Bone health awareness can reduce risk after age 30
STEAMBOAT SPRINGS — Once you hit age 30, your bones have achieved their peak mass.
“It’s downhill from there, so we’ve got to hold on to what we’ve got,” said Dr. Jessica Devin, an endocrinologist at UCHealth Endocrinology Clinic in Steamboat Springs.
There are a number of ways — at any age — to promote good bone health, primarily through diet and exercise. In terms of diet, beneficial foods include vegetables and foods high in protein, vitamins D and K, calcium, magnesium, zinc, and omega-3 fats. Maintaining a healthy weight helps bone health, as does strengthening and weight-bearing exercises.
And as people age, the risk of osteoporosis increases, especially for women. Osteoporosis translates literally to “porous bone,” and is defined as a disease in which the density and quality of bone are reduced.
It is easy to take bone health for granted, because often people don’t see any symptoms until a fracture occurs — and the bone loss is advanced.
According to the International Osteoporosis Foundation, one in three women and one in five men will experience an osteoporotic fracture after age 50.
Devin said that bone density tests are recommended for people 65 and older, or starting at age 50 for people with additional risk factors.
Aside from age, some of those risk factors that can influence bone loss include genetics; dietary limitations; and a history of breast cancer, thyroid disorders, steroid use and celiac disease, she said.
For women, menopause plays a big factor in increasing the risk of developing osteoporosis. Estrogen helps to keep bones strong, and when those levels drop during menopause, bones can become more brittle and the risk of fractures rises.
While there remains an ongoing process of bone turnover — osteoclast cells break down and remove old bone before osteoblast cells lay down new bone — when the rate of bone removal speeds up as people age. After menopause, the new bone formation can’t always keep up.
The bone density test is an easy one, Devin said, with less radiation than a mammogram.
The dual energy X-ray absorptiometry test results in a number called a T-score. Based on that, the doctor can determine whether patients have osteoporosis and how high a fracture risk.
From there, Devin said, there are multiple lines of treatment.
There are pills, injections and intravenous infusion options.
Bisphosphonates drugs like alendronate can help prevent further bone breakdown and are used as a first line of therapy, Devin said, and can cut fracture risk by about half.
The most common side effects of the oral medication are gastrointestinal tract issues, she said. There are also more serious, but less common, side effects related to thigh and jaw fractures, associated with longer-term use and higher dosage.
Side effects do increase after long-term use with some medications, so most patients stop taking them after about three to six years, though some of the bone-protective benefits continue.
One of Devin’s main goals is to help women understand their risk for fracture, and measure it against potential side effects from medication. That way, “people are able to make a really informed decision.”
Vitamin D and calcium play an important role, Devin said, and doctors test vitamin D levels as part of evaluating bone health. But it is possible to have too high of levels of vitamin D, which can result in kidney stones, she said. It’s hard to get levels of calcium that are too high.
Still, “There really is no evidence, looking across multiple clinical studies, that calcium alone or vitamin D alone is going to reduce the risk of fractures,” Devin said.
Staying active is one of the best ways to maintain bone health and reduce risk, Devin said. “Maintaining muscle mass, strength and balance are very important in preventing falls and fractures.”
Also, she advised, decrease your risk of fracture by identifying how fractures can occur — and prevent falls. Ninety percent of the time falls are preventable, she said. Identify what causes dizziness or hazards in the house like throw rugs, power cords or pets.
Bone density scans are available in Steamboat Springs at UCHealth Gloria Gossard Breast Care Center. Patients can call 970-871-2399 to schedule an appointment.
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