Throughout life, old bone is removed and new bone is added to the skeleton. During childhood and adolescence, new bone is added faster than old bone is removed. As a result, bones become heavier, larger, and denser. Peak bone mass is reached at around age 30. From that point, more bone is lost than replaced. If not treated, bone losses may lead to osteoporosis. Osteoporosis is more likely to occur if full bone mass was not achieved during the bone-building years.
Bone density also plays a role in bone health. Bone density is determined by the amount of
, and other minerals within the bone framework. As the mineral content of a bone (especially calcium) decreases, the bone weakens. Getting enough calcium and
and exercising regularly can keep bones strong throughout life.
There are many risk factors that may increase your chance of developing osteoporosis. Some of the risk factors include:
For older men, the American College of Physicians (ACP) recommends that your doctor check for risk factors for osteoporosis. The ACP also recommends that you have this test if you are at an increased risk and are a candidate for drug therapy. Ask your doctor about what is right for you.
Single-energy x-ray absorptiometry—measures bone density in the arm or heel
Exercise improves bone health. It also increases muscle strength, coordination, and balance. Do weight-bearing and strength-training exercises for maximum benefit. Balance training may prevent falls and fractures.
People who cannot eat enough calcium from food might want to take calcium supplements. Calcium citrate has the best absorption and is well-tolerated. Other vitamins and minerals may be recommended, including vitamin D,
. A study showed that Japanese postmenopausal women who took vitamin K supplements had a reduced rate of fractures. Talk to your doctor before
taking herbs or supplements.
Your doctor may prescribe medicine to prevent bone loss, increase bone density, and reduce the risk of spine and hip fractures:
(including estrogen replacement therapy, or ERT) may cut the risk of osteoporosis in half, research shows a strong association between longer-term HRT or ERT use
a significantly increased risk of invasive
, and blood clots. Be sure to discuss all of the health risks and benefits of hormone therapy with your doctor to find out if it is right for you.
HRT therapy may include:
Estrogen alone (ERT)
Estrogen and progestin—frequently preferred for women with an intact uterus because ERT slightly increases the risk of
Reduce bone loss
Increase bone density
Reduce the risk of hip and spinal fractures in postmenopausal women
Falls can increase the chance of fracture in someone with osteoporosis. Here are ways to prevent falls:
Wear rubber-soled shoes for traction.
Use plastic or carpet runners when possible.
Keep rooms free of clutter.
Install grab bars in bathrooms.
Building strong bones throughout the early years is the best defense against osteoporosis. There are four steps to prevent osteoporosis:
A balanced diet rich in calcium and vitamin D
Healthy lifestyle (eg, no smoking, drinking alcohol only in moderation)
Bone density testing and medicines where appropriate:
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: Qaseem A, Snow V, Shekelle P, Hopkins R Jr, Forciea MA, Owens DK; Clinical Efficacy Assessment Subcommittee of the American College of Physicians. Screening for osteoporosis in men: a clinical practice guideline from the American College of Physicians.
Ann Intern Med
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: Loke YK, Singh S, Furberg CD. Long-term use of thiazolidinediones and fractures in type 2 diabetes: a meta-analysis.
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Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a