We all know an older person with osteoporosis: it is one of the most common problems of aging, affecting more than half of adults over 50 years of age. We all hope that osteoporosis doesn't happen to us, as weak bones can lead to fractures, and fractures, in turn, lead to all sorts of terrifying consequences. But there are some signs that can tell you that you are having bone loss so you can start to solve it.
But how do you know if your bones are strong enough to keep you safe? It's tricky, because osteopenia, the bone-thinning process that precedes full-blown osteoporosis, can occur without obvious symptoms.
Signs that you are having bone loss
Here are the top 10 warning signs of bone loss, along with tips on how you can respond:
Have you had more than one fracture in the last two years, or have had a fracture that was much more serious than the circumstances seemed
There is an almost of a woman who discovered that she had osteopenia or mild osteoporosis, when she broke her ankle simply when leaving the sidewalk. Your bones need to be strong enough to withstand an impact, and if they aren't, you'll want to know more about what's behind that.
What you can do: Get a bone density test, also called a DXA test or densitometry, which is a specialized type of X-ray that measures the amount of calcium and other key bone-hardening minerals within each bone segment.
Doctors consider bone density tests to be a fairly accurate predictor of fracture risk, because they show whether your bones are dense and solid or porous (which makes them brittle).
Your bones are naturally thin
Unfortunately, if your bones are small and thin to begin with, you have less bone to lose. People with small, delicate bones are likely to develop osteoporosis at a younger age.
This does not mean that large or thick-boned people do not get osteoporosis; It's just that thin or small-boned people don't have to work too hard to be at risk for fracture.
We reach peak bone mass and stop building bone in our 20s to 25s, and sometime in our 30s to 40s we begin to lose bone.
The rate of bone loss depends on our genetics and how vigilant we are regarding diet, exercise, and other factors that keep our bones strong.
What You Can Do: If you're under 40, do everything you can in your 30s to build bone - eat a diet rich in dairy and other calcium-rich foods, and get plenty of high-impact exercise, which is anything that involves running or jumping.
If you are 40 or older, continue to eat nutritionally, add some calcium, magnesium and vitamin D supplements, and do strength training exercises in addition to impact exercise. Strength training has been shown to prevent bone loss.
You take prednisone or some other corticosteroid to treat an autoimmune condition
Taking cortisone medications over a long period of time interferes with hormone levels in a way that leaches calcium, vitamin D, and other nutrients from the bones.
People who have autoimmune diseases like Crohn's disease, lupus, or rheumatoid arthritis have osteoporosis at a much higher rate than the average person due to the corticosteroids used to treat these conditions.
This warning sign is more likely to be important for women, because they are more prone to autoimmune diseases to begin with.
They are also more prone because normal estrogen levels are necessary to maintain healthy bone.
Taking a thyroid hormone for a low thyroid or taking SSRI-type antidepressants is also linked to higher levels of bone loss, although experts are not yet sure why.
What you can do: If you need to take corticosteroids to treat a health condition, the resulting risk to your bones requires careful supervision by a doctor.
Most doctors now have patients have a bone density test shortly after receiving corticosteroids, to make sure they have the bone mass necessary to withstand the effects of the drugs.
Your doctor may also order a 24-hour urine calcium test and vitamin D test to check your level of this bone-building nutrient.
If you take corticosteroids long-term, you will likely have an X-ray of your spine, as small fractures sometimes occur that you cannot feel at first. Many doctors will also prescribe bisphosphonates, which are bone-building drugs.
Do you smoke
Experts don't know exactly why smoking affects bone health, but numerous studies make it clear that it does. Smoking has a high statistical correlation with osteoporosis, so if you have been a smoker your entire adult life, it is very likely that you have compromised your bones.
What You Can Do: No one wants to be told once again to quit, but that's exactly what your bones are asking you to do. The good news is that no matter your age when you quit smoking, you can still reap the health benefits of not smoking and give your body a chance to recover.
You have more than one alcoholic drink a day
Alcohol is a bone weaker; It leaches calcium, magnesium and other minerals from bones. The more you drink, the more likely this is to happen. Women are more vulnerable to this type of bone loss than men, perhaps because they are more vulnerable to the effects of alcohol in general.
What you can do: Unfortunately for those who like to drink, the main solution here is to cut back. Try sipping a glass or two of wine a night, then switch to herbal tea or warm milk with honey.
You are lactose intolerant or have other reasons not to consume milk
Milk is one of the best bone builders, and not just because of calcium. Vitamin D, an important ingredient in fortified milk, is even more important. Most adults are severely deficient in vitamin D, putting them at risk not only for weak bones but for various types of cancer.
And supermarket milk, fortified with vitamin D, is one of the only dietary sources of this important nutrient.
What You Can Do: It's the calcium, vitamin D, and other minerals in the milk that are important, not the milk itself. Get soy or rice milk enriched with these nutrients and drink it regularly.
Also take a supplement that contains calcium, magnesium, and vitamin D; These three minerals work synergistically to build and protect bones.
You have battled an eating disorder
A history of anorexia is a great red flag for osteoporosis. This is because artificially low body weight reduces hormone levels, causing missed periods. Anything that lowers estrogen levels interferes with bone building.
What you can do: If you have a history of anorexia or bulimia, inform your doctor or therapist. There are treatment programs that have been shown to be successful in managing eating disorders, and this is important so that you can protect your bones in the future.
Also, be sure to drink milk fortified with calcium and vitamin D.
Women only: your periods are irregular or infrequent
Low estrogen levels are generally responsible for missing periods or a cycle that starts and stops. Unfortunately, the low level of estrogen contributes directly to bone loss.
Low estrogen levels can be caused by an eating disorder, excessive exercise, or polycystic ovary syndrome (PCOS).
What you can do: If your periods are irregular and you're not underweight, talk to your doctor. You may have a hormone-related condition, such as polycystic ovarian disease (PCOS), that is easily treatable.
Your doctor can prescribe low-dose birth control pills, for example, which is an easy solution to irregular periods and the hormonal disruptions that can be behind them.
Relatives who had or have osteoporosis before age 50 or before menopause
Family history is an important indicator that your bones are weakening. If you come from a family in which older adults have a history of fractures, poor posture, or loss of height, chances are that your family members have had osteoporosis, whether it was diagnosed or not.
And if they did, you probably did too.
What you can do: Compile a family health history by talking to your parents, grandparents, and anyone else who has family information. If you have family members with osteoporosis, tell your doctor.
If you are younger and your doctor has resisted requests for a bone scan, this information will help you in your search.
You are Caucasian, Asian, female, or over 50
Having just one of these risk factors makes your bones more likely to be thinning. If all three apply to you, there is a good chance that your bones are at risk of fracture.
But African American women also have reason to be concerned. A recent study showed that low bone mass is much more common than previously believed in all ethnic groups, including African Americans.
If you are 60, 70 or older, pay even more attention. The risk of bone thinning increases with age; Osteoporosis experts estimate that after age 75, 90 percent of women will sustain a fracture.
What you can do: You can't change any of the racial, gender, or age factors that make you who you are. But knowing which risk category you fall into can help you be more aware of the state of your bones and advocate for yourself with your doctor.
If you are over 50 years old and tests show that your bones are weakening, your doctor should take a medical history and order laboratory tests before prescribing you. Based on your history and test results, this is the treatment that should be prescribed.
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