Bone Density

Osteoporosis and Bone Density

Marian Community Hospital is performing bone density scans which aid in the diagnosis of osteoporosis and other degenerative and metabolic bone diseases.

Osteoporosis affects over 25 million Americans 80 percent of whom are women. Half of all American women over age 50 can expect an osteoporosis-related fracture in their lifetime. This year some 200,000 women will experience a broken hip directly related to osteoporosis.

The loss of calcium from bones can lead to osteoporosis. Osteoporosis is a disorder in which bone mass decreases due to the loss of calcium. Osteoporosis is known as a silent disease. By the time that the symptoms are detected, the disease is usually in an advanced stage. Calcium is deposited in the bones until about age 30, after which people gradually lose bone tissue. This loss accelerates in women after menopause because they produce less estrogen, the main hormone that keeps bones strong. Years of low calcium, combined with other risk factors, result in bones that are brittle weak, and easily fracture.

While there is no cure for osteoporosis, it is important that women receive accurate diagnosis of bone density. To give the people of our service area that assurance, Marian Community Hospital has acquired the Toshiba Bone Density Scanning System. This advance technology software package is what we believe will provide the most accurate solution in the tracking or management of degenerative and metabolic bone diseases, such as osteoporosis.

By incorporating the principles of CT scanning to measure bone density against an established standard, the software is able to provide a complete data analysis in less than four minutes. The procedure is both painless and simple. One merely lies on the scanner bed and is carried through the filming area of the scanner.

Osteoporosis is too serious to go unchecked, discuss your concerns with your family physician, and ask about the Bone Density Scan at Marian Community Hospital. For more information or to schedule a Bone Density Scan, call the Radiology Department at 281-1092.

Medicare covers bone-mass measurement for beneficiaries at risk for osteoporosis and other bone abnormalities.

Calcium -- Key to Osteoporosis Prevention
As an essential nutrient, calcium contributes to a variety of life-sustaining processes: bone mineralization, blood clotting, muscle contraction including beating of the heart, nerve cell transmission and enzyme activity. Yet it's calcium's role in building strong bones and reducing the risk of osteoporosis that has won its claim to fame.

Not surprisingly, children's calcium needs are among the highest of any age group. Yet from the latest National Health and Nutrition Examination survey (NHANES III) and other sources show that more than half of all U.S. children fail to meet recommended calcium intake levels. Such deficits, the panel noted, not only impair youngsters' abilities to reach peak bone mass, but also increase their risk of skeletal fractures both now and later in life.

It is acknowledged that optimal calcium intake during these critical years of bone development may reduce the risk of fractures due to osteoporosis when these children get older. Optimal calcium intake may be achieved through diet, calcium-fortified foods, calcium supplements or various combinations of these, the panel concluded.

Development of osteoporosis is influenced primarily by two factors: peak bone density or bone mass, which is attained by about age 30 to 35, and the rate at which bone is lost in later life.

The peak adult bone mass is determined in each person by endogenous factors such as genetics and environmental factors such as diet and exercise. While genetics contributes to most variance in bone mass, nutrition plays a key role in one's ability to reach genetically determined peak bone mass. Also critical is calcium's role in preserving bone mass, especially in those over the age of 60.

Although the exact cause is unknown, calcium absorption decreases with aging. Thus the elderly require more calcium, whereas virtually all surveys indicate that they are ingesting less (than recommended levels).

Other risk factors associated with osteoporosis include family history of the disease, being Caucasian or Asian, inactivity, smoking, excessive alcohol intake, having a slight frame and estrogen deficiency.

Examples:
Yogurt, low-fat plain, 1 cup, calcium (milligrams) 415

Milk, 2% low-fat, 1 cup, calcium (milligrams) 313

Cheese, cheddar, low-fat, 1 oz., calcium (milligrams) 300

Optimal Calcium Intake
Age/Gender	NIH Recommendations	Current RDAs
Birth-1 yr	400-600 mg	400-600mg
1-5 yrs	800 mg	800 mg
6-10 yrs	800-1200 mg	1200 mg
11-24 yrs	1200-1500 mg	1200 mg
Females, 25-49 yrs	1000 mg	800 mg
Females, pregnant/nursing	1200-1500 mg	1200 mg
Females, postmenopausal, 50-65 yrs: On estrogen replacement therapy	1000 mg	800 mg
Not on estrogen replacement therapy	1500 mg	800 mg
Males, 25 - 64 yrs	1000 mg	800 mg
Males/females, 65+	1500 mg	800 mg

Osteoporosis Not Just for Women, Men May be Affected As Well
Osteoporosis, the bone thinning disease that leads to painful, debilitating bone fractures, affects five million American men. While there has been increased national recognition of osteoporosis as a major women's health problem, the impact of this disease on men has been under-diagnosed, underreported, and inadequately researched.

Chronic diseases that affect the kidneys, lungs, stomach, thyroid, parathyroid glands and intestines, or alter hormone levels could increase a person's risk factor for osteoporosis. Prolonged exposure to certain medications, such as steroids used to treat asthma, arthritis or other diseases, anticonvulsants, certain cancer treatments and certain types of malignancies, and aluminum-containing antacids also increase one's risk.

Osteoporosis can be prevented and effectively treated if it is detected before significant bone loss occurs. With Marian Community's Bone Density Scanning System, an individual's bone density can be precisely measured, predicting risk for future fractures. For more information or to schedule a Bone Density Scan, call the Radiology Department at 281-1092.

Osteoporosis Self Assessment for Men and Women
If you answer yes to several of these risk factors, you may be at an increased risk for developing osteoporosis.

• Do you have a family history of osteoporosis?
• Are you Caucasian or Asian? (Note that studies show that Africa Americans and Hispanic Americans are also at risk.)
• Do you smoke?
• Do you regularly take steroids, seizure medication, large amounts of thyroid hormone or any medications known to interfere with calcium absorption?
• Do you do weight-bearing exercise less than 3 times a week?
• Have you had extended periods of immobilization or bed rest?
• Are you a heavy drinker of alcoholic beverages?
• Do you have or have you had a low intake of calcium?
• Are you thin and /or have a small frame?
• Do you have an eating disorder?
• Did you have a late onset of menstruation (after age 16)?
• Did you have an early onset of menopause (before age 45), either naturally or due to surgery?
• Have you had an absence of menstrual periods for an extended time?
• Are you post menopausal, and not taking estrogen?
   

What Helps in Preventing Osteoporosis?
1. Eating calcium rich foods. Combine with a good intake of Vitamin D which helps the body absorb and use calcium.

2. Stimulating bones by doing weight-bearing exercise (i.e., walking, dancing, golfing, tennis) for 30 minutes at least 3 times per week.

3. Limiting intake of alcoholic beverages.

4. Avoiding excessive intake of protein.

5. Quitting smoking.

6. Considering hormone replacement therapy and some of the new bone health medications. Discuss treatment options with your doctor.

Indications for Bone Density Scans
1. Premenopausal women with high risks.

• Surgical menopause
• Absence of menses (especially associated with extensive exercise)
• Anorexia nervosa

2. Males with one or more major risk factors.

• Low pooled testosterone
• Alcohol abuse
• Osteoporosis on radiograph
• Fracture with minor trauma

3. Prolonged immobilization.
4. High suspicion of poor calcium intake.

• Excess of calcium in the urine.
• Gastrointestinal diseases.

5. Rheumatoid arthritis.
6. Beginning of chronic corticosteroid medication.
7. Anticonvulsant therapy with Dilantin or Phenobarbital.
8. Kidney disease.
9. Evidence of decalcification of the bones.
10. Evidence of hyperparathyroidism.
11. Prolonged use of excessive thyroid replacement.
12. Evaluation and monitoring of treatment program for osteoporosis.

• Estrogen or estrogen/progesterone
• Testosterone replacement
• Calcitonin therapy
• Pharmacological amounts of Vitamin D with calcium.
• Diphosphonate therapy

• Fluoride therapy
• Anabolic steroid therapy

13. Postmenopausal women with two or more major risk factors.

• Positive family history
• Loss of height over one inch
• Lifelong low calcium intake
• Previous fracture in adult years
• Evidence of osteopenia on plain radiograph
• Intolerance for estrogen therapy