Bone Health Part 10: Do You Need Osteoporosis Screening?

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Most people don’t realize they need osteoporosis screening because they don’t notice the symptoms. We’ll get into that, but first let’s identify part of the problem.

What are the Signs and Symptoms of Osteoporosis?

Osteoporosis is a silent disease that sneaks up on most people because the signs of osteoporosis may not show up until you experience an injury. There are rarely any symptoms of diminished bone strength with osteoporosis, which is why the osteoporosis screening is so important.

What Are Osteoporosis Risk Factors?

Risk factors help identify people who are more likely to develop osteoporosis. Key risk factors that affect bone mass are:

Is Osteoporosis Hereditary?

Heredity – gender, race, and genetics – can affect as much as 80% of your ability to build bone. Bone Mineral Density (BMD) is 30% higher for men than for women; 10% higher for blacks than whites; and as much as 60-80% of your BMD may be determined by genetics.

Lifestyle and Osteoporosis

Lifestyle or environmental factors can contribute up to 40%, especially for children and teenagers. Diets high in calcium and vitamin D plus regular weight-bearing physical activity are essential for developing and maintaining strong bones. Inadequate total calorie consumption, as in disordered eating, can negatively impact bone growth.

Medical Conditions That Can Cause Osteoporosis

Chronic disorders like hyperthyroidism, certain cancers, chronic liver disease and rheumatoid arthritis can cause bone loss, as can medications such as those used to treat thyroid issues and glucocorticoids to control asthma and immune disorders.

Age is a Factor: Bone Density by Age

Throughout your life, your skeleton loses old bone and forms new bone. During childhood and adolescence bones grow faster than they break down, creating strong, dense bones. Between the ages of 18-25, Peak Bone Mass (PBM) is achieved, the greatest amount of bone you will have in life. From this time on, the balance between bone loss and bone formation may start to change with bone breakdown outpacing bone formation.

  • Childhood and Adolescence – Fast growing bones

  • 18-25, Peak Bone Mass (PBM)

  • 26+ Bone loss begins slowly

Women Are More Susceptible to Bone Density Loss

All of us lose some bone as we age. Immediately after menopause, as women lose the protective effect of estrogen, bone loss accelerates to 3-5% per year for 3-7 years before leveling off. In our 60s declining estrogen and age play equal roles. By age 70, age is the predominant factor. It’s not true that every older person gets osteoporosis, but it does become more common with age.

About half of women in their 80s have osteoporosis.

Two main risk factors for osteoporosis are being female and of an older age.





How is Osteoporosis Screening Done?

3 Steps to Osteoporosis Screening

  1. Medical history or risk assessment tool

  2. Physical exam

  3. Bone Mineral Density (BMD) tests, also known as DEXA scans

FRAX Calculator: The Fracture Risk Assessment Tool

The most popular risk assessment tool is called the FRAX Calculator for Fracture Risk Assessment Tool.

FRAX involves a list of about a dozen factors, including age, gender, weight, height, previous fracture, parental fracture history, smoking, alcohol consumption and use of steroids. If your FRAX assessment indicates a risk of fracture, then you are encouraged to get a Bone Density Test or DEXA scan to determine your level of bone mineral density (BMD).

FRAX for osteoporosis screening calculates your risk of having an osteoporosis-related hip fracture in the next ten years.

Physical Exam for Osteoporosis Screening

One of the signs of loss of bone density is loss of height. So a physical exam can measure to see if you’ve lost any height and also check your spine to see if it is curving forward., either of which can indicate broken bones in the vertebrae of your spine.

Bone Mineral Density (BMD) Tests Diagnose Osteoporosis

While there are several tests used to evaluate bone, only a Bone Mineral Density Test can diagnose osteoporosis. It measures the amount of bone mineral you have in certain areas of the skeleton and can tell you if you have low bone density before you break a bone. When repeated periodically, it can tell you if your bones are losing density or staying the same. If you are being treated for osteoporosis, your healthcare provider may repeat the test every year or two and compare the results to see how well the treatment is working.

So Do You Need a BMD Test?

According to the National Osteoporosis Foundation, your healthcare provider may recommend a BMD test if you are:

  • A postmenopausal woman under age 65 with one or more risk factors for osteoporosis

  • Male age 50-69 with one or more risk factors for osteoporosis

  • Female age 65 or older, even without any risk factors

  • Male age 70 or older, even without any risk factors

  • Male or female age 50 or older who has broken a bone

  • A postmenopausal woman who has stopped taking estrogen or hormone therapy

  • Male or female who is being treated for osteoporosis

When you get your screening, this will help you learn how to read you Bone Density Test.

Disclaimer: The information presented in this article should not be construed as medical advice. It is not intended to replace consultation with your physician or healthcare provider.

Author

  • Joan Pagano

    Joan Pagano has specialized in strength training for women since 1988 – training, teaching, and writing books on the subject, including Strength Training Exercises for Women (DK, 2014). When the health benefits of strength training started making headlines in the 1990s, and in particular how weight training could protect the bones and prevent osteoporosis, it was a natural segue for her. At that time, Joan was developing and delivering fitness training guidelines for osteoporosis to national audiences of exercise professionals. Currently Joan is recognized by the industry as a leading authority on exercise program design for osteoporosis. She is certified as an Exercise Physiologist by the American College of Sports Medicine (ACSM) and is on the Ambassadors Leadership Council for the National Osteoporosis Foundation. Visit Joan at: www.joanpaganofitness.com/

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