Throughout our lives, our bodies continuously break down old bone tissue and form new bone tissue to replace it. But for the 10 million Americans with osteoporosis, bone tissue forms too slowly, breaks down too quickly, or both. When this happens, bones become thin, fragile and prone to fracture.
Fortunately, says Charlotte Harris, MD, director of the Osteoporosis Treatment Center at Rush University Medical Center, "there have been tremendous advances over the past several years in treatments for osteoporosis." Whether you have the condition, care for someone who has it or want to learn the best strategies for avoiding it, Harris suggests you know the following five things about osteoporosis.
Prevention should start early. Though osteoporosis usually occurs in people older than 65, its underlying causes can stretch back to childhood. We form about 90 percent of our peak bone mass before we turn 20 — and the less we form then, the more likely we are to develop the condition later on. While genes play a role in this process, environmental factors also have an impact, which means that everyone can take steps to prevent osteoporosis.
Getting enough calcium is only the first step. Calcium, a mineral found in our bodies as well as in foods such as milk and yogurt, helps us form and maintain healthy bones. (Read more about calcium and recommended intakes.) "It's very important, particularly during childhood," Harris says. "But getting enough calcium is only a first step in preventing osteoporosis." Other key prevention strategies include avoiding excessive alcohol use and cigarettes — which can weaken bones — and doing weight-bearing exercise such as aerobics or walking with weights. Because bones, like muscles, grow stronger in response to resistance, doing weight-bearing exercise for at least 30 minutes three times a week can help prevent bone loss.
Osteoporosis can go undetected for years. After prevention, the next best thing is early diagnosis, which can help people with osteoporosis limit bone loss by starting treatment as soon as possible. But it requires vigilance, because many people with the disease don’t experience symptoms in its early stages. For that reason, Harris recommends regular bone density scans for all women older than 65, whose lighter, thinner bones and decreased estrogen levels make them more likely todevelop the disease. Anyone else at high risk should also get regular scans. "You don't want to wait until you get a fracture," she says. "Because after the first vertebral fracture, the risk of a second increases ninefold."
Low bone density doesn't always mean osteoporosis. If your scan uncovers low bone density, you don't necessarily have osteoporosis. When bone density is lower than normal but not low enough to qualify as osteoporosis, doctors call it osteopenia. People with osteopenia have an increased risk of developing osteoporosis, but they may be able to follow a more conservative treatment plan that does not include medication.
Osteoporosis can't be cured, but it can be treated effectively. Most people with osteoporosis take biphosphonates, medications that safely and effectively slow bone loss and prevent the fractures it can cause. "Biphosphonates were a big step forward," Harris says. Moreover, the same strategies that may prevent osteoporosis — such as weight-bearing exercise, proper calcium intake and not smoking — can also fight the condition after it appears.
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Please note: All physicians featured in Discover Rush Online are on the medical faculty of Rush University Medical Center. Some of the physicians featured are in private practice and, as independent practitioners, are not agents or employees of Rush University Medical Center.
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