Osteoporosis
Osteoporosis
Normal boneOsteoporosis, which means "porous bones," causes bones to become weak and brittle — so brittle that even mild stresses like bending over, opening a window, or coughing can cause a painful fracture. In most cases, bones weaken when you have low levels of calcium, phosphorus and other minerals in your bones. Osteoporosis can also accompany endocrine disorders or result from excessive use of drugs such as corticosteroids.
Osteoporotic bone Although it's often thought of as a women's disease, osteoporosis also affects a significant number of men because of delayed puberty, inadequate calcium intake, smoking, alcoholism, or the use of medications such as glucocorticoids. Approximately 44 million women and men age 50 and older have osteoporosis and/or low bone mass.[1] Additionally, 1 in 2 women and 1 in 4 men will experience an osteoporotic fracture during the course of aging.[1] Spinal fractures are the most common, with more than 700,000 such fractures occurring each year in the United States alone.[2]
Osteoporosis Resources
Download these helpful resources to learn more:
Osteoporosis Patient Brochure (517 KB, PDF)
Osteoporosis Fact Sheet (595 KB, PDF)
Osteoporosis Mini-Magazine (732 KB, PDF)
Numbers to Know
1 in 2 – The ratio of women who suffer from osteoporosis or low bone mass[3]
20 – The percentage of Americans suffering from osteoporosis who are men[4]
30 – The age at which your optimal lifetime skeletal mass is achieved[5]
35 – The percentage of American adults who consume the recommended daily allowance of calcium[3]
62 – The percentage of your bone density that’s a result of genetics[6]
65 – Age at which men begin to lose bone mass by the same rate as women[7]
80 – The percentage of Americans suffering from osteoporosis who are women[4]
800 – The IUs of vitamin D recommended daily for adults age 50 and over[8]
1,200 – The milligrams of elemental calcium recommended daily for adults age 50 and over[8]
44,000,000 – The number of Americans affected by osteoporosis and osteopenia[4]
Symptoms
Osteoporosis is often called a "silent disease" because bone loss occurs without symptoms. Many people may not know that they have osteoporosis until their bones become so weak that a sudden strain, bump, or fall causes a fracture or a vertebra to collapse. Collapsed vertebrae may initially be felt or seen in the form of severe back pain, loss of height, or spinal deformities such as kyphosis or "dowager's hump." The resulting chronic pain and stooped posture can severely curtail day-to-day activities and compromise the quality of life.
A bone density test is a detection tool that uses x-rays or sounds waves to measure how strong your bones are. The test is quick and painless, and is recommended for women over 65.[9]
Bone Density Testing Scores[10]
Normal = T-score greater than -1
Low Bone Mass = T-score from -1.1 to -2.4
Osteoporosis = T-score of -2.5 and lower
Severe Osteoporosis = T-score of osteoporosis + fracture
Risk Factors
According to the National Osteoporosis Foundation, a number of factors can increase the likelihood that you'll develop osteoporosis, including:
- Gender. Fractures from osteoporosis are about twice as common in women as they are in men. That's because women start out with lower bone mass and tend to live longer. They also experience a sudden drop in estrogen at menopause that accelerates bone loss. Slender, small-framed women are particularly at risk. Men who have low levels of the male hormone testosterone also are at increased risk. From age 75 on, osteoporosis is as common in men as it is in women.
- Age. The older you get, the higher your risk of osteoporosis. Your bones become weaker as you age. One in two women and one in four men over age 50 will have an osteoporosis-related fracture in her/his remaining lifetime.
- Race. Caucasian and Asian women and men have a greater possibility of osteoporosis. African Americans and Hispanics have a lower but still significant risk.
- Family history. Osteoporosis runs in families. For that reason, having a parent or sibling with osteoporosis puts you at greater jeopardy, especially if you also have a family history of fractures.
- Frame size. Those who are exceptionally thin or have small body frames tend to have higher risk because they may have less bone mass to draw from as they age.
- Lifestyle. A sedentary lifestyle, low calcium intake, and tobacco use contribute to weak bones.
- Alcoholism. This is one of the leading factors for osteoporosis in men. Excess consumption of alcohol reduces bone formation and interferes with the body's ability to absorb calcium.
- Corticosteroid medications. Long-term use of corticosteroid medications, such as prednisone, cortisone, prednisolone, and dexamethasone, is damaging to bone. These medications are common treatments for chronic conditions such as asthma, rheumatoid arthritis, and psoriasis.
- Thyroid hormone. Too much thyroid hormone also can cause bone loss. This can occur either because of an overactive (hyperthyroidism) or from taking excess amounts of thyroid hormone medication to treat an underactive thyroid (hypothyroidism).
- Some diuretics. Drugs that prevent buildup of fluids in the body — diuretics — cause the kidneys to excrete more calcium, leading to thinning bones. Diuretics that cause calcium loss include furosemide (Lasix), bumetanide (Bumex), ethacrynic acid (Edecrin), and torsemide (Demadex).
- Other medications. Long-term use of the blood-thinning medication heparin, the drug methotrexate, some anti-seizure medications, and aluminum-containing antacids can cause bone loss.
- Breast cancer. Postmenopausal women who have had breast cancer are at increased risk of osteoporosis, especially if they were treated with chemotherapy or aromatase inhibitors such as anastrozole, letrozole, and exemestane, which suppress estrogen. This isn't true for women treated with tamoxifen, which may reduce the risk of fractures.
- Medical conditions and procedures that decrease calcium absorption. Stomach surgery (gastrectomy) can affect the body's ability to absorb calcium. So can conditions such as Crohn's disease, hyperparathyroidism, anorexia nervosa, and Cushing's disease — a rare disorder in which the adrenal glands produce excessive corticosteroid hormones.
It's important to know whether or not you have osteoporosis. With proper treatment, you can slow bone loss, reduce back pain, and even improve posture. For more information, please visit the National Osteoporosis Foundation.
Detection
Telltale signs you might have osteoporosis or a fracture.
You can’t feel yourself losing bone, but you might feel a spinal fracture – the most common complication from osteoporosis.[11][12][13] Acute and chronic back pain are outward signs of such fractures (also known as vertebral compression fractures or VCFs.[13]) It may be hard to believe, but even simple activities like carrying groceries or bending over to pick up your grandchild can cause a VCF.[13][14][15]
Your spine is stacked and structured with the precision of dominoes, allowing you to bend over and twist side to side. And just like dominoes, one VCF can change your spine’s alignment and cause other vertebrae to collapse or fracture. Multiple fractures may lead to loss of height and curvature of the upper back – like the hunchback of Notre Dame – called kyphosis or “dowager’s hump.”[16] Over time, kyphosis can cause your back to hunch over so badly that it reduces the space in your chest cavity, making it hard to breathe and eat.[13]
Don’t lightly dismiss new or unusual back pain as a part of growing old. Your backache could be a VCF. Sudden and severe pain or pain that lasts for more than a week should be seen by a doctor.
Prevention
You're never too old - or too young - to improve your bone health. There are many things that you can do to keep your bones strong and prevent fractures. A diet rich in calcium and weight-bearing exercise can prevent osteoporosis.[17]
Dietary guidelines
Calcium-rich foods are the secret to maintaining bone strength. Women 50 and under need 1,000 milligram a day. After age 50, daily calcium requirements jump to 1,200 milligrams.[18]
Lack of calcium has been singled out as a major public health concern because it is critically important to bone health. The average American consumes far less than the amount required. Calcium supplements are a good way to make up the difference.[19]
Vitamin D is important in your diet as well. It helps your body absorb that calcium. Aim for 200 to 400 international units (IU) daily if you’re 50 and under and 400 to 600 IU daily if you’re over 50.[20]
Sources of calcium[21][22]
- 8 oz. low-fat yogurt: 415 mg calcium
- 8 oz. milkshake: 300 mg calcium
- 24 almonds: 70 mg calcium
- 4 oz. instant pudding, made with 2% milk: 153 mg calcium
- 1 oz. cheddar cheese: 204 mg calcium
- 8 oz. 1% milk: 316 mg calcium
- 6 oz. calcium-fortified orange juice: 230 mg calcium
- 1/2-1 cup Total cereal: 258 mg calcium
Sources of vitamin D[23]
3 1/2 oz. salmon: 360 IU vitamin D
3 1/2 oz. mackerel: 345 IU vitamin D
1 cup vitamin D-fortified milk: 98 IU vitamin D
1 cup vitamin D-fortified cereal: 40 IU vitamin D
1 whole egg: 20 IU vitamin D
Be good to your bones with these tasty recipes.
Exercise
Weight-bearing exercises reduce bone loss and help prevent fractures. Activities such as walking, running, climbing stairs, tennis, and weight lifting put stress on your bones, signaling your body that your bones need to be made stronger. New cells are added to strengthen your bones. That’s why if you’re right-handed, the bones in your right arm are slightly larger and stronger – it’s from the extra use. To get the bone-building benefit from exercise, you must do it at least three times per week for 30 to 45 minutes. [24]
Download a helpful magazine (732 KB, PDF) that is full of good tips for healthy bones.
Frequently Asked Questions
Why do people shrink as they age?
As people age, several changes in their bodies can reduce their height by anywhere from one inch to three inches or more. They include VCFs, loss of muscle strength to support the spine, and even weakened arches, which flatten feet and contribute slightly to height loss. The good news is that a diet with enough calcium and vitamin D, together with weight- bearing exercise, can spare your spine from significant height loss.[25][26][27]
What's another sign that I could be at risk for a VCF?
Women who can’t get out of a chair without using their arms have twice the fracture risk of those who can stand up effortlessly.[28]
Am I too old to improve my bone health?
You’re never too old – or too young – to improve your bone health. There are many things that you can do to keep your bones strong and prevent fractures. A diet rich in calcium and weight-bearing exercise can prevent osteoporosis.[29] So can talking to your doctor. Schedule an appointment today to discuss ways to protect your bones and treat bone-related problems such as vertebral compression fractures.
