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Osteoporosis: What You Need to Know


Updated November 16, 2008


What Is Osteoporosis?

Osteoporosis is a disease that thins and weakens the bones to the point that they become fragile and break easily. Women and men with osteoporosis most often break bones in the hip, spine, and wrist, but any bone can be affected.

Throughout your life, your body breaks down old bone and replaces it with new bone. But as you age, more bone is broken down than is replaced. When your bones are weakened by osteoporosis, a sudden strain, bump, or simple fall can cause a fracture or a break.

What Are the Risk Factors for Osteoporosis?

Risk Factors You Can't Change

Gender. Women are at higher risk for osteoporosis than men. They have smaller bones and lose bone more rapidly than men do because of hormone changes that occur after menopause.

Age. Because bones become thinner with age, the older you are, the greater your risk of osteoporosis.

Ethnicity. Due to differences in bone mass and density compared with other ethnic groups, Caucasian and Asian women are at the highest risk for osteoporosis.

Family history. If a family member has osteoporosis or breaks a bone, there is a greater chance that you will too.

History of previous fracture. People who have had a fracture are at high risk of having another.

Risk Factors You Can Change

Diet. Getting too little calcium over your lifetime can increase your risk. Not getting enough vitamin D from your diet, supplements, or sunlight can also increase your risk.

Physical activity. Not exercising and being inactive or staying in bed for long periods can increase your risk.

Smoking. Smokers may absorb less calcium from their diets.

Medications. Some commonly used medicines can cause loss of bone mass. These include steroids used to control arthritis and asthma; some drugs used to treat seizures; some cancer drugs; and, too much thyroid hormone.

Low body weight. Women who are thin – and small-boned – are at greater risk for osteoporosis.

How Can I Lower My Chances of Getting Osteoporosis?

A balanced diet rich in calcium and vitamin D, a regular exercise program, and, in some cases, medication can help protect your bones and slow bone loss

Nutrition. People over 50 should get 1,200 milligrams of calcium daily. To do this, make foods that are high in calcium part of your diet. The most concentrated food sources of calcium include:

  • dairy products such as low-fat milk, yogurt, and cheeses
  • calcium-fortified orange juice

If you have a diet that does not contain enough calcium, calcium supplements can help fill the gap, ensuring that you meet your daily calcium requirement.

Vitamin D helps your body absorb calcium. Exposure to sunlight causes your body to make vitamin D. Some people get all the vitamin D they need this way. However, many older people, especially those who are indoors most of the time and/or live in northern areas, are not getting enough vitamin D.

The Institute of Medicine recommends people aged 51 to 70 should have 400 IU of vitamin D daily. People over 70 should have 600 IU.

Exercise. Exercise can make bones and muscles stronger and help slow the rate of bone loss. It is also a way to stay active and mobile.

How Is Osteoporosis Diagnosed?

Osteoporosis is often called "silent" because bone loss occurs without symptoms. You may not know that you have osteoporosis until a sudden strain, bump, or fall causes one of your bones to break.

Some people may be unaware that they have already experienced a spine fracture. Height loss of one inch or more may be the first sign that you have experienced a spine fracture due to osteoporosis. Multiple spine fractures can cause a curved spine, stooped posture, back pain, and back fatigue.

The test used to diagnose osteoporosis is called a bone density test. This test is a measure of how strong – or dense – your bones are and can help your doctor predict your risk for having a fracture. Bone density tests are painless, safe, and require no preparation on your part.

Bone density tests compare your bone density to the bones of an average healthy young adult. The test result, known as a T-score, can tell you whether you have osteoporosis and helps predict your risk for having a fracture.

What Is the Treatment for Osteoporosis?

The goal of osteoporosis treatment is to prevent fractures. A balanced diet rich in calcium, adequate vitamin D, and a regular exercise program are all important for maintaining bone health.

Several medications are approved by the U.S. Food and Drug Administration (FDA) for the treatment of osteoporosis. Since all medications have side effects, it is important to talk to your doctor about which medication is right for you.

  • Bisphosphonates. Actonel (risedronate), Boniva (ibandronate), Fosamax (alendronate), and Reclast (zoledronic acid) are from a class of drugs called bisphosphonates that slow bone loss, reduce fracture risk, and in some cases increase bone density. These drugs decrease the activity of bone-dissolving cells.
  • Estrogen. Estrogen is approved for the treatment of menopausal symptoms and osteoporosis. Because of recent evidence that breast cancer, strokes, blood clots, and heart attacks may be increased in some women who take estrogen, the FDA recommends that women take the lowest effective dose for the shortest period possible. Estrogen should only be considered for women at significant risk for osteoporosis, and nonestrogen medications should be carefully considered first.
  • Evista (raloxifene), approved for use in postmenopausal women, is a drug that has estrogen-like effects on the skeleton, but blocks estrogen effects in the breast and uterus. Evista slows bone loss and reduces the risk of fractures in the spine, but no effect on hip fracture has been seen.
  • Miacalcin (calcitonin), available as a daily nasal spray or injection, is approved for the treatment of osteoporosis in women who are at least 5 years past menopause. It is a hormone that slows bone loss and reduces the risk of spine fractures.
  • Forteo (teriparatide), a form of human parathyroid hormone, stimulates new bone formation. Given as a daily injection for up to 24 months, it increases bone tissue and bone strength, and has been shown to reduce the risk of spine and other fractures.

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