Osteoporosis may seem at first glance to be a very benign disease. If my bones are soft, I just have to be careful, maybe exercise a bit, and even if I break a bone it will heal, right?
Not so fast. Osteoporosis is a chronic, progressive disease that has several possible causes. It is seen more in women than men and often begins after menopause. Osteoporosis has a strong genetic component, so knowing your family history is important. Heavy smokers and very underweight peoples are also more prone to osteoporosis.
Hip fractures are a dreaded concern as we age, but even more so if we age with osteoporosis. Recovery from a fracture such as a hip fracture can damage your body in many ways. If you are bedridden for a long period of time, your immune system does not operate as efficiently and you may be more prone to infections. With little movement or exercise, your arteries become less elastic and are more prone to blockage. It has been postulated that there is a 25 percent mortality rate associated with hip fractures within one year of fracturing a hip. The best thing we can do is work on prevention of osteoporosis.
There have been correlations seen between diabetes and osteoporosis, predominantly in type 1 patients, but some of the complications of diabetes — such as neuropathy, blood vessel changes and kidney disease — can create problems with bones. This is not to scare you so you run off into the sunset saying, “No, not another disease!” but to increase awareness of this oftentimes silent malady, and to encourage you to have good conversations with your health care team about risk and prevention.
The easiest way to make sure your bones are healthy is to consume adequate amounts of calcium and vitamin D. The RDA for calcium per day is 1,000 mg for men and 1,200 mg for women. Vitamin D requirements vary and studies have shown that many of us are vitamin D deficient. It is best to have vitamin D levels checked periodically and to have your healthcare team recommend a supplement that is right for you.
There have been recent studies that have shown that calcium supplement use is associated with cardiovascular risk, so before you start a calcium supplement check with your own health care team. It is always best to try to get adequate calcium through your diet if you are able. Milk contains approximately 300 mg in 8 ounces, yogurt approximately 300 mg per 6 ounces, and cheese approximately 200mg per ounce. You can also find fortified foods and juices on your grocer’s shelves.
Remember that if you take calcium carbonate, you should take it with food to increase absorption. It’s also best taken in divided doses (twice daily) for best absorption. Calcium citrate does not require food, may have better absorption and possibly pose less risk of an upset stomach.
There are some prescription medications used for osteoporosis as well that can be very effective, but some such as Alendronate, may not be right for use in patients with kidney disease.
Balance, prevention and education are the key to staying healthy!