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Author: Jeanne M. Anderson, M.D.
Clinic: White Bear Clinic

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     Osteoporosis is a condition that affects primarily older women, but also may affect men and younger people. It is a condition in which the bones become weak due to loss of calcium and increased loss of bone cells.

 

     Risk factors for osteoporosis include aging, inadequate calcium intake at any time in a person's lifetime, lack of weight-bearing exercise, family history of osteoporosis, early menopause, small frame, smoking, excessive alcohol use, excessive caffeine use, hyperthyroidism (overactive thyroid metabolism), long- term use of corticosteroids and certain other medications, and Caucasian or Asian heritage.

 

     Osteoporosis can be assessed with a bone density scan or DEXA scan. This is a special x-ray of the lumbar spine and hip which looks at the thickness of the bone compared to that of a young adult woman, using a "T-score". A T-score of worse than -1 should at least evoke a change in lifestyle risk factors, and a T-score of worse than -2 may indicate a need for additional medications. Screening for osteoporosis with a DEXA scan should begin by age 65 or earlier with menopause if some of the above risk factors are present.

 

      To reduce your risk of osteoporosis, increasing calcium and Vitamin D intake and weight-bearing exercise is a good beginning. Prior to menopause a woman should obtain 1000 mg of calcium with 400-800 iu of Vitamin D daily, but after menopause 1200-1500 mg of calcium daily. This is best taken in divided doses, preferably with some calcium at every meal. Dairy products or calcium supplements with Vitamin D are the best sources. Eliminating tobacco use and decreasing alcohol use to less than three a day is also recommended.

 

      For those with osteoporosis, adding prescription medication will be helpful in stabilizing and sometimes improving osteoporosis. These include bisphosphonates (Actonel and Fosamax), raloxifene(Evista), calcitonin (Miacalcin) nasal spray, and teriparatide (Forteo).