Osteoporosis: Understanding the Risks and Management

Written by Jennifer E. Cho, MD, FACOG

Osteoporosis is a condition characterized by low bone density and reduced bone strength, leading to an increased risk of fractures. Fractures can occur even without any trauma, causing chronic pain and difficulties in daily life. According to studies conducted up until 2015, the rate of spinal fractures was found to be the highest in South Korea and the United States. Let's explore osteoporosis in more detail.

Risk Factors for Osteoporosis

Factors that increase the risk of osteoporosis and fractures include age, medical history, long-term glucocorticoid therapy, low body weight (below 58 kg or 127 lbs), smoking, excessive alcohol consumption, and family history of hip fractures.

General Screening Recommendations

It is widely agreed among major medical institutions that postmenopausal women over 65 and men over 70 should undergo a comprehensive bone density screening, regardless of other risk factors for fractures. Those with risk factors or a family history should consider earlier screening.

Optimal Method for Osteoporosis Testing

Dual-energy X-ray absorptiometry, or DXA scan, is the most widely used method for measuring bone density. It accurately assesses the bone density in areas prone to fractures, such as the spine, hips, and femur. Numerous studies have shown that DXA scans are effective in predicting overall osteoporotic fractures. However, it is worth noting that the equipment is large and expensive, and it employs a minimal amount of ionizing radiation. Patients requiring a DXA scan are recommended to repeat it every two years.

Preventive Lifestyle Choices for Men and Women with Low Bone Mass

Adequate Vitamin D and Calcium Intake: Postmenopausal women are advised to consume about 1200 mg of calcium and 800 IU of vitamin D daily.
Engage in Weight-bearing Exercises: Activities such as walking, jogging, and jump rope are encouraged.
Avoid Smoking
Limit Excessive Alcohol Consumption
Avoid Medications Affecting Bone Health: such as corticosteroids.

Treatment Options for Osteoporosis

For most postmenopausal women with osteoporosis, bisphosphonates (e.g., Alendronate or Risedronate) are the most effective, cost-efficient, and long-term treatment options. These medications can be taken daily or weekly and require the patient to remain upright for 30-45 minutes after ingestion with a glass of water. If bisphosphonates are unsuitable, alternatives such as Prolia injections every six months, or intravenous medications like Zoledronic Acid and ibandronate, can be considered.

It is advisable to consult your physician for specific inquiries and to maintain annual checkups related to osteoporosis and its risks. Uphold a balanced diet and engage in regular exercise to safeguard your bone health.

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