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A few tips to avoid brittle bones as we age - Ogden Clinic provided source, Standard-Examiner 8/13/2014

(Standard-Examiner) OGDEN -- For some people, climbing the stairs, getting in and out of the tub or lifting a gallon of milk can leave them with debilitating pain, or even a fractured bone.

Approximately 54 million people have low bone density or osteoporosis according to the National Osteoporosis Foundation. About one in two women and up to one in four men over the age of 50 will break a bone due to the disease.

“Osteoporosis is a condition in which the bones thin, becoming brittle, weak and more prone to fracture,” said Dr. Critt Aardema, a family practice physician at Tanner Clinic. “Risk factors include aging, low body weight, smoking, being female, low sex hormones or menopause and some medications such as prolonged use of proton pump inhibitors, acid reducers and steroids.”

Dr. Mark Alder, a radiologist at Ogden Clinic said osteoporosis is often hereditary. Anyone can get it, but typical patients are Caucasian or Asian women with a low body weight who tend to be inactive.

“The things young women do now will absolutely impact their risk of Osteoporosis in the future,” he said. “People who don’t participate in weight baring exercise are far more likely to have osteoporosis. You are also at higher risk for osteoporosis if you use certain steroids, alcohol, or if you are a smoker.”

Bone health is vital to our well-being Aardema said. Patients with osteoporosis and other bone issues suffer from chronic pain, loss of independence and limited functionality.

“For example, elderly patients who experience pelvic fracture have up to a 30 percent increased risk of mortality from acute delayed complications,” Aardema said.

Alder said as a person ages, fragility and fractures become a huge concern.

“If you experience a hip fracture or a fragility fracture you have a 25 percent chance of death within one year,” he said. “You may also need long term, or nursing home care if you experience a hip fracture.”

Menopause can also have an impact on your bones, said Ogden Clinic orthopedic surgeon, Dr. Michael Hall.

“As women start going through menopause they may need to seek hormone replacement therapy to ensure that estrogen levels remain intact,” Hall said. “Also, activity is extremely important. Keep in mind that bone is a living tissue. If it is left inactive it doesn’t think that it needs to keep the bone mineral density.”

There are preventative measures, said Aardema. They include smoking cessation, weight bearing exercises, well balanced diet, and adequate vitamin D and calcium intake.

“According to the American Cancer Society, calcium supplements with vitamin D have shown some promise in cancer risk reduction, but results have been mixed,” Aardema said. “In fact, high doses of calcium have been linked to a high risk of prostate cancer.”

Aardema said there is no definitive evidence to substantiate the need to avoid calcium supplementation and he recommends his patients continue to consume daily calcium and vitamin D as recommended by the National Institutes of Health. Those recommendations are 1,000 to 1,200 mg. of calcium and 600 to 800 IU of vitamin D.

In addition, Hall said the best exercise is weight bearing exercise where you fully engage your bones and muscles. Walking, running, bike riding, weight lifting, and other physical activities are encouraged at all stages of life.

Alder said the biggest issue is that most people don’t really think about their bone density because it is often an unseen issue. We get busy and don’t think about how our actions now can affect us in the future.

“If you can identify osteoporosis early it can have a huge impact on quality of life by preventing fractures,” Alder said. “It’s a simple, inexpensive screening test that makes a huge difference in long term outcome.”

DEXA scan is a fast, non-evasive procedure using two different energy levels of x-ray. The scan is unique, Alder said, because it can tell how much mineralization is in your bones.

“DEXA scans measure your bone density and are a great way to prevent and treat osteoporosis,” Alder said.

Aardema said the general consensus is to start DEXA screening in women 65 years and older, or sooner in postmenopausal women at increased risk of developing osteoporosis. Recommended screening for men is 70 years old or sooner if there's an increase risk.

If your DEXA scan results show you have low bone density, you should follow up with your primary care physician to determine a plan of action. You may need to take medication and other action to slow the progression of Osteoporosis.

There are several medications to help maintain, strengthen and build bone mass, Hall said. Some drugs slow or stop the natural process that dissolves bone tissue. Others increase the number of bone forming cells.

“It is believed by many with osteoporosis that their bones won’t heal. Their fractures will heal, the fractures just have lower mineral density,” Alder said. “Regardless, prevention is key and patients should work with their providers to receive proper screening and treatment.”