Osteoporosis

Osteoporosis is a disease that involves the human skeleton. It is, by definition, a decrease in the density of bones. Early in its course, osteoporosis is a silent disease that weakens bones without signs or symptoms. The decrease in bone density causes the bones to become more susceptible to breaking from minor trauma (such as a fall from standing height, or even in extreme cases from twisting the wrong way or coughing). In many people, the diagnosis of osteoporosis comes only after sustaining a fracture.  Furthermore, osteoporosis is a progressive disease that left untreated can lead to additional fractures occurring. Osteoporosis is most common overall in women, however the incidence increases with age among both men and women.

Some of the most commonly fractured bones in patients with osteoporosis are the vertebrae (spine), the hip, the wrist, and the shoulder. These fractures can have profound consequences including disability and even death (one year mortality rate in elderly patients after hip fractures approaches 30%). Fractures related to osteoporosis are often referred to as “fragility fractures”, and the risk of having a fragility fracture goes up significantly for people who have had a previous fragility fracture.

The diagnosis of osteoporosis is made by bone densitometry testing (also known as a DEXA scan). It is a noninvasive test that measures bone loss. A DEXA scan should be performed on all women age 65 or older, men over the age of 70, in women under 65 that are post menopause, anyone with a fragility fracture, or in males or females over age 50 with risk factors.

A partial list of the risk factors for osteoporosis include female gender, advancing age, post-menopausal, anorexia, smoking, low calcium and vitamin D, certain medications (such as chronic steroid use), kidney disease, and disuse (inactive lifestyle).

Treatment should be discussed with your doctor and will be determined on an individual basis after any needed tests have been ordered. In general, treatment often consists of calcium and vitamin D supplementation. Recommendations are based largely on age. According to the National Institutes for Health current recommendations for Ca and vitamin D for females are:

Treatment may also involve the use of prescription medications such as Reclast, Boniva, Actonel, Fosamax, Forteo, Prolia, and others such as hormone therapies. There are possible side effects to the supplements and prescription medications mentioned above and you should discuss these side effects with your doctor prior to beginning treatment.