Osteoporosis
Nina Radford, M.D.

The first and most important task for you to complete (if you are over age 35) is to get a BASELINE bone density test (DEXA of the hip and spine). Your baseline test helps us to assess your short and long term risk for osteoporosis. As with any other medical condition, the sooner you diagnose low bone density, the more effectively it can be treated.

Your baseline bone density test measures the bone in the lumbar spine and hip(s). Your bone density is then compared to a 30-year-old woman's bone density. Ideally, you will have 100 percent or MORE bone as compared to the average 30 year old woman. Most of my patients say, “that isn’t fair!” They realize that you achieve peak bone density by about age 35, and then you begin losing bone. Women go through a period of rapid bone loss during menopause, losing 3-7 percent of their bone PER YEAR for 3-5 years. The bottom line is, the more bone you lose, the higher your risk for fracture. It is imperative that we compare you to a “young normal 30 year old” in order to determine your fracture risk. When your bone density approaches about 75 percent of the "young normal" (or a t-score of –2.5), then you are diagnosed with osteoporosis.

There are changes you can make in your lifestyle to maintain or even improve your bone density. Most importantly you must consume enough calcium, whether through dietary sources or supplements. Great dietary sources of calcium include: low fat milk, cheese, calcium fortified juices, and yogurt; each of these provides about 300 mg of calcium per serving. From your general diet, give yourself credit for 300 mg of calcium per day. Taking a multivitamin adds a few hundred milligrams more (check your vitamin label). Pre-menopausal women need a total of 1200 mg/day. Post-menopausal women and those with low bone density need 1500 mg/day.

If you don't consume enough calcium through your diet, then take a supplement. READ THE LABEL on your supplement. Some calcium products must be taken on a full stomach for best absorption. Try chewable products if you can’t swallow bulky pills. Don’t take more than 600 mg at one time; your body can’t absorb it. Split your supplement into smaller doses throughout the day if needed.

Remember, calcium and Vitamin D work together to build bone. Taking a multivitamin ensures you get adequate Vitamin D (400 IU/day for most people; 800 IU/day for those with low bone density). You do not have to take your calcium and Vitamin D together. Other additives to calcium supplements, such as magnesium, Vitamin K or boron don’t have strong data to support their use in maintaining bone health.

Too much caffeine interferes with calcium metabolism. Sodas in particular are a poor choice for a healthy diet. Sodas are a "triple whammy" to the bones. They contain caffeine, sodium and phosphates, all of which promote calcium loss. Limit yourself to no more than 1-2 (12 ounce) servings per day.

Alcohol, used in excess, likewise is "bad to the bone." Consume no more than three to six alcoholic beverages per week. Keep in mind that a serving size of wine is 5 ounces.

To maintain or even build bone: EXERCISE. Weight bearing activities, such as walking, and strength training (lifting weights) promote healthy bone. A consistent exercise program will get you the best results. Do aerobic exercise at least 3 times a week for 30 minutes and strength training 2 times a week of the upper AND lower body. Meet with a personal trainer to design a program especially for you; this is important if you have other orthopedic concerns or osteoporosis.

To maintain healthy bone, NEVER use tobacco products.

What about hormones and bones? A very positive result from the WHI study was decreased risk of hip and spine fractures in women who took Prempro. Many studies support this finding. Women who take hormones during menopause offset that period of rapid bone loss. Once hormones are stopped, rapid bone loss may resume. Estrogen protects bones both short and long term if taken consistently.

There are several other wonderful medications for treating low bone density. Given the success of Fosamax, Actonel, and Raloxifene—no woman should ever fracture. We have the tools to prevent and treat osteoporosis.

In short, there are many things you can do to ensure bone health. The first step is to get a baseline bone density test—know your risk! Review your diet/supplements to be sure you consume adequate calcium and Vitamin D. Avoid excessive caffeine, alcohol and tobacco. Exercise regularly including weight bearing and strength training activities. Take hormone replacement therapy if it is otherwise appropriate for you. Ask your doctor about other medicine to re-build bone if your bone density is too low. Recheck your bone density regularly to monitor progress.

Contact Us

Ordering Info:
(877) 2-HEALTH
(888) 393-2221

 

General Info:
12200 Preston Road
Dallas, TX 75230
Phone: 972/560-2702
Fax: 972/560-3260
Send us an e-mail