Osteoporosis: Should You Be Tested?
(continued)
Prevention is the First Step
- Prevention:
Tips to prevent osteoporosis include getting adequate amounts of calcium
and Vitamin D in your diet as early as possible; living an active lifestyle
with frequent weight bearing exercise (e.g. walking); preventing falls and other
accidents; and giving up smoking and heavy drinking. The recommended calcium
intake for postmenopausal women is 1,500 mg/day. It is difficult for most women
to get this amount of calcium from their diets alone. In fact, the average
44-year-old American woman consumes only 440 mg of calcium per day! As a result,
most physicians recommend calcium supplements for the balance. These can be
tablets that you swallow (e.g. Caltrate®, Os-Cal®, or Citracal®), that you chew
(e.g. Tums®), or even the new products that are "disguised" as chocolate covered
candies (for 20 calories each)! This is especially important for women with
lactose intolerance, even though there are products such as Lactaid® to help
with the symptoms of this condition. Many women avoid dairy products
in fear that they will increase their cholesterol levels or add too many unwanted
calories. To address these concerns, look for skim or fat free products (which
actually contain higher calcium levels than their fuller fat counterparts).
Non-dairy foods that are high in calcium include tofu, broccoli, and calcium-fortified
orange juice.
Medications are also available to prevent osteoporosis in women at high risk.
These include estrogen replacement therapy and alenronate (see treatment section
below) and raloxifene (Evista®), a selective estrogen receptor modulator (SERM).
Both estrogen replacement therapy and alendronate reduce fracture risk as
well as osteoporosis risk. Raloxifene slows bone loss and may reduce fractures.
It should not be confused with estrogen, as they have many different actions.
It is considered a good choice of medication for women who cannot or will
not take estrogen who are also at high risk for (or who have had) breast cancer;
one of its other actions is that it may reduce breast cancer risk.
- Screening:
The most simple screening test is measuring height. The most common cause
of decreased height in an adult is a spinal crush or compression fracture associated
with osteoporosis. Bone mass measurement (bone densitometry) is the only test
that can be used to make a definitive diagnosis of osteoporosis. This non-invasive
test can be used to assess a baseline (of where your bone mass is now), when
beginning therapy, and then to monitor the effect of therapy. There are several
different machines using different technologies to measure bone mass- some use
x-ray and some use ultrasound. Your physician will recommend which test you
should have based upon your individual circumstances and your insurance coverage.
The National Osteoporosis Foundation (NOF) recommends bone mineral density testing
for all women over the age of 65 and for those women under age 65 who have risk
factors for bone loss other than menopause.
- Diagnosis:
As above, the definitive diagnosis of osteoporosis is made using bone
density testing (bone densitometry or bone mass measurement). In addition,
there are blood and urine tests your physician might order to further evaluate
the specific type of osteoporosis you have, to confirm that you are in menopause,
or to rule out secondary causes. Bone density testing is now covered by Medicare
and many major insurance plans for women at risk.
Many women report feeling depressed when they have osteoporosis. While this
is not unusual--and it is certainly understandable--it is still important
to speak with your doctor about these feelings.
|
 Whatever your choice of therapy, remember that you’re not committed to that choice for life! You and your physician will monitor your progress and your comfort level with your treatment plan. If there are factors that change—including your level of satisfaction—discuss this with your physician.
|
