Osteoporosis is a skeletal disorder of compromised strength as a result of poor quality of bone and increased risk for fracture.Osteoporosis is linked to high risk of fractures causing pain and permanent disability. Avoiding osteoporosis requires proactive preventive strategies, active lifestyleand anti-inflammatory nutrition.
More than 10 million people in United States have osteoporosis and more than 2 million osteoporotic fractures occur each year. Women carry higher risk of fractures than men and 75% of fractures effect women, however, men are at a greater risk of dying of a hip fractures. Osteoporosis is diagnosed with use of DEXA scans which assess the bone mineral density, but the limitation is it does not assess quality of the bone. It is estimated that about 47% of population of women above age of 50 or older have low bone density.
I am frequently asked these questions
Are There Risk factors?
Women's health initiative study following risk factor play a major role in osteoporosis; age above 50, weight, height, race, ethnicity, physical activity, history of fracture, parents with hip fracture, smoking, chronic inflammation, corticosteroid use and history of rheumatoid arthritis, hypothyroidism, celiac disease and diabetes.
What Are My Pharmacological TreatmentOptions?
There are many treatment options available for patients with osteoporosis, including estrogen hormone replacement, bisphosphonates, selective estrogen receptor modulators, calcitonin, and strontium to mention few. Fosamax, Actonel, Boniva and Reclast, belong to class of drugs calledbisphosphonates. In recent years new medications like Prolia and Forteo have been approved. All medications have scientifically proven benefits, but also can have side effects. Therefore a thorough discussion with your healthcare provider is important to inquire about your needs for osteoporosis, early detection, steps of prevention, and choice of medications.
Is There Something I can do by Changing Lifestyle and Diet?
Attaining a high peak bone mass at the age of 30-50 is important factor in predicting risk of osteoporosis and it is found that women with diet adequate in calcium, vitamin D, and proteins and active lifestyle during adolescence and young adulthood have less risk of developing osteoporosis.
There are substances that are harmful for bone health includingexcessive amount of vitamin A, caffeine, sodium, imbalance of calcium and phosphorus. Smoking and excess of alcohol is linked to increased risk of osteoporosis related fractures and complications.
Are There Nutritional supplements Which Can Help?
Following have been studied extensively for their proven role in building and maintaining healthy bones.
Calcium: Calcium is important and to get about 300mg of calcium, you will need 8 oz of milk or yogurt or 1 oz of Cheddar, Swiss or Monterrey cheeses. Non dairy calcium sources include 1oz of white beans, 1/2 cup of spinach, turnips greens, 1/2 cup of cooked or fresh broccoli or bok choy, 1/2 cup of soybeans, 1 oz of dry roasted almonds. Salmon and dried figs are also good sources.
Which Calcium type is the best: Calcium carbonate should be taken with meals and is less expensive. It provides 40% elemental calcium. Calcium citrate is expensive but has some advantages; it is well absorbed and can be taken with or without meals. If you are on medication to reduce stomach acids this is the best form. Calcium citrate provides 21% elemental calcium. Calcium from sources like dolomite, oyster shell, or coral are not recommended.
How to take it: Large tablets may be difficult to swallow and may not absorb or disintegrate in the stomach, so calcium in the powders, capsules, and liquids is better. How much to take: Remember that calcium supplements should not exceed 500 mg at any one time. You should avoid taking calcium supplements along with psyllium or with foods high in oxalic acid (e.g., spinach) or phytic acid (e.g., wheat bran).
What is Vitamin D? Why is it Important?
Over the last decade there has been enormous advancement in the field of Vitamin D. Active form of vitamin D improves transport of calcium across the intestinal system. It also stimulates the absorption of other minerals like phosphate and magnesium. Vitamin D and K stimulate bone mineralization.
It is not a secret that Vitamin D deficiency is widespread throughout North America. Studies have found that women, older adults, obese and dark skin tone individuals and breast-fed infants are at higher risk. An international study found 64% of postmenopausal women with osteoporosis have low vitamin D have less than 30 ng/mL level. It makes sense to supplement with vitamin D at doses of 400 - 800 units/day. It has been shown to reduce fracture risk in older adults. Vitamin D also reduces the risk of falls and improves leg function in older adults.
Vitamin D Supplementation Doses Are Optimal?
Normal dosing of vitamin D depends on your blood levels. Treatment doses ranges from 2,000 to 10,000 units per day after you have discussed it with a healthcare provider. If you are already taking a vitamin D, add calcium, magnesium and vitamin K.
How much is too much: It is very difficult to get too much vitamin D but regular monitoring is required. People with sarcoidosis, lymphoma, or kidney disease have to be carefully for increased risk calcium level becoming too high.
About the Author: Dr Farhan Tahir MD is board certified in American Board of Internal Medicine, Rheumatology and Integrative & Holistic Medicine. He is member of American College of Rheumatology and founder of Pennsylvania's only and first integrative rheumatology practice. He lives in Bucks County with his wife and three young boys. Rheumatology Care Consultants, PLLC, Ph 267-685-6070 or email: firstname.lastname@example.org. On web www.RheumPA.com.