It’s common to think of your bones as solid and unchanging, but they’re made up of living tissue in constant flux.
Consider: Each year, 15% of your spine and 5% of your hips are replaced with new bone through a process called remodeling. Every 10 years, your entire skeleton will be rebuilt.
With aging and some chronic diseases, however, you can gradually lose bone faster than it is replaced, increasing your risk of low bone density and osteoporosis, which can lead to hip, spine and wrist fractures.
But the good news? Osteoporosis is preventable and treatable. We spoke with Dr. Paula Rackoff, a rheumatologist at NYU Langone and clinical associate professor in the Department of Medicine at NYU’s Grossman School of Medicine, on steps you can take to keep your bones strong for a lifetime.
Who should worry about osteoporosis?
Bone health should be on everyone’s radar, especially in middle age and beyond. About 10.2 million people age 50 and older have osteoporosis, and about 43.3 million more people have low bone mass, which puts you at high risk for osteoporosis.
Perimenopausal and menopausal women are particularly at risk due to the natural decline in estrogen levels. Estrogen is a key hormone in the bone remodeling process. When estrogen levels fluctuate during perimenopause and then decline after menopause, bone loss accelerates.
People with hormonal disorders, such as hyperthyroidism and hyperparathyroidism, as well as the endocrine condition Cushing’s syndrome also have a greater chance of developing osteoporosis.
But anyone who has a condition that is rooted in chronic inflammation is at increased risk for osteoporosis and should also be screened. These conditions include multiple sclerosis, Parkinson’s disease, rheumatoid and psoriatic arthritis, inflammatory bowel disease, chronic lung disease and skin conditions such as severe eczema and autoimmune skin diseases such as psoriasis.
Why is it so important to pay attention to bone health?
It’s important because your skeletal integrity often determines the quality of your life in your 70s, 80s, and 90s. We are seeing more and more people surviving strokes and even more than one cancer diagnosis. But once you start breaking bones, it can really affect your quality of life because it has the potential to make you lose your independence.
What is the link between chronic inflammation and osteoporosis?
Treatment for inflammatory diseases, such as long-term use of corticosteroid medications or certain anticonvulsant medications, can accelerate bone loss. But the inflammatory process itself can lead to bone loss, even before treatment begins.
Inflammatory diseases can potentially affect bone health because they produce an abundance of pro-inflammatory cytokines. These small proteins produced by the immune system increase the rate of bone resorbing cells, which break down bone through the remodeling process.
How is the bone examination?
A dual energy X-ray absorptiometry (DEXA) scan is the gold standard for osteoporosis and low bone mass screening and diagnosis. It is a painless, low-dose X-ray, generally of the hip and spine, to assess bone mineral content that only takes about 20 minutes. A DEXA scan provides a T score, which is compared to the average bone density in a young, healthy male or female adult of the same race or ethnicity.
A bone density test is recommended for:
- Women 65 and older
- Men 70 years and older
- Anyone who has broken a bone after 50
- Women 50 to 64 years of age with risk factors
- Men 50 to 69 years of age with risk factors
Risk factors may include long-term use of steroid medications, such as prednisone, having an inflammatory condition, or a family history of osteoporosis. Your doctor will consider your T score along with your risk factors to determine if you need treatment.
Anyone who is at increased risk of falling should also have a bone density scan, such as those with Parkinson’s disease or other chronic conditions that affect your ability to be physically active. Anything that causes immobility increases the risk of osteoporosis.
What happens if I am diagnosed with osteoporosis or low bone density?
The good news is that there are many treatments that can slow bone loss to increase bone density and improve bone strength and quality. If you have osteoporosis or low bone density, start treatment right away. Now there are so many options.
The NYU Langone Osteoporosis Center, located at NYU Langone Orthopedic Hospital, specializes in the diagnosis and treatment of osteoporosis, providing comprehensive support during diagnosis, initial treatment and beyond. The center gives patients access to physiotherapists, psychologists, exercise experts and social workers after a comprehensive assessment and state-of-the-art bone mineral density testing to measure bone strength.
Any other strategies for strong bones?
yes. Be sure to focus on balance training to reduce the risk of falls and weight-bearing exercises, which can help maintain bone mass and slow bone loss at any age. The force exerted on the bones during strength training stimulates bone-forming cells to build more bone, making the bones denser and stronger.
If you can get in two strength training sessions per week as recommended by the CDC, that’s great, but more can be even better. Evidence shows that if you exercise aggressively six days a week, you can maintain bone density without medication.
Dr. Paula Rackoff is a rheumatologist at NYU Langone and clinical associate professor in the Department of Medicine at the NYU Grossman School of Medicine. She works closely with Dr. Nicole Leung and Eileen Lydon, NP as part of our Osteoporosis and Bone Health Program.
#Doctor #shares #bones #strong #life
Image Source : nypost.com