- Repeat every 1-2 years if you are at risk or being treated with osteoporosis medicine
- Over the age of 65 yrs
- Postmenopausal under age of 65 or menopausal age with risk factors
- Over the age of 70 yrs
- 50-69 yrs with risk factors
What can I do to improve my bone health?
There are many things you can do to improve your bone health and prevent bone loss! Next time you press the elevator button, consider the stairs!
- Exercise. Just like our muscles, our bones are stronger when they are used to bear weight. High impact exercises include jumping rope, tennis, hiking, running and dancing. Medium impact exercise may be safer if you already have osteoporosis. Always talk to your doctor and/or physical therapist if you have osteoporosis since certain movement and activities could increase your risk of fracture. These include elliptical, yoga, Pilates, walking, stair climbing, and dancing, are examples of weight bearing exercise.
- Talk to your primary care provider (PCP) about screening tests. Radiology tests can measure bone density to identify if you are at risk or have osteoporosis or osteopenia. Ask your doctor about screening with a DEXA scan if you are over 65 y.o. or if you have any risk factors. Check a vitamin D level. Vitamin D levels may be lower in people with Parkinson's or MS compared to the general population even if they received the same amount of sunshine. Your healthcare provider can check your level by ordering a simple blood test.
- Obtain adequate amounts of calcium and vitamin D in your diet. Calcium is a necessary mineral for bone growth and development. Vitamin D regulates our body’s calcium by increasing calcium absorption from the intestines and into bone. You can still be deficient of calcium even if you eat adequate amounts if your vitamin D level is low.
- Get outdoors! Vitamin D is called the sunshine vitamin since it is produced when your skin is exposed to ultraviolet rays from the sun. People that live in northern climates, get little sun exposure or use sunscreen will make less vitamin D. ‘Getting out doors’ may help in many ways such as increasing your level of exercise and even reducing depression. Exposure to sun increases your risk for skin cancer so talk to your healthcare provider about how much is right for you.
- Medications are available to treat osteoporosis. Your healthcare provider can help you determine if this is right for you.
For more information on osteoporosis log onto the National Osteoporosis Foundation at www.nof.org.