DXA (dual energy X-ray absorptiometry) and BMD (bone mineral density) exams use X-rays to measure bone mineral density in hips and spines. The exams are painless and may be covered by insurance and Medicare. Dr. Cosman recommends that women start taking regular bone density tests by age 65, and that men be checked routinely by the age of 70. Younger individuals, she says, should review their susceptibility to osteoporosis with their doctors. “Look at all the risk factors—such as medications that may cause risk to the bones—and [assess] the environmental safety in the home for falling risks.”
In addition, doctors stress the importance of getting adequate calcium and vitamin D and avoiding excess alcohol—more than two drinks a day. Cosman recommends eating three servings a day of milk, yogurt, cheese, and other foods containing high amounts of calcium. She lists fortified cereal, oranges, salmon, mackerel, and grapefruit juice as good sources of vitamin D. Many doctors also recommend calcium supplements with vitamins D and K.
“It’s a disease that really begins in youth,” says Cosman, which is why nutrition and lifestyle are so important for its prevention. “The genes are there, [and] the lifestyle choices that we make are already acting on bone strength during youth.”
Doctors may prescribe bisphosphonates, powerful drugs that reduce the incidence of fractures by altering bone physiology, to treat or prevent the progression of brittle bones. These can be taken once a day, week, or month depending on the dosage and the patient’s needs. Possible side effects include muscle aches, constipation, abdominal pain, nausea, and heartburn.
Fernandes, who also serves as president of the AYR Consulting Group medical services provider, reacted badly to the first two bisphosphonates her physician prescribed. “The first caused total body urticardia—my whole body starting itching,” says Fernandes, and the second made her upper eyelids swell. Happily, the third proved effective with no negative side effects.
“These medications are safe if they're given to the patients who need them," Cosman says. "People should talk to their doctors about their prescriptions and [whether] the medication’s results on improving your bone health outweigh the side effects you may experience.”
To allow her to maintain an active lifestyle, Fernandes and her physician agreed on a plan of care. “We decided that I should take medication, walk regularly, and begin a regimen of physical therapy regularly to strengthen my muscular system,” she says.
Tamayo has also developed a new lifestyle to strengthen her bones; she takes her medication, watches out for falls, eats more fruits and vegetables and foods containing calcium, and exercises daily. And, she says, indulging as much as possible in her favorite exercise: “I dance at family get-togethers and holiday celebrations.”
Bottom line: It’s never too late to improve your bone health, even if you already have osteoporosis. Taking care of your bones will help keep you active into your later years. And that’s cause for celebration.
Risk Factors for Osteoporosis
- Low body weight
- Family history of osteoporosis
- In women, post-menopause
- Tall stature
- Long periods of bed rest due to illness
- Insufficient calcium in diet
- Long-term use of certain drugs
- Excessive alcohol