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Osteoporosis: Battling brittle bones

Cartoon doctors examine giant bones

If you're not paying attention, osteoporosis can sneak up on you. Protect yourself by making healthy choices, learning your risks and working with your doctor.

There may be some things you can "feel in your bones," but the start of osteoporosis isn't one of them. In the early stages, this bone-thinning disease has no symptoms at all. And when it progresses, the resulting broken bones can be disabling or even life-threatening.

That's why it's important to learn your risks for osteoporosis, take steps to prevent the disease and talk with a doctor about screening if you are at risk. Treatment can help prevent, slow or reverse bone loss. And the earlier treatment starts, the better.

The risk list

According to the Bone Health & Osteoporosis Foundation (BHOF) and the National Institute on Aging, risk factors for osteoporosis include:

Being female. Women account for 80% of all osteoporosis cases. And half of all women over 50 will experience an osteoporosis-related fracture.

Age. Though osteoporosis can strike at any age, your risk rises as you get older.

Family history. If someone in your family has osteoporosis, you're more likely to have it too.

A small frame. Osteoporosis works faster in bones that are already small and thin.

Menopause. Menopause lowers levels of the female hormone estrogen. Lower estrogen levels can lead to bone thinning and osteoporosis.

Lifestyle risks

Unlike the factors listed above, you can control the following risk factors:

Diet. People who don't get enough calcium are more likely to have osteoporosis. The National Academy of Medicine gives these guidelines for daily calcium intake:

  • Males and females age 9 to 18: 1,300 milligrams.
  • Women age 19 to 50: 1,000 milligrams.
  • Women age 51 and older: 1,200 milligrams.
  • Men age 19 to 70: 1,000 milligrams.
  • Men age 71 and older: 1,200 milligrams.

Good sources of calcium include:

  • Low-fat dairy products such as cheese, yogurt and milk.
  • Kale, collards, broccoli and other dark green leafy vegetables.
  • Breads made with calcium-fortified flour.

Medication use. Prescription medicines such as steroids and thyroid hormones may cause bone loss. Ask your doctor how to counter this side effect.

Smoking. Cigarettes contain chemicals that are harmful to bone cells, according to the BHOF. Smoking might also make it more difficult for your body to absorb calcium.

Exercise. Weight-bearing exercises such as walking, jogging or playing tennis will help strengthen bones and prevent osteoporosis if they're done on a regular basis.

Another important choice is getting screened for osteoporosis. All women should be screened starting at age 65, according to the U.S. Preventive Services Task Force. Postmenopausal women under 65 who have been determined to be at increased risk of osteoporosis by their doctor should also be screened.

The treatment plan

If you have osteoporosis, your doctor can help you make lifestyle changes that protect and strengthen your bones. You may also be given medicines to slow, stop or reverse bone loss. Medicines used to treat osteoporosis include:

  • Calcitonin, a natural hormone that can help increase bone density. A synthetic form is available as an injection or nasal spray.
  • Bisphosphonates, which can slow bone loss and increase bone density. They're taken in pill form, first thing in the morning, on an empty stomach.
  • In women, hormone therapy can help slow bone loss after menopause. However, hormone therapy may increase risks for other health problems such as breast cancer, heart attack and stroke. Because of this, the U.S. Food and Drug Administration recommends that women consider other treatment options for osteoporosis before they consider hormone therapy. Women who do take hormones should take as little as possible for the shortest time possible, says FDA.
  • Raloxifene, which is a selective estrogen receptor modulator (SERM). It works to strengthen bones much like natural hormones but without the potential side effects.
  • Parathyroid hormone, which stimulates the formation of new bone. It's taken as an injection every day for up to two years.
  • Denosumab, a drug which is given by injection every six months.

Reviewed 2/3/2023

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