Carmel Bitondo Dyer, MD, FACP, AGSF
Professor of Geriatric and Palliative Medicine
McGovern Medical School
The University of Texas Health Science Center at Houston
Q: What is osteoporosis?
A: Osteoporosis is a disease that causes thinning of the bones. Osteoporosis causes bones to become more fragile and increases the risk of fracture after a bump or fall. Fractures due to osteoporosis occur most commonly 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 include:
- 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 (such as prednisone) and certain anti-seizure medications (such as phenytoin or Dilantin)
- Gland diseases of thyroid, or parathyroid, and/or adrenal diseases
- Eating disorders
- Low calcium and vitamin D levels
- In women:
- Being post-menopausal
- Beginning menopause early
- Having had ovary-removing surgery 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 thinning 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 detect very advanced osteoporosis. The best test to diagnose osteoporosis is a DXA scan. A DXA scan is a special type of x-ray of the lumbar spine and proximal femur that measures the density of bones.
Q: Who should have a DXA scan done?
A: A DXA 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 DXA scan?
A: You should ask your doctor if you need a DXA scan. Some physicians can do a DXA 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. There are some healthy lifestyle measures that can help prevent osteoporosis. These include:
- Participate in weight-bearing exercise like walking, jogging, or weightlifting.
- 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 healthcare provider about how much calcium and vitamin D is right for you.)
- If you smoke cigarettes, quit.
- Avoid excessive alcohol use.
Q: What medications are there for osteoporosis?
A: Osteoporosis can be treated. In addition to eating a good diet, exercising, and not smoking, your healthcare provider may suggest taking medication to maintain or increase your bone strength. 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®)
- Desonumab (Prolia®)
Last Updated July 2019