How maintaining bone strength is vital as you age
THE EXPERT : Victoria Camille Hammonds, MD
HER EXPERTISE: Family and Geriatric Medicine
Victoria Camille Hammonds, MD is a family medicine and geriatric medicine provider at Novant Health UVA Health System Bristow Run Family Medicine – Stonewall. For more information or to schedule an appointment with a Novant Health UVA Health System geriatric medicine provider, please visit NovantHealthUVA.org/pf.
By Kim Conquest
If you’re a postmenopausal woman, osteoporosis is a major cause of fractured bones, which occur most often in the hip, vertebrae and wrist.
“Estrogen is necessary for bone health,” said Victoria Camille Hammonds, MD, a family medicine and geriatric medicine provider at Novant Health UVA Health System Bristow Run Family Medicine – Stonewall. “When you reach menopause, and you’re producing very little to no estrogen, bone density starts to decline.”
Osteoporosis is a disease in which bone density decreases, which can lead to loss of bone strength and increase the risk of fractures. It can happen to anyone – in any bone – but your risk increases as you age.
- Symptoms of osteoporosis
“There are no signs or symptoms of osteoporosis,” Dr. Hammonds said. “The only way to know what’s happening is through a bone density study.”
She recommends the test at age 65 for women and 70 for men, earlier if you smoke, drink heavily, or take large doses of steroid medications.
Bones affected by osteoporosis can become fragile enough that fractures occur spontaneously by minor falls or normal stresses, such as bending, lifting, or coughing.
- 2. Osteoporosis risk factors
Some risk factors are innate, such as gender (women are at higher risk) and age (bone loss increases as you get older). Others include:
- Body size: Slender, small-boned people are at greater risk for osteoporosis because they have less bone mass.
- Race: White and Asian women are at highest risk. Black and Mexican-American women have a lower risk. White men are higher risk than Black and Mexican-American men.
- Family history: Your risk of osteoporosis is higher if one of your parents has a history of the disease.
- Other medical conditions can increase your risk, including endocrine and hormonal diseases, gastrointestinal diseases, rheumatoid arthritis, cancer, HIV, AIDS and anorexia nervosa.
- What you can do to reduce your risk
Include calcium and vitamin D in your diet: If you don’t take in enough calcium, your body takes it from your bones. Good sources of calcium include:
- Low-fat dairy products
- Dark green leafy vegetables (e.g., spinach, bok choy, collards and turnip greens)
- Sardines and salmon
- Calcium-fortified foods (e.g., soy milk, tofu, orange juice and cereals)
Foods that contain a lot of vitamin D include:
- Fatty fish (e.g., salmon, tuna, sardines, mackerel and trout)
- Fish oils
- Egg yolks
Another easy way to receive vitamin D is through sunlight.
“The problem is, we’re also skin-cancer-conscious,” Dr. Hammonds said. “We use sunscreen to block ultraviolet rays, but it can also prevent some of the vitamin D from being absorbed into our bodies, so increasing our vitamin D levels through diet helps us not be so dependent on the sun.”
Exercise: “Do resistance or weight-bearing exercises,” Dr. Hammonds said. “Walking, using hand weights or bands, or walking in a pool are good bone-building exercises. Any sort of exercise is crucial.”
Do not smoke: Tobacco usage increases your rate of bone loss.
Limit alcohol: Too much alcohol can decrease bone formation. Women: no more than one drink per day. Men: no more than two drinks daily.
Prevent falls: Remove electrical cords, area rugs and slippery surfaces. Keep rooms brightly lit, install grab bars inside in the bathroom, and make sure you can get into and out of bed easily.
4. Treatment for osteoporosis
Dr. Hammonds said there are several options, and that most patients start with bisphosphonate therapy, an oral medication that helps slow bone loss and lower the chance of fracture. Alendronate and Actonel are two common oral medications taken weekly or monthly. Reclast is an annual infusion of bisphosphonate medication. Patients also can choose Prolia, which is given as a twice-a-year injection.