What is the strength of your bones?
In the United States, osteoporosis affects at least 1 in 5 women over 50, but many are unaware of this.
According to recent recommendations from the U.S. Preventive Services Task Force, women 65 and older should undergo a bone density scan to test for osteoporosis.
Since osteoporosis rarely causes symptoms until a bone fracture occurs, generally in the hip, wrist, or spine, it is frequently referred to as a silent illness. Although bone loss can affect men as well, women who have had menopause are most at risk.
The task force, a powerful government-appointed panel of medical experts, reaffirmed the current recommendation that a risk assessment questionnaire can determine whether a scan is necessary for postmenopausal women under 65 if there are one or more risk factors, such as low body weight, a family history of broken hips, cigarette smoking, and excessive alcohol consumption.
A member of the task forceOsteoporosis weakens bones and makes them more prone to fracture, which can result in disability, chronic pain, loss of independence, and even death, according to Dr. Esa Davis, a professor of family and community medicine at the University of Maryland, Baltimore.
According to study, between 21% and 30% of individuals who have a hip fracture pass away within a year.
Although there aren’t many overt symptoms, stooped posture, height loss, and bone pain all be indicators that the problem is progressing. However, a number of diseases, including arthritis, can also cause bone discomfort.
According to Dr. Andrea Singer, chief medical officer of the Bone Health & Osteoporosis Foundation, osteoporosis is a dangerous bone condition that develops when the body either produces too little bone or loses too much bone.
What is osteoporosis screening?
In an email, Dr. Thomas Weber, an endocrinologist at Duke University Medical Center who studies and treats patients with osteoporosis and metabolic bone disorders, defined osteoporosis screening as the use of bone density, x-ray studies, or other tools to identify people at an increased risk of fractures or bone breaks.
According to Weber, doctors could not understand the terrible effects of bone fractures, such as long-term agony, incapacity, or early death. A national survey of physicians published in 2023 suggests that doctors may view bone density screening as a low priority as a result. Women may not get checked because of patient worries about the expense.
Less than 25% of privately insured women aged 65 and over who did not have an osteoporosis screening diagnosis were screened, according to a comprehensive study that examined insurance claims data from over 1.5 million women between 2008 and 2014.
Just 9% of women and 5% of men on Medicare obtained a bone density test within six months after a new fracture, according to a 2021 National Osteoporosis Foundation research.
According to Singer, even fewer males obtain the essential test for osteoporosis, while too few women do.
There was not enough data in the task force criteria to recommend either screening for men or not.
Rapid weight loss poses potential risk
According to Dr. Christopher McGowan, a gastroenterologist and obesity specialist who owns True You Weight Loss in Cary, North Carolina, rapid and drastic weight loss might be harmful to bone health.
The revised guidelines actually coincide with an increase in the use of prescription weight-loss pharmaceuticals by both men and women, including tirzepatide, the active component of Eli Lilly’s Zepbound, and semaglutide, the active ingredient in Novo Nordisk’s Ozempic and Wegovy.
According to a recent study, those who used GLP-1 drugs without exercising saw a substantial decline in hip and spine bone density. Bone mass density was preserved by the combination of weight loss drugs and exercise.
If a bone density test hasn’t been performed recently, McGowan advised women over 65 in particular who are at risk of having decreased bone density to get one before using anti-obesity medication.
According to other studies on patients taking weight loss drugs, lean muscle mass accounts for 25% to 40% of weight loss, which has important ramifications for bone health, strength, mobility, and fracture risk, he said.
According to a Novo Nordisk representative, osteoporosis is not mentioned in the Ozempic prescribing material as an adverse effect.
According to a Lilly representative, there is no information or statistics on how tirzepatide affects osteoporosis or bone density.
Is osteoporosis preventable or reversible?
Although osteoporosis can be prevented and treated, experts emphasize that it cannot be cured because it is a chronic condition like diabetes and hypertension. Therefore, early detection is crucial.
According to doctors, the majority of patients with osteoporosis will require medication to prevent fractures.
Medication can stabilize or improve bone density, which can lower the risk of bone fractures by half to two-thirds, depending on the medicine and fracture site, according to Weber.
According to Columbia University medical professor and osteoporosis specialist Dr. Felicia Cosman, everyone should adhere to universal preventive measures, which include:
- A healthy diet with lots of fruits and vegetables.
- Avoiding excessive smoking and alcohol consumption.
- An active lifestyle, which includes strength training, weight bearing aerobic exercise and balance training, as needed, to reduce the risk of falls.
According to the majority of research, strength training is safe for elderly individuals with bone disease; however, those who are susceptible to spinal fractures should refrain from activities that cause their spines to twist quickly or move forward, according to Cosman.
Protein, calcium, and vitamin D levels must all be sufficient for strong bones.
When feasible, Cosman advised obtaining calcium through diet, aiming for roughly three calcium-rich items day, such as cheese, milk-fortified plant-based yogurt, and dairy products.
The lowest dosages of calcium supplements are recommended for those with poor calcium diets, she noted.
Vitamin D is more difficult to obtain through diet, and while exposure to sunlight helps the skin produce it, sunscreen slows down this process, she says.
A vitamin D supplement is necessary for many people, but the dosage varies from person to person, she said.
According to Cosman, vitamin D dosages of 800-1000 international units per day are typically sufficient for adults 50 and older.
According to a significant clinical study conducted in 2022, vitamin D supplements do not prevent fractures in healthy women aged 55 and over or men aged 50 and over.
If you are unsure about the risks and benefits of taking vitamin D supplements, experts advise discussing them with your doctor.