Osteoporosis: Prevention, Diagnosis And Treatment

The old country road hadn't been patched or paved in years. Without rehabilitation, it withstood the weight and wear from days of bustling traffic. no one suspected a problem until the surface cracked under a heavy tractor-trailer load one day.

Bone in the spine and hips can deteriorate in much the same way as an old road can crumble--silently, gradually and without warning. Osteoporosis is a chronic, degenerative process that causes bones to become fragile and brittle, susceptible to major fractures in the hip, spine and wrist. This silent epidemic affects 25 million Americans, mostly women; yet three out of four women ages 45 to 75 have never spoken to their doctor about the disease.

Osteoporosis often lies dormant until a bone breaks, and that brings its own set of major complications. But this disease is largely preventable.

Osteoporosis by the numbers

By age 70, Americans have lost about 30 to 40 persent of their peak bone mass
Osteoporosis leads to 1.3 million fractures each year
One in three women older than 50 will suffer a vertebral fracture, which can lead to stooped posture
More than 250,000 hip fractures occur each year because of osteoporosis
$4 to $6 billion is spent on treating osteoporosis each year; this ranks with the cost to treat both diabetes and alcohol abuse

Throughout a person's life, bone undergoes a continuous remodeling process--building up a storehouse of calcium within its spongy material, removing it and replacing it with a new supply. Until about age 35, the body adds more bone tissue than it takes away--helping women reach their peak bone mass. After age 35, however, new bone diminishes as the body removes more vital tissue. Menopause hastens the process; women lose up to 5 percent of their peak bone mass each year as estrogen, a hormone vital in maintaining bone density, is rapidly depleted from their bodies.

To help prevent osteoporosis, women can start by building up their peak bone mass before age 35. Women should consume 1,000 to 1,200 mg of calcium a day, the equivalent of about four glasses of milk. Postmenopausal women may need a s much as 1,500 mg. a day. But fewer than 20 percent of American women meet that requirement. Calcium should be obtained primarily through diet with supplementation if necessary to achieve optimal levels. Vitamin D3 (400 IU) is also recommended to increase calcium absorption. Exercises such as walking, jogging or biking are also beneficial.

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Until recently, women concerned about osteoporosis were encouraged to consider starting hormone replacement therapy following menopause. While it's true that HRT can help prevent bone loss, it has inherent risks. HRT can increase the risk of heart disease, stroke, blood clots in the legs and lungs and breast cancer.

During the last decade, advanced diagnostic techniques have fueled osteoporosis prevention efforts. Women with a family history of the disease or those at risk should have a bone density test of the hip and spine taken at or before menopause. Simple, painless tests such as dual energy X-ray absorptiometry (DEXA)use a small amount of radiation to determine the density or thickness of certain bones.

A bone density study can help determine whether to begin a prevention or treatment program. For women already suffering from osteoporosis, medications such as Fosamax®, Actonel® , Boviva® and Evista® are available to prevent further bone loss.

Although the condition progresses silently, the consequences of osteoporosis can be frighteningly visible: gradual loss of height, stooped posture and severely broken hips. The key to battling osteoporosis is prevention--halting the disease process before it can have a dangerous effect.

Last Updated: September 29, 2009