Osteoporosis requires proactive management
by Dr. Chaim Vanek
Your body continually changes and adapts. You feel it in your heart and lungs when you run. You see it in your skin when a minor cut scabs, heals and fades away. Although you may not see or feel it, your skeleton also grows and changes as it removes old bone and lays down fresh bone in its place.
But when bone tissue becomes thin and bone density decreases over time and/or not enough new bone is formed, we're susceptible to spine, hip and other fractures. The disease, known as osteoporosis, affects about 8 million women and 2 million men in the U.S.
While osteoporosis commonly occurs in elderly women and men, younger people with other health issues, such as delayed or absent puberty or cystic fibrosis, can also get it. Oral steroids like prednisone, used to treat rheumatoid arthritis, also can reduce bone mass.
My patient Susan Dean was in her early 50s when a bone density scan, which costs about $150 to $250 at Oregon Health & Science University, detected osteoporosis in her spine. The disease runs in her family. Now 58, she fortunately has never had a major fracture, which could have caused more costly care. Her diagnosis doesn't mean her bones are turning to dust or doom her to an inactive life. But it does require management. That's where I come in.
The simplest and healthiest way to protect your skeleton is with a combination of adequate calcium, vitamin D and staying active.
Calcium is an essential ingredient to form new bone and replace old, worn-out bone. Without enough in our diet, the body will rob the bones of calcium to make sure there is enough for our nerves and tissues to function.
Women over age 50 should get 1,200 milligrams of calcium daily and a men over 50 should get 1,000 milligrams daily, according to The Institute of Medicine of the National Academies.
The IOM also recommends 600 international units (IU) daily of vitamin D, which also plays a key role in bone health because it allows our bodies to absorb calcium. Our skin produces vitamin D upon exposure to sunlight. Unfortunately, our skin becomes less efficient in producing vitamin D as we get older or we live in climates that don't have a lot of sun exposure.
Exercise is the final component in osteoporosis prevention and management. It keeps your bones strong by stimulating them to continually replace our old bone with new.
Osteoporosis can be frightening, especially if you have had a loved one suffer a debilitating fracture. But when people take proactive steps, they can prevent or manage the disease. Today, Susan participates in yoga, exercises regularly and takes calcium and vitamin D supplements. Focusing on these three components, we'll continue to work together toward better bone health to keep her osteoporosis in check.
Dr. Chaim Vanek is a highly rated endocrinologist at Oregon Health & Science University in Portland, Ore. He is an assistant professor in the Division of Endocrinology; Bone & Mineral Unit. He specializes in the treatment of osteoporosis, vitamin D deficiency and other disorders of mineral metabolism such as hyperparathyroidism, a gland disorder.