What is Osteoporosis and why should I care?
Dr. J. Harrell Docherty Jr., HopeHealth Rheumatologist
Osteoporosis is a bone condition that causes the bones to get thin, lose their strength, and increases the risk of fractures (broken bones) at the wrists, shoulder, spine and hips. Osteoporosis is a quiet condition that occurs slowly over time as we all get older. It is usually not discovered until we start breaking bones from simple falls or less.
All of us are born with thin bones, and as we grow, our bones grow and thicken. So, when mom said “eat your veggies and drink your milk to grow up big and strong” she was telling the truth. Microscopically bones are built like steel girder bridges or scaffolds, lots of bone girders holding up our bodies. Our bones should be their strongest by about age 30. After that, our bones gradually lose their strength and the bone girders are taken away till we cannot support ourselves.
Why is this important? Osteoporosis is a treatable condition, but in the U.S.:
- 3/4 women will not be treated even a year after their fracture
- 1/3 women over age 50 will develop an osteoporosis fracture
- those with one osteoporosis fracture have a five times higher risk of a second fracture within a year
- 33 percent of women and 50 percent of men who experience an osteoporosis hip fracture die within a year due to complications
Many things affect our bone strength. Factors that increase bone loss include: age, being underweight, Caucasian, female, sedentary, having a family history of fractures, low estrogen and testosterone levels, smoking, using steroids, and excessive alcohol. Medical conditions can also decrease bone strength such as: thyroid and other endocrine diseases, liver or kidney disease, kidney stones, malnutrition, malabsorption of nutrients, rheumatoid arthritis, lupus, seizure disorders, and cancers.
Diagnosing osteoporosis is easy and painless. Your medical provider can order a DEXA scan of your low back and hip. This screening measures bone density and provides a T- score that can help identify those at risk for osteoporosis and bone fractures:
- normal is +1 to -1
- osteopenia (thin bone with an increased risk of fracture) is -1 to -2.5
- osteoporosis (with a high risk of fracture) is any score less than -2.5.
It is recommended that all women over age 65 and men over 70 should get a DEXA scan. Others who should be screened include postmenopausal women under age 65 with significant risk factors and men age 50 to 69 with risk factors. Risk factors include:
- family history of osteoporosis
- diseases such as rheumatoid arthritis
- low body mass index (BMI)
- physical inactivity
- previous fractures
- height loss of more than one inch
- use of tobacco and alcohol
- use of corticosteroids and some other drugs
Another tool is FRAX, or Fracture Risk Assessment Tool, which can be completed online in seconds and gives a 10-year risk assessment for an osteoporosis fractures. To assess your 10-year risk, search for FRAX and select the appropriate region from the website’s calculation tool menu.
People with osteoporosis should be on 1,000 mg of elemental calcium and 2-5,000 units of vitamin D per day. Depending on past fractures and risk of future fractures, medications, including oral bisphosphonates and biologic therapies, can also be used to slow bone loss and thicken bones.
Reduce your risk for osteoporosis fractures by stopping smoking, reducing alcohol intake, and including at least 30 minutes of weight-bearing exercise in your schedule three times per week to strengthen bones and improve balance.
Dr. J. Harrell Docherty Jr. joined HopeHealth in 2019 as a rheumatologist. He is board certified in internal medicine and rheumatology and completed his internship in internal medicine, his residency, and a fellowship in Rheumatology at the University of Tennessee in Memphis. He serves patients at HopeHealth on Palmetto Street in Florence and HopeHealth in Manning.