Osteoporosis: Are You At Risk?
Our bones are made of living tissues that change in each cycle of our lives. Even after we stop growing, our bones continue to become denser until age 30, when they are at their strongest. Bones are continually changing in a process called remodeling. During this process, small areas of old bone are removed and gradually replaced by new bone, with every bone in our body completely reformed about every 10 years.
Once we reach middle age, bone loss tends to speed up. This is especially true for women, once they reach menopause (when menstrual periods stop). The hormone, estrogen, plays an important part in maintaining strong bones. However, after menopause, there is less estrogen made, leading to greater bone loss. A woman can lose up to 20% or more of her bone density after menopause.
Osteoporosis, meaning “porous bone,” happens when we lose too much bone, do not make enough bone, or both. The result is weaker bones that can easily break.
Risk factors for Osteoporosis include:
· Women get osteoporosis more often than men
· The older we are, the greater our risk
· Small frame: Thin women are at greater risk
· White and Asian women are at highest risk. African-American and Hispanic women have a lower risk
· Family history
· Women: Low estrogen levels
· Men: Low testosterone levels
· Anorexia nervosa (an eating disorder in which people lose more weight than is considered healthy for their age and height)
· Low diet intake of calcium and vitamin D
· Some medications
· Lack of exercise
The best test to determine your current bone health is called a Bone Mineral Density (BMD, DXA, DEXA) test. An order is required by your provider to have the test done.
· This test compares your bones to that of a 30-year old. (Remember, this is the age at which your bones are the strongest)
· The test is quick and painless and is much like having an x-ray taken
The resulting number of the BMD test is call the T-score:
· A T-score of 0 (zero) means you have the bones of a health 30-year-old (Normal: +1 to -1)
· A T-score of -1 to -2.5 means you have low bone mass or bone thinning called osteopenia
· A T-score of -2.5 or lower gives you a diagnosis of osteoporosis. As a result, your bones become weak and may break easily
Recommendations for who should have Osteoporosis Screening
U. S. Preventive Services Task Force (USPSTF):
· Women aged 65 years and older
· Postmenopausal women (after menopause) younger than 65 years who are at increased risk of osteoporosis
· Men: Current evidence is insufficient to assess the balance of benefits and harms of screening for osteoporosis
National Osteoporosis Foundation:
· Woman age 65 years and older
· If you break a bone after age 50
· Women of menopausal age with risk factors
· Postmenopausal woman under age 65 with risk factors
· Men age 70 or older
· Men age 50-69 with risk factors
Learn more about Osteoporosis in my book, The Practical Patient: Your Personal Guide Through The Medical Maze!