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Health Bulletin - October 2022


What is osteoporosis?

  • Osteoporosis is a bone disease characterized by loss of bone mass and weakened bone structure, leading to increased risk of fracture.
  • There are cells in your body that remove old bone and other cells that rebuild bone which is an ongoing natural process happening.
  • As you age, you lose more bone than you gain.
  • Bones may become so weak that a sudden twist, fall or strain causes a fracture.
  • When bones are affected by osteoporosis, the honeycomb spaces within the bone become much bigger, making the bone less dense, weaker and more prone to breaking.

What are the risk factors for fracture related to osteoporosis?

Older age (Men and Women) Parent had a hip fracture
Low bone density Low calcium/vitamin D intake
Previous broken bone as an adult Frequent falls
Smoking/ excess alcohol intake Long term use of steroid medications
Very low body weight Inactive lifestyle
Early menopause Rheumatoid arthritis
Loss of height Secondary causes

Where do fractures from osteoporosis occur?

  • Spinal fractures/vertebral fractures: In severe cases, such fractures can occur from stepping out of a bathtub, sneezing or lifting a small object
  • Hip fractures: Often times, requires surgical treatment, happens from falling
  • Wrist fractures: Commonly after a fall from an outstretched arm.

Impact of a fracture:

  • Pain, disability and deformity      Impaired mobility
  • Requiring assistance with self-care      Impaired quality of life

When to get screened:

  • All women age 65 and older, men age 70 and older.
  • If risk factors present, then early screening recommended for women age 50-64 yrs., men age 50-69 years.

How to get screened:

Bone Density T-Score
Normal BMD +1.0 to -1.0
Low BMD -1 to -2.5
Osteoporosis -2.5 or higher
  • Bone mineral density (BMD) is used to diagnose osteoporosis, determine severity and assess fracture risk.
  • BMD test provides a T-score which compares your bone density to healthy young adults of the same gender
  • Here’s what the T-score means:
  • Bone density should be done every two years to continue to assess fracture risk and monitoring.
  • Each 1 point drop in the T-score means a loss of 10% bone density which doubles the risk of fracture.

How to prevent fracture risk:

Treatment of osteoporosis:

  • Eat adequate amounts of calcium and vitamin D, supplements are often required.
  • Get regular exercise which is weight bearing, strength training, and resistance exercise.
  • Avoid excess alcohol and do not smoke
  • Measure height once a year for those at risk for osteoporosis
  • To get enough vitamin D, generally, you should try to get 10–20 minutes of sun exposure to your bare skin (face, hands, and arms) outside peak sunlight hours (before 10 AM and after 2 PM) daily – without sunscreen – and taking care not to burn.
  • Unfortunately, sunlight is not always a reliable source of vitamin D. The season and geographic latitude, use of sunscreen, city smog, skin pigmentation, and a person’s age are just some of the factors that will affect how much vitamin D is produced in the skin through sunlight.
  • Because many of us spend most of our times indoors, low levels of vitamin D have become a worldwide problem and there is concern that this is having a negative impact on bone health.
  • Daily Vitamin D supplementation dose is 1000 IU of vitamin D3.
  • It is important for young people to eat enough protein-rich foods so their bones develop and grow optimally.
  • In seniors, protein plays a role in preserving bone and muscle. Lack of protein robs the muscles of strength, which heightens the risk of falls, and contributes to poor recovery in patients who have had a fracture.
  • Lean red meat, poultry and fish, as well as eggs and dairy foods, are excellent sources of animal protein.
  • Vegetable sources of protein include legumes (e.g. lentils, kidney beans), soya products (e.g. tofu), grains, nuts and seeds.
  • Above all, fall prevention is very important.
    • Fall-proof your home by removing hazards, installing grab bars and using extra lighting
    • Do regular, suitable weight-bearing and muscle strengthening exercises, alongside exercises to improve balance.
    • Keep your glasses clean and in good repair, being careful on stairs if wearing bifocals, and wear sunglasses on bright days to reduce glare.
    • Wearing comfortable shoes with good support, a broad heel and non-slip soles.
    • Maintain a nutritious and protein-rich diet.
    • Talk to your doctor about any previous falls, if you feel dizzy and ask about your medications.
  • Calcium , Vitamin D and exercise
  • Medications that broadly fall in bone strengthening and bone building medications
  • Fall prevention.

Author information
Geetha Soodini, MD
North Georgia Diabetes & Endocrinology
Northside Hospital, Forsyth Cumming, GA 30041

Coordinated By
Sujeeth R. Punnam, MD
Chair, ATA Health Committee

(Dr. Sujeeth R. Punnam is a cardiologist in Stockton, California and is affiliated with multiple hospitals in the area, including Dameron Hospital and St. Joseph's Medical Center-Stockton. He received his medical degree from Kakatiya Medical College NTR and has been in practice for more than 20 years.)