Bone health: Osteopenia and osteoporosis
IF you have been diagnosed with osteopenia, this means that your bone mineral density is lower than normal and your bone health is at risk. This is a potentially serious condition because it can be a precursor to osteoporosis. Bone mineral density is a measurement of the level, density and strength of minerals in the bones. Osteoporosis is a common bone disease which affects many women and men as they age.
Osteoporosis occurs when more of your bone tissue is being removed from your bones (in a process called resorption) than is being created. If you need to have a picture of someone who has been affected by osteoporosis, think of an older woman who seems to have shrunk over time.
Bone formation usually peaks at age 30; after that, resorption occurs slightly more quickly than formation. In some persons, resorption happens much more quickly than normal. In these individuals, the affected bones become thin and fragile and prone to fracture. Any bone can be affected by osteoporosis, however, the hip and spine are particularly vulnerable because they are under continual heavy stress.
When they fall, older men and women are at greater risk of fracturing their wrists, hips, or spines because of osteoporosis. These broken bones can cause loss of mobility and death.
Women over the age of 50 and men over the age of 70 have a higher risk for the development of osteoporosis. This occurs because of a decrease in oestrogen in women at the time of menopause and a drop in testosterone in men as they age.
Other causes include:
*Sedentary lifestyle or confinement to bed.
*Chronic rheumatoid arthritis, chronic kidney disease, eating disorders.
*Taking corticosteroid medications ( eg prednisone) or anti-epilepsy drugs.
* Vitamin D deficiency.
* Dietary calcium deficiency.
* Race (Asian and Caucasian women have a greater than average risk of developing osteoporosis).
* Thin small-boned frame.
* Excessive alcohol drinking.
* Cigarette smoking.
* Family history of osteoporosis.
* History of hormone treatment for prostate or breast cancer.
* Absence of menstrual period for long periods of time.
Osteoporosis is often referred to as a "silent" disease because most persons have no symptoms until the disease has progressed to an advanced stage. By the time symptoms such as back pain, loss of height, spinal deformity or an unexpected fracture appear, osteoporosis is already in an advanced stage. Osteopenia and osteoporosis can be diagnosed using a bone density scan or bone densitometry which measures the mineral content of the bone.
If not treated, osteoporosis can result in:
* Increased risk of fractures from trips or falls that would not have caused a fracture when the bones were stronger.
* Loss of height due to fractures in the vertebrae causing them to compress.
* Curving of the spine.
* Back pain.
* Loss of mobility or independence.
The best way to mange your bone health is to prevent bone loss. If you have osteopenia, lifestyle changes are recommended to prevent the progression to osteoporosis. These changes include:
* Exercise especially upper and lower body strength training, weight training and resistance exercises.
* Sun exposure. Get at least 15 minutes of sunlight once daily. Sun exposure triggers the production of Vitamin D, which is essential for the production of healthy bones.
* Do not smoke. Do not consume excessive amounts of alcohol, coffee, and soda; they can decrease bone density.
* Supplement your diet with calcium, magnesium, potassium, boron and vitamins D and K.
* Eat plenty of leafy green vegetables, fruit, whole grains, and seaweed.
* Maintain a healthy weight.
If you have osteoporosis, in addition to the above-mentioned lifestyle changes, you should consider taking prescription medication to slow the progression of osteoporosis. Fractures due to osteoporosis can cause loss of mobility and death. It is therefore very important that you get your eyesight checked and make changes to your physical environment to reduce the risk of slipping, tripping or falling.
Dr Campbell is a family physician and the author of A Patient's Guide to the Treatment of Diabetes Mellitus.