Graceful Health: Bone Density and Silent Disease

May is National Women’s Health Month and I would like to take this opportunity to focus on the importance of osteoporosis screening for fracture prevention. This topic is important for women’s health and deserves more attention.

Osteoporosis affects millions of Americans. It is more common in women than men and the risk increases with age. One in three postmenopausal women suffer from osteoporosis.

Loss of bone mass is an expected part of aging; however, this comes with consequences. Osteoporosis develops when bone mineral density and bone mass decrease, or when bone structure changes. This makes the bones brittle and prone to breaking.

Osteoporosis is often referred to as a “silent disease” because it develops over time and has few or no symptoms. In the early stages of bone loss, patients usually do not have symptoms. Once bones have been weakened by osteoporosis, patients may experience loss of height over time, changes in posture, back pain due to sagging of the spinal bones, or fractures ( broken bones). The most common bones to break due to osteoporosis are the wrist, lower back, and hips.

Hip fractures are a very serious problem as we age. People who break their hip may not recover for months or even years. This reduces independence and shortens lifespan. People often cannot care for themselves after a hip fracture and are more likely to have to live in a nursing home. About half of people who suffer a hip fracture are unable to return to independent living. Hip fractures also significantly increase the risk of death, especially during the first year after the fracture.

Throughout our lives, our bodies are constantly breaking down old bones and building new ones. For most people, the rate of accumulation exceeds degradation until around age 30-35. Until then, the body makes new bones faster than it destroys old ones. As we age and hormone levels decline, the rate of replacement slows and the rate of breakdown increases. This happens to both men and women, but women lose bone mass more quickly after menopause.

Early detection of osteoporosis can help prevent the worst effects of the disease, and with early treatment and intervention we can reduce the risk of fractures.

Depending on your insurance plan, you may be able to have a screening at no cost to you. Medicare may cover bone density tests for free.

Under the Affordable Care Act, insurance plans must cover osteoporosis screening for women age 65 and older, as well as women age 64 and younger who are postmenopausal and therefore have an increased risk of osteoporosis. In addition, some other exceptions allow more frequent bone density scans, including follow-up scans for people undergoing treatment for osteoporosis and for people taking high-risk medications such as steroids or certain chemotherapy agents. .

The Grace Cottage Radiology Department provides bone density testing services Monday through Friday, 7 a.m. to 6:30 p.m.

Bone density screening exams, commonly called DEXA scans, are non-invasive. They require no effort or preparation and the test only takes about 15 minutes.

During the test, the patient lies comfortably on a table while a licensed radiologic technologist uses a machine to acquire images of the patient’s lower back and hip. The patient’s bone density levels are compared to baseline standards and assigned a score. This information is passed on to your doctor, who will review the results and, if necessary, discuss treatment.

If your doctor notices that your bones are weakening, there are steps you can take to strengthen them. You can become more physically active by combining strength and weight-bearing exercises. If your bones are already weak, there are medications that stop bone loss. Some can even build new bones and reduce the risk of fractures.

It is also important to get enough calcium in your diet. Currently, women over 50 are recommended to consume at least 1,200 mg of calcium. Good sources of calcium include low-fat dairy products, dark green leafy vegetables, canned sardines with bones, canned salmon, and soy products. If you have trouble getting enough calcium in your diet, you can take a calcium supplement.

It’s also important to get enough vitamin D, which helps your body absorb calcium. Postmenopausal women need 800 IU of vitamin D per day. Potential sources of vitamin D are sunlight, as well as certain dietary sources, such as cod liver oil, trout, salmon, and milk and grain products fortified with vitamin D. People who live in areas with little sun exposure, such as Vermont, may need a supplement.

Why do some people develop osteoporosis and others do not? Certain things can increase your risk, including hormonal changes, not getting enough calcium and vitamin D in your diet, smoking cigarettes, drinking too much alcohol, not getting enough physical activity , have a low body weight or suffer from certain illnesses or take certain medications. Additionally, genetic factors also contribute. Working on reducing risk factors will reduce your chances of osteoporosis.

In summary, your quality of life is determined by your level of daily activities and your physical health. Osteoporosis can seriously disrupt this quality of life. Early detection can help ensure you can continue the activities you are used to, leading to a longer, healthier, happier life!

Dr. Ewa Arnold graduated from the University of Guelph in Ontario, Canada, and the Jagiellonian University in Krakow, Poland. She completed her residency in family medicine at UVM College of Medicine in Burlington and joined the staff at Grace Cottage in 2012.