Ask the Geriatrics Healthcare Scientist: Osteoporosis

Carmel Dyer

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®)
Talk to your healthcare provider about whether you need a medication and which one is right for you.

 

 

Last Updated July 2019