Osteoporosis: who gets it?

All of us will get osteoporosis if we live long enough. Since none of us have a crystal ball to predict our life expectancy, we should all do our best to ensure good strong bones and prevent falls no matter how long we live.

Osteoporosis is extremely common. It is estimated that 25% of all women by age 50 have osteoporosis and that this risk doubles to 50% by age 70. Another fact about osteoporosis is that if a woman lives to age 80 she has a 15% risk of developing a hip fracture. This risk will double in her remaining life. In men, we are only beginning to appreciate the significance of osteoporosis. Men typically have a higher peak bone mass, so it takes longer for bone loss to reach a level where the bones fracture. Nevertheless, as men increasingly live past age 80, osteoporosis is going to become a more common problem for men.

Research has identified a number of risks that make it more likely for one individual over another to get osteoporosis.

If several of these risk factors apply to you, you may want to check with your doctor about how to prevent osteoporosis.

Risk factors for osteoporosis we cannot change:

• genetics (family history)
• female sex (osteoporosis affects women more than men)
• age (even if we keep saying we are 39, our bone mass decreases with age)

Lifestyle risk factors for osteoporosis we can change:

• low dietary calcium and vitamin D
• little or no exercise
• smoking
• excess alcohol use (more than 4 ounces per day)
• excessive emotional stress
• possible excess caffeine (more than 4 cups per day)
• excessive physical activity that results in low body weight

Medical conditions and diseases that increase risk of osteoporosis:

• anorexia nervosa
• renal (kidney) stones
• thyroid disease (overactive thyroid or excess thyroid supplements)
• cortisone or prednisone use (also high dose use of inhaled steroids for asthma)
• anticonvulsants (seizure medications)
• liver or kidney disease

Medical conditions in women:

• estrogen deficiency (surgical removal of ovary)
• early menopause (before age 46)
• irregular periods

Medical conditions in men:

• testosterone deficiency (gonadal or testicular failure) measured by an early morning testosterone level (blood test)

If you find that a number of these risks apply to you, you may want to think about making some simple changes in lifestyle, doing a test for osteoporosis or even starting medications that are available.

The risk factors of family history, female sex, and advancing age are powerful predictors of osteoporosis.

If you have these risks, then a bone density test can more accurately predict if osteoporosis is present.

The other risk factors for osteoporosis should be assessed as well and modified for their own sake, if possible. Each added risk factor contributes towards the suspicion of osteoporosis. One or more risk factors might be reason enough to proceed to a bone density test.