Osteoporosis

Osteoporosis is thinning of the bones, making them more vulnerable to fracture.  Diagnosis is made with the use of a DEXA scan, which typically evaluates density at the hip and the lower spine.  Osteopenia is “borderline osteoporosis.”  These conditions are fairly common as we get older, and are suspected if someone has lost an inch or more of height during their lifetime or has had a fracture without any preceding or very little trauma.  Post-menopausal women are especially vulnerable because they no longer produce estrogen to keep their skeletal frame strong.  However, older men also at some risk due to decreasing testosterone levels.  Other risk factors include Caucasian or Asian race, alcohol abuse, anorexia nervosa, hyperthyroidism, early menopause (before age 45), smoking, family history of osteoporosis, long term steroid use (ie: medication such as prednisone), early total hysterectomy, long term use of potent acid blockers such as Prilosec, sedentary lifestyle and petite skeletal frame.

Prevention of osteopenia and osteoporosis centers around eliminating as many of the above risk factors as possible, such as stopping smoking, and taking adequate amounts of calcium (1000-1500 mg/day) and Vitamin D (1000-2000 IU/day).  Certain medications including hormone replacement and bisphosphonates (ie: Fosamax) can be helpful in maintaining and increasing bone density respectively.  These medications have certain risks, however, and their use needs to be closely monitored by a physician…Richard R Samuel, MD     Family Practice and Urgent Care   Hayden, ID  USA