Osteoporosis is treatable, preventable | PostIndependent.com

Osteoporosis is treatable, preventable

Post Independent/Kara K. Pearson

Imagine how your bones look from the inside, like a sponge with holes connected by delicate bridges. As we get older, those bridges break down and cause osteoporosis. It’s a common ailment among the elderly, especially women over 60.According to Dr. Glenn Kotz, bone fractures are more frequent in the elderly “than heart attack, stroke and breast cancer combined.”Osteoporosis is a “very significant health risk,” he said. “We have found in the vast majority of older women over 65 who break a hip, 25 percent will die in one year. Why? We don’t know; all we know is 25 percent will die and about 50 percent will be really disabled.”Kotz, who practices family medicine in Basalt at Alpine Medical Group, and specializes in sports medicine, explained that osteoporosis is a decrease in the density and quality of the bone, the bridges that connect the holes. That decrease in density and quality, “predisposes (people) to increased risk of fracture,” he said.According to the National Osteoporosis Foundation Web site, any bone can be affected, but fractures of the hip and spine are of special concern. A hip fracture almost always requires hospitalization and major surgery. Spinal fractures also have serious consequences, including loss of height, severe back pain and deformity.While women are four times more likely than men to develop the disease, men also suffer from osteoporosis.”After age … 30, both men and women start losing bone,” Kotz said, about one-and-a-half percent a year. Women going through menopause lose between one and two percent. “That’s why you always worry about post-menopausal women. Between 50 and 60, women’s bone loss doubles then goes back to average. That’s a critical 10 years.”However, there is good news in this gloomy picture. Osteoporosis is treatable and preventable.

The key to preventing osteoporosis later in life is encouraging good bone growth early on.”One of biggest things is making sure all adolescents are building bone mass well,” Kotz said. “If they don’t build enough bone before age 30, they will have lower mass to begin with.”Delayed puberty can also affect bone quality in girls. Normally, girls go through puberty between the ages of 11 and 13. But if their first period is delayed until 15, they do not develop the bone mass of girls who go through puberty earlier, Kotz said. That also happens with athletes, or girls who are very thin and may have an eating disorder. “They will not make up that bone,” he said. “It’s critical that young adults eat right and get enough calcium.”Smoking, said Kotz, is the prime risk factor for osteoporosis.”Smoking is horrendous for bone,” he said. “It’s one of our first treatments, to get people who smoke to quit.”There are a whole host of other factors, including steroid use, a family history of the condition and a Vitamin D deficiency.Although osteoporosis has been known as a condition that affects the elderly, Kotz said not a lot is known about direct causes.”A lot of what we know we’re still learning,” he said. “We know if you break a hip skiing or jump off a cliff and break your back, you’re three times as likely to break your back again. You are more likely to fracture that area because it’s weakened. And even if you break your back, you’re one to two times more likely to break a hip. We think there’s a poor quality of that bone.”

Fortunately, there are diagnostic tests for bone density. Kotz recommends that any woman who is in menopause and has another risk factor should get the test. So should all women over 65, men over 70, any adult who’s had a fracture, any adult at high risk for a liver transplant, anyone who’s on steroids, or who has kidney disease.In Glenwood Springs, Glenwood Medical Associates (GMA) offers bone-density scanning.”GMA was the first to offer it between Denver and Salt Lake City,” said Mari Brennan-Combs, radiology supervisor at GMA.The bone densitometer measures bone density. It scans the lower back and hips, as well as the forearm, “with a minimal dose of radiation,” Brennan-Combs said, “so we can predict the risk for fracture.”Bone density measurements are based on healthy bones in persons 20 to 30 years old. If you have a “T score” of less than 2.5, you have osteoporosis, Kotz said.To stave off osteoporosis and build bone when you’re older, he recommends women take 1,500 milligrams (mg) of calcium per day, and men 1,000 to 1,200 mg.Calcium can also come through good nutrition, but not enough to actually build bone, Kotz said.In addition, Vitamin D is a must.”Vitamin D is more important than calcium,” he said. “It is the only way for calcium to get beyond the gut and into the blood … and to make bone.”

We get Vitamin D naturally from the sun, from orange juice and milk.”As we get older, Vitamin D deficiency rises dramatically,” he said.Although living at Colorado’s high altitude, we must be wary of exposing our skins to too much of the sun’s rays, which can cause skin cancer, it’s also important to let the sun shine in.”Go outside 10 minutes and then put on sun screen,” Kotz said. “It’s good to go out and get a little bit of sun.”It’s also important to take Vitamin D as a dietary supplement. He recommends taking 800 International Units daily, and 1,000 if you’re over 50.Exercise is another good preventive measure, especially weight-bearing exercises.”Walking and hiking will help decrease loss of, but do not build bone,” he said. “If you do bone-stressing exercises like … weight-lifting, you can build bone. If you’re walking, you still lose bone.”Contact Donna Gray: 945-8515, ext. 510dgray@postindependent.com

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