Ask the Geriatrics Healthcare Scientist: Osteoporosis
Ask the Expert
G. Darryl Wieland, PhD, MPH
Research Director, Geriatrics Services
Palmetto Health Richland Hospital
Q: What is osteoporosis?
A: Osteoporosis is a bone disease that causes thinning of the bones. Osteoporotic bones are fragile and have an increased risk for fracture with bumps or falls. Osteoporotic fractures most commonly occur in the hip, spine, and wrist.
Q: How common is osteoporosis?
A: It is estimated that ten million Americans have osteoporosis. It can affect both men and women, but 80% of cases are diagnosed in women. People from all ethnic backgrounds can be at risk for osteoporosis.
Q: Am I at risk for osteoporosis?
A: Risk factors for osteoporosis are:
- Advanced age.
- Having a small body frame
- A family history of osteoporosis
- Excessive use of alcohol
- Cigarette smoking
- Lack of exercise
- Taking some types of medication, especially steroids, like prednisone, and certain anti-seizure medications, like phenytoin (Dilantin)
- Glandular Diseases like thyroid, parathyroid and adrenal diseases
- Eating disorders
- Low calcium and vitamin D levels
- Being Caucasian or Asian
- In women:
- Being post-menopausal women
- Having had an early menopause
- Having had surgery that removed their ovaries before menopause
- In men:
- Having low levels of the male hormone, testosterone
- Having prostate cancer treatments that lower testosterone levels
Q: How can I tell if I have osteoporosis?
A: Osteoporosis is often called a "silent disease" because bone loss occurs without symptoms. Many people do not find out that they have osteoporosis until after they break a bone. Finding osteoporosis early may help prevent bone fractures. Simple x-rays can only see advanced osteoporosis. The best test to diagnose osteoporosis is a DEXA scan. A DEXA scan is a special type of x-ray of lumbar spine, or proximal femur that measures the density of bones.
Q: Who should have a DEXA scan done?
A: A DEXA scan should be considered for:
- Women 65 years of age or older.
- Women younger than 65 who have risk factors for osteoporosis
- Anyone with previous fracture suspicious for “brittle bones”.
- Anyone with a condition or taking a medication associated with osteoporosis.
Q: Where can a get a DEXA scan?
A: You should ask your doctor if you need a DEXA scan. Some physicians can do DEXA scan in their offices. Otherwise, you may be given a prescription to go to a radiologist or a women's health center.
Q. How can I reduce my risk of osteoporosis?
A. Osteoporosis is preventable. Your risk for developing osteoporosis can be reduced by having a healthy lifestyle. To reduce the risk of osteoporosis:
- Participate in weight bearing exercise like walking, jogging, or weight lifting
- Get enough minerals and vitamins through diet and supplements. (Most people at risk for osteoporosis need approximately 1,200 mg of calcium and 400-800 international units of vitamin D daily; talk to your doctor about how much calcium and vitamin D is right for you.)
- If you smoke cigarettes, quit.
- Avoid excessive alcohol intake.
Q: What medicines are there for osteoporosis?
A: Osteoporosis can be treated. In addition to a eating a good diet, exercising, and quitting smoking, your doctor may suggest taking a medication to maintain or increase your bone density. Several types of medications exist, including:
- Bisphosphonates. Examples include aledronate (Fosamax®), risedronate (Actonel®), ibandronate (Boniva®) and zolendronic acid (Reclast®).
- Calcitonin (Miacalcin® or Fortical®)
- Raloxifene (Evista®)
- Teriparatide (Forteo®).
Discuss with your doctor about whether you need a medication and which is right for you.
Updated: March 2012
Posted: March 2012