9 Things Doctors Want You to Know About Osteoporosis
- What Experts Say About a Serious but Often Overlooked ConditionAbout 10 million Americans have osteoporosis: a weakening of the bones that makes them more susceptible to fractures. Another 44 million have lower bone density than normal, meaning they are at risk of developing osteoporosis. If you break a bone due to osteoporosis, you're more likely to break others, and could wind up impaired for the rest of your life—or even die early. The disease has no warning signs until you break a bone, but there are ways to help prevent osteoporosis or slow its progress. Here’s what doctors who treat osteoporosis want you to know about the disease and how to reduce your risk.
- 1. “Osteoporosis should be recognized as a warning sign for fracture.”Preventive care involves identifying warning signs for future health crises. High cholesterol is treated so you don’t have a heart attack or high blood pressure is lowered so you don’t have a stroke, says E. Michael Lewiecki, MD, who heads the New Mexico Clinical Research & Osteoporosis Center. "By the same token," Dr. Lewiecki says, "we don't want to wait until someone breaks their hip before we treat their osteoporosis. We need to do a better job of identifying patients with osteoporosis." Once identified, you can be preventively treated, just as you would be for other chronic conditions.
- 2.“The biggest risk factor for osteoporosis is a low-impact fracture.”“Too often fractures in those over 50 are ignored as signs of possible osteoporosis,” says Dr. Lewiecki. "Patients and sometimes their doctors mistakenly believe they just fell down, that anybody's bone would have broken, and nothing needs to be done about it. That couldn't be further from the truth." When a patient breaks a bone in a low-impact manner, such as a fall from a standing height, this could be a sign of osteoporosis.
- 3. “Fractures can be devastating, life-changing events.”Andrea Singer, MD, an osteoporosis specialist at MedStar Georgetown University Hospital, says she “can’t stress enough the importance” of getting treatment if you are at high risk for this disease, given the severe consequences of not doing so. If patients’ brittle, porous bones break, these fractures can result not only in illness and disability, Dr. Singer notes, but even death. "The mortality rate is significant with fractures, particularly hip and spine fractures, but can occur with all fractures," she says.
- 4. “Osteoporosis is not just your grandmother’s disease.”While the majority of people with osteoporosis are post-menopausal women, a significant number—20%—are males. "People tend to think about this as their grandmother's disease," says Dr. Singer. But, she says, “There are a myriad of risk factors” for the disease, affecting people of both genders and all ages. These can include being on certain medications, having a family history of the disease, being small and thin, or being a smoker. Talk to your doctor about your individual risk and steps you can take to reduce it.
- 5. “We can test your bones to find out your bone density—it's quick and painless.”People who are at risk for osteoporosis or who have already had a possible osteoporosis-related fracture can have a bone density scan to find out what treatment might be needed. The test is also recommended for all women over 65 and men over 70. "You lie on a table and can relax while it's being done, and it yields a lot of information—the lower the bone density, the greater the risk for fracture," says Dr. Singer. However, Medicare reimbursement rates have fallen below cost for these relatively inexpensive scans, so fewer facilities are offering them, says Dr. Christina Morganti, MD, a sports medicine specialist in Maryland. This could affect whether such scans are available where you live.
- 6. “Don’t get discouraged; osteoporosis is treatable.”Patients don’t always realize their osteoporosis can be helped and fractures prevented, says Dr. Morganti. “They think nothing can be done. They say, ‘I’m just too old,’ and don’t try to intervene and make things better.” Yet medications can cut fracture rates in half, while diet, exercise and other lifestyle modifications, such as quitting smoking, can improve your bone health and help you avoid breaking bones.
- 7. “Patients are sometimes afraid of medications due to possible side effects.”Osteoporosis can be treated by medications to help stop bone loss. The most commonly prescribed drugs are bisphosphonates like Boniva and Actonel. These medications have been linked to jaw cancer and femur fractures in rare instances in rats, says Dr. Morganti. As a result, "Many people are refusing to take those medications,” she says. “It's certainly possible to get those side effects, but it's a very low probability and the risk of another fracture is very high. We counsel patients to weigh your risks and the benefits of taking the drugs.”
- 8. “Diet and exercise can prevent fractures.”"People should have between 1,000 and 1,200 mgs of calcium from their diet if possible," says Dr. Lewiecki. Dr. Singer recommends foods like yogurt, milk, leafy greens, prunes, figs and almonds. Vitamin D is also essential and isn't as easy to get from diet, so you may need a supplement, she says. Exercise also is key: Dr. Morganti recommends weight-bearing exercise most days for at least 30 minutes, plus weightlifting two to three days per week and balance training or fall prevention exercises one or two days a week, which can include practicing balancing on one leg.
- 9. “New medications to treat osteoporosis are on the horizon.”Most current medications work to preserve bone rather than add new bone. Dr. Singer says new drugs are awaiting FDA review that—if approved—would attack osteoporosis in new ways, including increasing bone formation. "It is exciting that we have some potential for new medications," she says. "It gives us more options and patients more options to find a treatment that is right for them."
9 Things Doctors Want You to Know About Osteoporosis