About 10 million Americans have osteoporosis, while about 34 million are at risk. Get answers to frequently asked questions about this condition that affects approximately one in two of all women over age 50.
- What is osteoporosis?
- How likely am I to get osteoporosis?
- Who is at risk for osteoporosis?
- What are common risk factors for developing osteoporosis?
- Which bones are most likely to break with osteoporosis?
- What are the symptoms of osteoporosis?
- How is osteoporosis diagnosed?
- What is bone density measurement or bone densitometry?
- Should I have a bone mineral density test?
- How often do I need osteoporosis evaluation with a bone mineral density test?
- Is there a risk of osteonecrosis of the jaw while taking osteoporosis medications?
- How much dietary calcium and vitamin D should I be taking?
- Will it help to take more than the recommended dose of calcium?
- What else can I do to take care of my bone health?
- What steps can I take to prevent falls and fractures?
Osteoporosis is a condition that causes bones to become fragile and break more easily.
About 10 million Americans have osteoporosis, while about 34 million are at risk. Approximately one in two women over age 50 and up to one in four men will break a bone because of osteoporosis.
Women (usually after menopause, natural or due to surgery) are at greatest risk for osteoporosis, although men may also be at risk. People on steroids also are risk for osteoporosis. Caucasians, Hispanics and Asians are the more predisposed ethnicities.
- Past history of fracture as an adult
- Family history of osteoporosis
- Low body weight
- Inadequate dietary calcium ingestion
- Immobilization (e.g., stroke)
- Cigarette smoking
- Excessive alcohol intake
- Other medical problems such as thyroid and parathyroid conditions, digestive problems, eating disorders, kidney disease, rheumatoid arthritis and ancer
- Medications such as steroids, blood thinners and others
The bones that most commonly fracture in osteoporosis are the spine, hips and wrists.
Osteoporosis may cause pain in the bones and muscles, loss of height and forward stooping of the spine, or you may not notice any symptoms. Sometimes a severe pain in the back may be caused by fractures in the vertebra.
A complete medical history and physical examination is required along with bone mineral density testing. In addition sometimes laboratory blood and urine tests are needed to determine the cause of osteoporosis.
Bone mineral densitometry (BMD) testing is performed to diagnose osteoporosis and osteopenia (decreased bone mass). The bone densitometry test determines how dense your bones are. This level is compared to that of healthy young adults (your T-score) and age-matched (your Z-score) to people of same gender and ethnicity.
If you have risk factors for osteoporosis, or aren’t sure, it’s important to speak with your health care provider. The National Osteoporosis Foundation recommends osteoporosis testing for the following patients:
- Women age 65+ or men age 70+
- Bone fractures occurring after age 50
- Perimenopausal woman (of menopausal age) with risk factors
- Postmenopausal woman (under age 65) with risk factors
- Men age 50-69 with risk factors
People taking an osteoporosis medicine should repeat their bone density test every one to two years. After starting a new osteoporosis medicine, health care providers may repeat a bone density test after one year to evaluate the effects of the medicine.
Ostenonecrosis of the jaw has been reported to occur rarely patients with the use of bisphosphonate medications, including alendronate (Fosamax), ibandronate (Boniva), risedronate (Actonel, Atelvia) and zoledronic acid (Reclast). It usually is seen among cancer patients who may have received repeated high dosages of bisphosphonates by vein.
Calcium cannot be made within the body and if it is lacking in our diet, calcium is taken from our bones to fulfill our body’s needs. Dairy products are excellent source of calcium; for lactose-intolerant people, lactose-free dairy products, calcium-fortified foods and calcium supplements are helpful. Women before menopause need a total of 1,000 milligrams of calcium and 400-800 international units of vitamin D daily. Postmenopausal women need a total of 1,200 mg of calcium and 800-1,000 international units of vitamin D daily. Men younger than age 70 need a total of 1,000 milligrams (mg) of calcium, while those older than 70 need 1,200 mg daily. Vitamin D requirements in men are as follows: 400-800 IU daily for under 50 years, 800-1,000 IU daily for 50-70 years, and 800-1,000 IUs daily for older than 70 years.
No. Taking too much calcium may increase risks for developing kidney stones and other health problems.
Regular exercise and physical activity are necessary for healthy bones. Make exercise a part of your daily routine. High-impact exercises, when possible, are recommended. Smoking, drinking and high caffeine intake are known to cause poor bone health.
- Wear shoes with rubber soles instead of leather soles to get solid footing.
- Use handrails on stairs and escalators.
- Avoid walking on wet surfaces. Look out for black ice.
- Walk in lighted areas when possible.
- Use hands free bags to carry personal belongings.
- Use walking aids if these have been prescribed to you.
Make sure the walking areas surrounding your house are clear of snow and salted in winters.
- Secure loose wires/cords; carpets should be secure/tacked to the floor.
- Install grab bars beside the tub/shower and toilet or beside the bed if needed.
- Use a non-skid rubber mat in the shower/tub.
- Place light switches within reach of your bed.
- Keep stairwells well lit, with light switches at the top and the bottom.