Bone Up on Good Bone Health

Feb 4, 2019

In many ways, bones are the unsung heroes of our bodies. The strong, silent stanchions that protect our organs, provide a vital underframe that supports our muscles and skin, and power our mobility. Still, they’re vulnerable to breaks and disease—most notably, osteoporosis.

Over time, the 206 bones in our bodies can become less dense, thin and brittle due to aging, lifestyle choices, and health issues. While there has been a big push to boost awareness among women about the dangers of bone loss, the truth is, men are at risk for osteoporosis too. Left untreated, osteoporosis can be dangerous for both sexes.

“A broken hip or spine can be quite serious for a senior—man or a woman,” says Ho “Bing” Oei, MD, a board-certified rheumatologist with at the USMD Las Colinas Clinic. “They can become bed-bound, which makes them at greater risk for more easily developing infections. Their health can spiral downward, and they may not be able to recover. The mortality rate for people with hip fractures is 20 percent greater than it is for their peers the same age. People in their 60s, 70s, 80s and older have the highest mortality rates associated with hip and spine fractures.”

Dr. Oei advises men and women of all ages to be proactive about protecting their bones from osteoporosis.

Know your risks factors.
Many things can boost your risk for osteoporosis. Here are some of them.

Age: With natural aging, bones can become less dense, more hollow and brittle.

Genetics: “Caucasian and Asian populations have a greater risk for osteoporosis, as do individuals with a slender build who weigh less than 127 pounds,” Dr. Oei explains. “A family history of osteoporosis also boosts your risk.”

Gender: Women, especially post-menopausal women, have a higher risk for osteoporosis. “Estrogen offers a protective effect that helps keep bone density up,” says Dr. Oei. “Post-menopause, women usually experience lower estrogen levels, so they lose that protective effect and their bones begin to thin out over time. Similarly, men with low testosterone levels are at higher risk for osteoporosis as well.”

Lifestyle Choices: You are not doing your bones any favor if you are drinking too much caffeine, smoke tobacco, use steroids, or spend most of your day sitting on the couch or behind a desk. “It’s important to move your body,” says Dr. Oei. “Load-bearing activities such as brisk walking, jumping rope, or high-impact aerobics all help keep bones strong.”

Low Calcium and Vitamin D:
If you’re not getting enough calcium through a balanced daily diet that includes milk, cheese, yogurt, or other calcium-rich foods, your physician may recommend supplements. “Talk with your doctor first before you begin taking calcium or vitamin D supplements to ensure you take the proper amount,” Dr. Oei advises. “You should not take calcium supplements all at once because your stomach can only absorb so much at one time. Divide your calcium supplements into doses and take it throughout the day.”

Medical Conditions: “There’s a long list of medical conditions that can contribute to osteoporosis,” says Dr. Oei. Uncontrolled thyroid disease, parathyroid disease, rheumatoid arthritis, inflammatory bowel disease like Crohn’s disease or ulcerative colitis, celiac disease, ankylosing spondylitis, certain cancers, and heart issues all increase your risk for the disease.

“If you have an eating disorder, or underwent a gastric bypass to lose weight, you have a greater risk for osteoporosis due to absorption issues related your calcium and vitamin D.”

Have your bone density tested.
A baseline bone mineral density (BMD) test lets you know how your bones are holding up. A special X-ray machine measures how dense or thin your bones are. While Medicare approves bone density testing for individuals 65 and older, earlier testing is recommended for:

Women once they reach menopause

Women who’ve undergone an early hysterectomy

Individuals who suffer from a parathyroid disease or other hormonal diseases

Individuals who have had a compression fracture in their spine

Individuals who have been on steroids for a prolonged period of time

Men can typically wait until they are 70 for a baseline bone density test if they don’t have any of the risk factors that warrant earlier testing.

Understand your T-score.
Every bone density test yields a T-score that rates the density of your bones against the bone mineral density of a healthy 30-year-old adult. T-scores are ranked as follows:

-1 or above is normal bone density
-1 to -2.5 indicates osteopenia, bone thinning which is not quite as serious as osteoporosis
-2.5 or below is osteoporosis

With a -2 T score, your risk for a bone fracture is four times greater than someone in the general population. A score of -3 means it’s eight-fold, and -4 means your risk for a bone fracture is 16 times greater that someone with a T-score of -1 or above.

Your doctor will calculate a “FRAX score” to determine your risk for fracture. The FRAX score determines whether or not a patient should begin treatment.

“If someone has been diagnosed with osteoporosis following a bone density test, a rheumatologist will also consider if there may be another cause contributing to their condition,” says Dr. Oei. “Possibilities can include early menopause, low calcium, abnormal parathyroid hormones, or other hormonal abnormalities. If all secondary causes are ruled out, then medication may be prescribed to increase bone density.”

Protect your bones.
There are effective treatments to help rebuild your bones, make them stronger, and prevent fractures. Depending on the severity of your osteoporosis, your rheumatologist may recommend medications, but there are positive steps you can take to strengthen your bones.

A well-balanced diet that includes foods rich in protein, calcium, vitamins C and D, iron and potassium is a good start. Avoid alcohol and too much salt and caffeine. And do not smoke!

“Weight-bearing exercises are also very important in building bone strength,” says Dr. Oei. “We can recommend specific exercises that will work best. Your rheumatologist is a real advocate for your strong, healthy bones.”

Are you concerned about osteoporosis? Dr. Oei is here to help. Read more about him, or call 972.556.1616 to schedule an appointment.