Thinning Bones

Hi everyone!

Now that the new year is upon us, and almost everyone has a New Year’s resolution to lose weight and exercise more, let’s talk about thinnning bones or osteopenia and osteoporosis. The image is an example of a DEXA scan.

How are they related and why do we care about thinning bones?

Between a 20 year old who broke her leg skiing and  a 70 year old who broke her leg falling on ice, we know that most likely, the 20 year old will be fine in 6 months. Why?

Because the 20 year old has healthy bones that will mend together well, while the 70 year old probably has thinner bones that will not.

We cannot make thin bones become robust again, but there are ways to stabilize bone loss or reduce bone loss related to aging.

First, we recommend a baseline DEXA scan either at menopause or if there is a long standing history of not having periods, long term steroid use, history of anorexia, rheumatoid arthritis or Depo Provera use.

If there is osteopenia or osteoporosis, there’s still things we can do to help ourselves. If we have osteopenia, then medication will probably be the first recommendation. Instead consider the following:

Diet and Social Activities:

Don’t eat too little as to become anorexic (don’t laugh). Take about 800 I.U (international units) of vitamin D a day. Take about 1000mg of calcium a day.  Some will recommend 1200mg a day.  If you a have a history of kidney stones, you may need additional testing before starting calcium. Also, keep alchohol intake under 3 drinks a day. Stop smoking. Those women who smoke have an accelerated bone loss rate compared to their non-smoking counterparts.

Exercise:

(This is how osteoporosis is related to New Year’s resolutions). Studies have shown that 30 minutes of walking a day or on most days will decrease our risk of osteoporosis. Any activity is thought to be more beneficial than none at all.

Medications:

There are basically 4 classes of medications: bisphosphonates, estrogens, SERMS and calcitonin. Of the 4, bisphosphonates are thought to work the best but is not without its side effects.

Who should be started on medications? If our risk over the next 10 years is greater than 3% for a fracture or greater than 10% for an osteporotic fracture, then medication may be recommended.

So, have fun exercising this year (but not too much)  and remember that we are not only working our muscle and heart and lungs, but improving our bone density as well!