The National Osteoporosis Foundation (NOF) recently issued specific guidelines for managing and preventing this potentially crippling disease. Developed in collaboration with ten multidisciplinary medical organizations, the Physician’s Guide to Prevention and Treatment of Osteoporosis includes recommendations on treatment, based on bone mineral density (BMD) tests, in combination with other risk factors.
The NOF recognizes many women are developing osteoporosis without being diagnosed or treated. Only 29% of American women with Osteoporosis are properly diagnosed. Only 14% of women with Osteoporosis receive treatment. With an abundance of new clinical trial results and with an increasing number of treatment options, the NOF has made an important step in aiding physicians’ fight against osteoporosis, a disease that costs the United States nearly $14 billion each year.
Prevention
The NOF recommends all adults consume 1200 mg of calcium and 400 to 800 IU of vitamin D daily, perform weight-bearing exercise regularly, and avoid abuse of tobacco and alcohol.
Treatment
Along with a thorough medical history, the results of the BMD tests (expressed in a T-score) help physicians determine a proper course of therapy to help reduce fracture risk and prevent further bone loss. Each standard deviation represents a 10-12% bone loss and a T-score (via central DXA) of –2.5 indicates Osteoporosis. NOF guidelines conclude that women with no risk factors should begin therapy if their T-score is –2 or below and women with one or more risk factors should begin therapy if their score is –1.5 or below.
About the NOF
With more than 200,000 members, the NOF is the only nonprofit, voluntary health organization dedicated to reducing the proliferation of osteoporosis through programs of research, education and advocacy. To obtain a copy of the Physician’s Guide to Prevention and Treatment of Osteoporosis, call or write the National Osteoporosis Foundation, Professional Education Order Fulfillment, 1150 17th Street, NW, Suite 500, Washington, DC 20036-4603, Fax: 202/223-2237.
What Is a Bone Density Test?
A Bone Density Test is a way to help your doctor measure the health of your bones. It may also be sued to monitor your rate of bone loss and response to therapy.
Who Should Have A BMD Test
The National Osteoporosis Foundation (NOF) recommends Bone Density Testing for all women under the age of 65 who have one or more risk factors for osteoporosis, not including menopause. The NOF also recommends Bone Density Testing for all women over age 65.
• Women who are 65 and older, regardless of other risk factors.
• Postmenopausal women with one or more risk factors.
• All postmenopausal women who have a fracture.
If you are over age 65 and you qualify, the cost of your Bone Density Test may be covered by Medicare. Ask your doctor if a Bone Density Test is right for you.
Why Is It Important to Get Tested?
Bone Density Testing is the most accurate way to assess bone health. Early diagnosis can make a difference in your life.
How Is Testing Done?
Some tests use sound waves. Others use small amounts of radiation to determine the thickness or density of bones. Bone Density Tests are safe, painless and noninvasive. In many cases, you don’t even need to undress. And most tests take just a few minutes.
What Do the Results Mean?
Test results, known as T-scores (which measure bone strength), compare your bone density with that of normal young adult women. Normal bones are healthy and strong. Bones weakened by osteoporosis have become thin, making them more likely to break.
If your T-score is –1.5 or less, you may benefit from therapy. The NOF recommends treatment for women with the following t-scores:
Below –2.0 in the absence of other risk factors.
Below –1.5 with other risk factors present.
Getting Treatment
Talk to your doctor about your T-score and your need for treatments that help build bone and prevent broken bones due to osteoporosis.
Bones Change As You Age
Throughout your life, your body loses bone. New bone grows to replace this lost bone, but the rate of new bone growth changes as you age. When you are young, the amount of bone formed is greater than the amount of bone lost. As you grow older and reach menopause, however, your body is less able to stay ahead of bone loss. Your bones can then become weak and brittle.
During Childhood
Children’s bones grow quickly and most reach their full length during teenage years. During this time of rapid growth, you can help build strong bones by eating calcium-rich foods and getting plenty of exercise.
Young Adults
When you’re a young adult, your bones thicken. They reach their “peak bone mass” between the ages of 25 and 35. Bones are strongest at their peak bone mass. You can help maximize your peak bone mass by being physically active and getting enough calcium and vitamin D.
Age 35 to Menopause
From about age 35 to menopause, bone mass slowly declines. And gradually, your body starts to lose more bone than it makes. To help minimize bone loss and protect your bones, be sure to exercise and get adequate amounts of calcium and vitamin D.
At Menopause
The female hormone called estrogen helps women maintain bone strength. But at menopause, your supply of estrogen decreases. As estrogen levels decline, you lose bone much faster during the early postmenopausal years. Your bones may become thinner and weaker. Talk to your doctor about what you can do to prevent bone loss.
Later in Life
After the early postmenopausal years, the rate of bone loss slows. But your body may still be losing bone faster than it is being replaced. Once too much bone is lost, you have osteoporosis and are at increased risk for breaking a bone (fracture). That’s why it’s important to have a Bone Density Test. And if appropriate, ask your doctor about medications that can treat or prevent osteoporosis.
Please note that although exercise, calcium and vitamin D are important, they may not be enough to stop bone loss, especially in the menopausal years. Talk to your health care provider about ways to protect your bones.
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