May is National Osteoporosis Awareness and Prevention month. The National Osteoporosis Foundation estimates that 1 out of every 2 women and 1 out of every 4 men, over the age of 50 will break a bone due to osteoporosis. I find that figure staggering.
What are the risk factors?
Well, based on the statistics I just mentioned, being female and over the age of 50 are risk factors. If you have a family history of osteoporosis, statistically you are more likely to break a bone due to this condition. Obviously these are risk factors that cannot be changed; so let’s look at the ones that we can do something about:
FRAX is a great tool that calculates your risk for a potential fracture. It takes race, age, weight and other risk factors into consideration. Under the menu select Calculation Tool, then follow the menus to select your continent, country, and race. For those of you who do not know your weight in kilograms or your height in centimeters, do not panic. On the right side of the screen is a handy conversion tool for you.
My diet is healthy and I exercise every day. Am I still at risk?
Some of the most commonly prescribed medications actually lead to bone loss. Corticosteroids are anti-inflammatory agents that are commonly prescribed to help control chronic conditions such as asthma and arthritis. Unfortunately, studies show that patients lose an average of 14% of bone mineral content in the first year after starting corticosteroid treatment. Most people achieve peak bone density around age 25. However, for patients who develop asthma at an early age, and use corticosteroids to manage their condition, they may never achieve maximum bone density.
SSRIs such as Lexapro, Prozac and Zoloft have been linked to decreased bone density. Here is a great article from the May 2009 issue of Psychology Today explaining the misuse of these medications. According to Dr. Lane, 80% of patients surveyed who were taking these medications showed no depressive symptoms at all. These medications are often prescribed to women for PMS symptoms or menopause symptoms. This may be another reason that more women than men are diagnosed with osteoporosis.
Here are some other common prescription drugs that affect bone health:
When should I request a bone density test?
The US Preventative Screening Task Force (yes, the same task force that caused an uproar with their breast cancer screening recommendations) recommend bone density screenings for the following demographics:
The National Osteoporosis Foundation recommends bone density testing of:
I utilize the NOF’s guidelines when making recommendations to my patients. However, for patients with long-term SSRI use or corticosteroid use, I encourage them to get a DEXA scan earlier. If you suspect that osteoporosis may be a problem for you, ask your doctor for a bone density test. You may have to pay out of pocket for it, but the sooner you start to reverse bone loss, the better off you will be.