Bone Density and Osteoporosis
Osteoporosis
Osteoporosis is a disease in which the bones in the body decrease in mass over time. If the disease were named for what it actually does, perhaps “vanishing bone disease” would get the attention it deserves. The name osteoporosis instead comes from the Greek words meaning “porous bones.” Its less severe form is called osteopenia, which literally means “bone poverty.” This is often a silent problem that may go unnoticed until people develop fractures, leading to decreased quality of life and occasionally even death.
Although you wouldn’t know it, bones are a dynamic tissue in our bodies. They are constantly being broken down and built up. These processes are influenced by a wide variety of factors. Some things that you can control that affect your bone health include:
Calcium
Most experts agree that you should get about 1200 mg of calcium per day to help ward off bone loss. Each serving of dairy gives you about 300 mg of calcium, so most people don’t get the daily requirement and need to take calcium supplements. You should also know that calcium can only work in the presence of vitamin D. Working indoors, poor vitamin D intake, or dark skin can predispose you to low serum vitamin D levels. If you think you are at risk, you can talk with your doctor, who can screen you with a simple blood test.
Exercise
The old adage “if you don’t use it you lose it” is as true with your bones as with anything else. Your bones are strengthened when stressed, so regular weight bearing exercise is recommended to prevent bones from becoming weak.
Alcohol
Excessive alcohol consumption (more than 2 drinks per day) can increase your risk for osteoporosis, possibly by affecting the absorption of calcium.
Eating Disorders
People with anorexia nervosa and bulimia have dietary patterns that upset the normal absorption of minerals and vitamins.
Medications
Many medications can negatively affect your bone mass, including steroids, some antidepressants, chemotherapy drugs and acid blocking drugs among others. If you need to be on these medications for an extended period, you should talk with your doctor about osteoporosis screening and treatment.
There are other things you cannot control that can affect your bone health:
Being female
Bone fractures from osteoporosis are almost twice as common in women as in men.
Age
The risk for osteoporosis increases steadily as we get older. For women, this loss can occur most rapidly in the first few years after menopause as your body withdraws the calcium it has “banked” in the bones for years.
Small body frame – People who have a smaller skeleton have a smaller “bank reserve” of calcium from which your body can withdraw as you get older. This leads to a higher risk for osteoporosis.
Hormones
Low estrogen due to natural or artificial menopause, as well as too much thyroid hormone, can cause excessive bone loss.
The majority of experts in the United States recommend screening for osteoporosis in postmenopausal women older than 65 and in younger men and women with risk factors. The most common form of screening for osteoporosis is a DEXA scan, which uses low energy x-ray beams to measure bone density. You should talk with your doctor about when and how often you should undergo this test.
By Patrick Markwalter, MD, Staff Radiologist, Triad Radiological Associates
