What Should People Be Doing To Prevent Osteoporosis?

Question: What Should People Be Doing To Prevent Osteoporosis?

What are the key factors which lead to osteoporosis? It is sometimes called a silent disease - how can people be aware of the clinical symptoms before fracture occurs? What should people be doing to prevent osteoporosis? Please briefly explain a bone density scan and how it can detect osteoporosis? What is the difference between osteopenia and osteoporosis?

Answer:

Osteoporosis: A Silent Disease

Osteoporosis is a disease that can cause bone fractures due to brittle or weak bones. As opposed to osteoarthritis where there can be too much bone, patients with osteoporosis have too little bone. It is considered a "silent disease" because you cannot feel your bones becoming weak. As a result, it is important to find out how your bones are doing before you have a fracture. Bone density measurement is a non-invasive way to get this information. This 10 minute x-ray which uses minimal radiation can diagnose osteoporosis as well as its precursor, osteopenia. Patients at an increased risk for osteoporosis should ask their doctor about getting a bone density test.

Osteoporosis Vs Osteoarthritis: Similar Names, Very Different Conditions

Osteoporosis Risk Factors

Risk factors include but are not limited to:

(1)Small thin females - especially those who are post-menopausal
(2)Caucasian or Asian descent
(3)Advanced age
(4)Family history of osteoporosis
(5)Low calcium diet
(6)Use of the following medications: steroids (e.g. prednisone), some anti-seizure drugs, excess thyroid hormone
(7)Low testosterone levels in men
(8)Cigarette smoking
(9)Sedentary lifestyle
(10)Malabsorption problems (e.g. celiac disease)

Osteoporosis Risk Factor Quiz

Osteoporosis Treatment

If you are found to have osteoporosis, treatment consists of:

getting adequate calcium (1500mg/day through calcium supplements or food)

adequate vitamin D (typically 400 IU per day which is found in most multi-vitamins though your doctor may recommend a higher dose)

avoid smoking and excessive alcohol

Weight bearing exercise such as walking is also helpful.

Osteoporosis: The Role of Calcium and Vitamin D

How Smoking Affects Osteoporosis

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Osteoporosis Medications

Medications which are available to improve bone density or prevent further loss of bone include:

Miacalcin nasal spray (calcitonin)

Evista (raloxifene)

estrogen

Bisphosphonates including weekly Actonel (risedronate) and Fosamax (alendronate), as well as the new monthly preparation, Boniva (ibandronate).

Forteo (teriparatide) is an injectable treatment reserved for patients with significant osteoporosis.

Related Resources

Osteoporosis

Guide To Osteoporosis In Men

The Rheumatoid Arthritis-Osteoporosis Link

The Lupus–Osteoporosis Link

What You Need to Know About Corticosteroid Drug-Induced Osteoporosis

Answer provided by Scott J. Zashin, M.D., clinical assistant professor at University of Texas Southwestern Medical School, Division of Rheumatology, in Dallas, Texas. Dr. Zashin is also an attending physician at Presbyterian Hospitals of Dallas and Plano. He is a fellow of the American College of Physicians and the American College of Rheumatology and a member of the American Medical Association. Dr. Zashin is author of Arthritis Without Pain - The Miracle Of Anti-TNF Blockers. The book is a must-have for anyone on one of the biologic drugs (Enbrel, Remicade, Humira) or considering the biologic drugs. Read our review of the book.