Osteoporosis: The Silent Thief

Osteoporosis causes more than 1.5 million fractures each year and presents a major public health threat for 28 million Americans, 80% of which are women. In fact, one in four women over the age of 50 has osteoporosis, low bone mass and deterioration of bone tissue which leads to increased bone fragility and risk of fracture. Osteoporosis is called “the silent thief” because bone loss occurs without symptoms. People may not be aware that they have the disease until their bones become so weak that a sudden strain, bump, or fall causes a fracture or collapsed vertebra.

Following a comprehensive medical assessment, your doctor may recommend that you have your bone mass measured. Bone mineral density (BMD) tests measure bone density in the spine, wrist, and/or hip (the most common sites of fractures). These tests are painless, noninvasive, and safe.

World Health Organization (WHO) has developed diagnostic definitions based on standard deviation (SD) with regard to bone mass, or how far a person is above or below “normal.” This definition is based on a comparison of bone density with the peak average value for a healthy 30 year old, or the young adult mean. Ideally, peak bone density achieved by age 30 should be maintained for life.

According to WHO, bone density within one SD (10-15% difference) above or below the young adult mean is categorized as normal. Bone density between 1 and 2.5 SD below the young adult mean is considered low bone mass, or osteopenia. When bone density measurements are 2.5 or more SD below the young adult mean, the diagnosis is osteoporosis. This represents about a 25-35% decrease in bone mass. Osteoporosis is classified as severe when bone density falls more than 2.5 SD below the standard and the person has experienced one or more osteoporotic fractures.

There is no cure for osteoporosis, but treatments are available. The key to managing osteoporosis is to prevent as much bone loss as possible with a healthful diet and exercise. There are several medications available to aid in the treatment and prevention of osteoporosis, including Raloxifene and Fosamax®. Benefits, side effects, and possible risks should be discussed with your doctor.

Osteoporosis can strike at any age. One out of every two women and one in eight men over 50 will have an osteoporosis related fracture in their lifetime. Some risk factors for osteoporosis include:
  • Past menopause or early menopause (natural or surgical before age 45)
  • Thin, small build
  • Race (especially Caucasian or Asian ancestry)
  • Family history
  • Lack of physical activity
  • Lack of Calcium
  • Limited exposure to sunlight (or Vitamin D deficiency)
  • Excessive intake of alcohol and/or caffeine (3 or more a day)
  • Smoking
  • Prolonged use of some medications (such as thyroid treatment, cortisone, prednisone or anti-convulsants)
  • Primary hyperparathyroidism

The best defense against osteoporosis is building strong bones during childhood and young adulthood. Lifestyle factors play an important role in keeping your bones strong. Eating a well-balanced diet rich in calcium and vitamin D is essential as well as regular exercise, such as daily walking. For more information, visit the National Institutes of Health or the National Osteoporosis Foundation.

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