Osteoporosis: You can prevent it
June 2, 1999
Web posted at: 11:49 AM EDT (1549 GMT)
By Deborah Messecar
(WebMD) -- Osteoporosis is a very common bone disease that affects older women and men. It causes a reduction in bone density that allows the bone to fracture under minimal stress. Osteoporosis is categorized as either Type I (postmenopausal) or Type II (senile osteoporosis). Type I osteoporosis primarily affects women between the ages of 55 and 75. With this type, fractures of the vertebrae and wrists are the most common. With Type II osteoporosis, both women and men are equally affected, usually between the ages of 70 and 80, and fractures of the vertebrae, hip and long bones (such as those of the arms and legs) are common.
Unfortunately, in many ways osteoporosis is a silent disease and usually shows no symptoms until a complication develops, such as a fractured bone or collapsed vertebrae. People with osteoporosis may develop a kyphotic hump (hunchback), or reduced height and decreased spinal movement as later signs of the disease. Back pain may become severe as nerve roots are compressed.
Osteoporosis has serious consequences, as it is a major cause of falling, and thus the injuries associated with falls. Approximately one-third of women and one-sixth of men who live to 90 years of age will experience a hip fracture as a result of falling. Complications associated with a hip fracture can predispose the person to considerable disability.
Fortunately, osteoporosis is detectable before symptoms occur. Bone-density tests can detect low bone density before a fracture, confirm a diagnosis of osteoporosis after a fracture, predict chances of fracturing in the future, determine the rate of bone loss and monitor the effects of treatment.
Osteoporosis is both preventable and treatable. Recent information indicates that calcium and vitamin D intake, exercise and sex hormones play important roles in normal skeletal aging. Among healthy older Americans, the average dietary intake of calcium is about 700 to 800 milligrams per day. Supplementation with 500 milligrams of calcium per day is recommended, except for those with a history of kidney stones or hypercalciuria. For vitamin D, a daily dose of 700 IU per day (the amount found in many multivitamin tablets) is safe for most people and prevents vitamin D deficiency. Products that promote calcium loss such as carbonated and alcoholic drinks, caffeine, sugar, protein and sodium should be limited. Menopausal and postmenopausal women should ask their physicians about estrogen replacement.
Because cigarette smoking can cause bone mineral depletion, stopping smoking can dramatically reduce bone loss. When possible, medications such as aluminum-based antacids, isoniazid and steroids should be avoided. A regimen of moderate weight-bearing exercise such as walking for 45 to 60 minutes three to five times a week is safe and reasonable (but check with your doctor before starting any exercise program).
There are treatments for established osteoporosis: Calcitonin is a hormone that influences bone metabolism and increases bone mineral density. Biphosphonates, such as Didronel and Fosamax, increase bone mineral density in the spine and decrease the rate of spinal fractures. Biphosphonates should be taken with both calcium and vitamin D supplementation.
If you are at risk for osteoporosis, discuss with your doctor some of the ways you may supplement your diet and modify your lifestyle. A little effort now may mean years of living without the painful effects of a debilitating bone disease.
Copyright 1999 WebMD, Inc. All rights reserved.
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