Around age thirty, your body reaches a stage of peak bone mass, where your bones are as large and dense as they will ever be. At that stage, resorption slowly begins to outpace bone production. If resorption becomes too rapid or if bone cell production becomes too slow, you’re at risk for developing osteoporosis. If you didn’t build your bones to their optimum size during the years leading to peak bone mass, your risk is even greater.
Young girls need to build bone density, but it’s not a subject that interests most teenagers. So, if you have a young daughter or niece, make sure she’s taking in adequate amounts of calcium, especially during her early teen years’ growth spurt.
Right now, there is no cure for osteoporosis. But you can slow the progress of the disease dramatically through a treatment plan involving some combination of medication, diet, and exercise. Recent experiments with drugs that may actually help rebuild lost bone tissue offer true encouragement to victims of this disease and those who treat them. But remember, prevention is easier than treatment.
How Osteoporosis Strikes
Osteoporosis, even today, is underdiagnosed and undertreated. Like many deadly diseases, osteoporosis gains much of its power through its ability to progress silently without any readily apparent signs or symptoms. Bone tissue loss isn’t painful in its early stages—everyone experiences it every day. Weak bones don’t ache, or creak, or exhibit any other kind of warning. In fact, osteoporosis frequently is diagnosed only after someone suffers a bone fracture. And even then, if the person who suffered the break and/or her doctor doesn’t suspect that the break could be related to osteoporosis, and follow up with the proper diagnostic tests, the disease can remain undiagnosed and untreated.
The most common and effective diagnostic tool for osteoporosis is a bone density measurement known as a bone mineral density (BMD) test. BMD tests can measure the density of the bones in your spine, wrist, heel, and/or hip.
The most common type of bone density test is a dual energy X-ray absorptiometry (DXA) test. In this test, low-dose X-ray beams scan your lower (lumbar) spine and/or hips for ten to twenty minutes. The test isn’t painful, and you’re exposed to minimal radiation, so it’s a safe and effective diagnostic tool. Other types of bone density scans use ultrasound to measure the bone mass in your heel or wrist, but aren’t as conclusive as the DXA test. However, a quick office scan of the density of your heel or wrist still provides very useful knowledge, especially if you are relatively young (less than forty-five years old), and have risk factors for this condition. This type of peripheral bone density testing is a great screening tool, because it takes less than two minutes to perform, and most doctors can conduct the test right in the office during a routine visit.
Besides warning you about osteoporosis before you suffer a fracture, bone density tests can help you determine your rate of bone loss and help you gauge the effectiveness of your efforts to slow that loss. A BMD test can tell you how your bone density compares to that of healthy bone tissue from a person of your age and—more importantly—to that of an average twenty-five-year-old.
Other Options for Slowing Bone Loss
In addition to estrogen, some “designer” estrogens, including raloxifene, and the biphosphonates alendronate and risedronate have been approved by the U.S. Food and Drug Administration (FDA) for the prevention and treatment of postmenopausal osteoporosis. Though these drugs don’t share estrogen’s other benefits, they may help to maintain bone density, and represent a welcome alternative to estrogen for women who want a sound defense against osteoporosis, but who cannot or choose not to take estrogen in HRT.
Alendronate, risedronate, and raloxifene have been shown to reduce bone loss, increase bone density, and reduce the risk of fractures, just like estrogen. Raloxifene is among the newest of these designer estrogens, and it may offer some of the most attractive benefits. Raloxifene comes from a relatively new class of drugs called selective estrogen receptor modulators (SERMs) that prevent bone loss. According to the National Osteoporosis Foundation, early tests have shown that raloxifene increases bone mass and, after three years of use, can reduce the risk of spine fractures by about 50 percent.
Whether you choose to use medication to prevent postmenopausal bone loss, your doctor or health care professional is your best source of advice and information for making this important decision. You should never consider taking any medication without weighing the pros and cons very carefully. But don’t depend on drugs as your only solution for staving off bone loss. No matter what type of medications or supplements you take, a healthy diet and regular weight-bearing exercise are important components of your anti-osteoporosis arsenal.
