Osteoporosis and Bone Density: Who Needs the Screening?
A bone density test determines if you have osteoporosis — a disorder characterized by bones that are more fragile and more likely to break.
What Is Osteoporosis?
Osteoporosis is a disease that weakens and thins the bones. Individuals with osteoporosis notice that, over time, their bones become fragile and can fracture or break easily. Osteoporosis can affect bones throughout your entire body, but people most often notice the weakness in bones in the hip, spine and wrists.
Osteoporosis is often described as a “silent disease.” This means many people may not even know they have it until after they have broken a bone.
There are no symptoms during the early stages of osteoporosis. Usually, people do not notice the effects of bone loss until far after the process begins. However, once your bones have been weakened by osteoporosis, you may see signs such as:
- Loss of height over time
- Stooped posture
- Bone fractures or bones that break much easier than expected
- Pain in the lower back
- Shortness of breath
How Is Osteoporosis Diagnosed?
Many people do not realize they have osteoporosis until after the damage to their bones has been done. This can be incredibly dangerous because, at this point, your bones have likely been considerably weakened.
But the good news is that you do not have to wait until you’ve broken a bone to know if you have osteoporosis. Instead, you can get a bone density test or screening to determine your bones’ strength. This test will tell you whether or not you have osteoporosis.
How Do Bone Density Screenings Work?
A bone density test, or dual X-ray absorptiometry or DEXA scan, measures bone density by passing high and low-energy X-ray beams through the body. These scans will usually be performed on the hip and spine.
This scan is used to diagnose osteoporosis and track changes in bone density. DEXA scans use a similar amount of radiation as a standard X-ray and can be repeated over time to track any changes to your bone health.
To perform the scan, you will be asked to lie on a cushioned table so that the images of your bones can be taken. You will be instructed to lie still during the imaging process, and the procedure usually takes around 15-20 minutes. Once the images have been taken and reviewed by a radiology specialist, you will receive your results. These results will include a T-score which tells you how strong your bones are and whether or not you have osteoporosis.
Who Is at Risk for Osteoporosis?
Unfortunately, everyone is at risk for osteoporosis, especially as we age. It can affect men and women of all races. However, white and Asian women—especially those older and past menopause—are at the highest risk of osteoporosis.
Additionally, certain factors can increase your risk of developing osteoporosis. These factors can be organized into six categories— uncontrollable factors, hormonal changes, dietary problems, medications, medical conditions and lifestyle choices.
Some of the risk factors for osteoporosis are factors out of your control. Examples of these factors include:
Sex – Women are much more likely to develop osteoporosis than men. Women have smaller bones and a lower peak bone mass than men, which makes osteoporosis more common in women.
Age – As you age, new bone growth slows, and bone loss happens more quickly. This can weaken your bones over time and increase your risk for osteoporosis.
Body size – People with petite or slim body types (both men and women) are at a higher risk for osteoporosis because they have a smaller overall bone mass than larger people.
Race – White and Asian women have the highest risk of osteoporosis, whereas African American and Mexican American women have a lower risk. When it comes to men, white men are at a higher risk than African American or Mexican American men.
Family history – If one of your parents has a history of osteoporosis or hip fracturing, your risk is higher for developing osteoporosis.
Too much or too little of certain hormones can also increase your risk of osteoporosis.
- Thyroid problems – Too much thyroid hormone can lead to bone loss. If you have an overactive thyroid or are taking medication for an underactive thyroid, you are at higher risk for osteoporosis.
- Sex hormones – Too little estrogen or testosterone can increase your risk of osteoporosis. Because of this, women who have experienced a drop in estrogen levels due to menopause are oftentimes at the highest risk for osteoporosis. Additionally, treatments for cancer that decrease estrogen or testosterone levels can increase your risk for osteoporosis.
The risk of developing osteoporosis is higher in individuals with:
- Eating disorders – Being underweight and having severe restrictions on food intake can weaken the bones in both men and women.
- A low calcium, vitamin D, and protein intake – Lifelong lack of calcium, vitamin D, and protein can dramatically weaken the bones and lead to lower bone density.
- Gastrointestinal surgery – Surgery that reduces the overall surface area in your stomach or intestines can affect your ability to absorb nutrients — such as calcium and vitamin D. This can lead to insufficient nutrients in your diet to combat the natural loss in bone density that happens as we age.
There are several medications that can increase your risk of developing osteoporosis. Some of these are:
- Antiepileptic medications – these are usually used to treat seizures and neurological disorder
- Cancer medications that use hormones
- Proton pump inhibitors – these lower stomach acid
The risk of developing osteoporosis is also higher in individuals with certain medical problems, such as:
- Celiac disease
- Inflammatory bowel disease
- Kidney or liver disease
- Blood diseases, such as multiple myeloma
- Rheumatoid arthritis
Your lifestyle habits can also impact your risk for osteoporosis. Some habits that can increase your risk are:
- Low physical activity levels – Individuals who spend a lot of time sitting are at a higher risk of osteoporosis.
- Tobacco use
- Excessive alcohol use – Regularly consuming more than two alcoholic beverages daily can increase your risk of osteoporosis.
What Can You Do to Protect Yourself?
There are three primary ways to protect yourself when it comes to osteoporosis. These are promoting healthy eating habits, exercising regularly, and getting bone density screenings.
What we eat can play a tremendous role in the health of our bodies — and by extension, our bones. To reduce your risk for osteoporosis, you will want to adopt a diet that is high in calcium and vitamin D. For a breakdown of how much calcium and vitamin D you should be consuming per age, check out this article from the Cleveland Clinic.
- Foods that are high in calcium include:
- Dairy products
- Salmon and sardines
- Kale and broccoli
- Dried figs
- Calcium-fortified drinks
Unfortunately, other than vitamin-D-fortified milk, there are not really foods that are high in this vitamin. But, you can get vitamin D from getting exposure to sunlight a few times a week or taking a supplement.
Also, be sure to limit your intake of alcohol and caffeine.
Any exercise that makes your muscles work against gravity is a great option. This could be walking, jogging, weightlifting, or aerobics. These types of activities are going to be the best for your bones and therefore help you best reduce your risk of developing osteoporosis.
You do not have to exercise rigorously, though you can if you want to. The goal is to just try to be more active throughout the day.
Get Bone Density Screenings
As we mentioned, many people don’t know they have osteoporosis until something goes wrong. So do not wait for a bone to break before getting a screening.
Individuals at higher risk may want to consider getting a screening even if they are young.
Where to Start
If you are at risk for developing osteoporosis, you may want to consider talking to your doctor about getting a bone density screening.
Even if your scan comes back negative for osteoporosis, it is crucial to maintain a healthy and active lifestyle that keeps your risk of developing this bone-weakening disease as low as possible. This is especially true if you are at a higher risk from any uncontrollable factors mentioned above. If you are an older adult, check out this list of essential health screenings you may want to ask your doctor for this year.
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