Osteoporosis and Bone Health
Your bones are made of living tissue. Each day, your body breaks down and reabsorbs old bone tissue, and forms new bone cells to replace it.
When bone tissue is reabsorbed faster than new tissue is made, the condition is called osteoporosis.
Osteoporosis, which means "porous bones," causes your bones to lose density. This makes them weak and more likely to fracture—especially bones in your hip, spine, wrist, and forearm.
If your primary care provider thinks you may have osteoporosis or more moderate bone loss (osteopenia), the University of Iowa Health Care team can help.
Our experts, including orthopedic specialists and endocrinologists, use state-of-the-art bone density testing such as DEXA scans to evaluate your bone health. They'll work with you to prevent further bone loss and build stronger bones.
Osteoporosis risk factors, symptoms, and diagnosis
Osteoporosis occurs in both women and men, although it's much more common in women.
Risk factors for osteoporosis
Osteoporosis can result from many factors, including the following:
- A decrease in estrogen in women after menopause, and testosterone in men as they age
- An overactive parathyroid or thyroid gland
- A family history of osteoporosis
- Low body weight and a small frame
- Drinking more than one alcoholic drink per day for women or two drinks per day for men
- Some medications, including some steroids and anti-epileptic drugs
- Some autoimmune and digestive diseases, and other medical conditions
- Not getting enough calcium and vitamin D
- Lack of exercise, especially strength training
Symptoms of osteoporosis
Osteoporosis is often called a "silent" disease because bone loss often occurs without obvious symptoms.
The following can indicate possible osteoporosis:
- Loss of height over time
- Stooped posture that develops as you age
- A fracture resulting from a seemingly minor bump or fall
How UI Health Care experts diagnose osteoporosis
Osteoporosis is most often diagnosed during routine screening. The U.S. Preventive Services Task Force recommends screening for:
- Women over age 65
- Women of any age who have any of the symptoms or risk factors listed above
Screening for osteoporosis involves the following:
- Annual physical exam: Every year after you turn 50, your primary care provider should record how tall you are without shoes. This will detect any loss of height.
- Bone density test (DEXA scan): An imaging test, called dual-energy x-ray absorptiometry, or DEXA, is the only way to diagnose osteoporosis before you break a bone. It estimates the density of your bones and the probability that you'll have a fracture.
- Fracture risk assessment (FRAX): This calculator uses information about your bone density and other risk factors to estimate your 10-year bone fracture risk.
Osteoporosis treatment from UI Health Care
Although there's no cure for osteoporosis, UI Health Care experts can help slow or stop its progress. It may even be possible to slightly reverse the effects of the disease.
A plan tailored to you
In addition to orthopedic and endocrine specialists, your care team might include nutritionists and physical therapists.
To treat your osteoporosis—or prevent your osteopenia from becoming osteoporosis—they will work with you to develop a personalized plan. It might include the following:
- Changes in your diet: Low-fat dairy products, dark-green leafy vegetables, and calcium-fortified foods could be part of your eating plan. You might also need to take calcium and vitamin D supplements.
- An exercise program: Weight-bearing and strength-training exercises are some of the best protections against osteoporosis. A customized exercise program can help you build strength and increase muscle mass. Exercise can also improve your balance to reduce your risk of falling and breaking a bone.
- Other lifestyle changes: Quitting smoking and reducing alcohol intake are two ways to slow bone loss.
- Medication: Some medications can slow or stop bone loss. These include biophosphonates such as Fosamax and Boniva; hormone therapies; and bone-building medications that are given by injection. Your provider will talk with you about options and potential side effects.
Tips for preventing osteoporosis
If you have a family history of osteoporosis or other risk factors, you can make lifelong choices that help protect your bones. And, of course, you can adopt healthy bone habits at any age.
UI Health Care osteoporosis experts recommend:
- Getting enough calcium and vitamin D
- Exercising regularly. Good choices include weight-bearing exercise (dancing, aerobics, running, walking) and muscle-strengthening exercise (lifting weights, using resistance bands)
- Eating a diet rich in fruits and vegetables, including those containing potassium (bananas, beans, melons) and magnesium (greens, nuts, whole grains). A recent study showed that eating just five or six prunes each day has a positive effect on bone health.
- Avoiding smoking and limiting alcohol to no more than one alcoholic drink per day for women or two drinks per day for men