Osteoporosis... The Silent Health Threat
It affects over 10 million Americans. Of those affected, 80% are women. Osteoporosis is characterized by the weakening of basic bone structure from calcium loss. This change in structure makes bones porous or full of microscopic holes. Once the bone structure has weakened, it is more likely to break easily. A simple fall can cause a serious fracture in a patient with osteoporosis. According to the National Osteoporosis Foundation, 50% of women and 25% of men over age 50 will have at least one fracture related to osteoporosis in their remaining lifetime.
High Risk Patients
Certain patients are at a higher risk for developing osteoporosis. These patients may have a family history of osteoporosis, a personal history of decreased calcium intake, a history of prolonged steroid use, or the presence of certain chronic diseases. Anyone’s risk can also increase with cigarette use, inactive lifestyle, excessive alcohol use, and advancing age. Hormonal changes such as decreased estrogen in women through menopause or surgical ovarian loss and low testosterone levels in men can also increase the rate at which bone loss occurs.
Detecting The Disease
Because this disease is silent, most people do not know that they have osteoporosis until they have serious symptoms such as broken bones. Fortunately, osteoporosis can now be detected before bones are weak enough to easily break. The test is called a BMD or bone mineral density test. BMD is a quick and painless procedure that is very similar to an x-ray. It does not take long to get results and the information can help you and your doctor make the best decision for your medical care.
The BMD reports bone health in two specific categories called the T and Z-scores. The Z-score is specific for your age and body size while the T-score determines your fracture risk. T-scores are represented in numbers of standard deviation from normal. Normal, for calculation purposes, is the bone density of a healthy 30 year old adult. Low T-scores are represented by negative numbers. A T-score below -2.5 indicates osteoporosis. The National Osteoporosis Foundation recommends BMD testing for patients with significant risk factors, postmenopausal women with new fractures, and all women over age 65.
After having the BMD test, many patients will be reassured to find that they have strong healthy bones. Fortunately, there are many treatments available for those people who do have bone mineral loss. It is always best to begin treatment as early as possible to prevent osteoporosis progression and fractures. The American Academy of Family Physicians recommends a daily intake of 1,000 mg of calcium for adults and 1,500 mg for women after menopause. In general, we can all help prevent osteoporosis with exercise, a calcium rich diet, and by healthy lifestyle choices such as stopping smoking and limiting alcohol use.
Alison Hitz, MD