Separating Myths From Facts
Felicia Cosman, MD, professor of clinical medicine at Columbia University and clinical director of the National Osteoporosis Foundation, and Richard S. Bockman, MD, PhD, chief of endocrine service at the Hospital for Special Surgery and professor of medicine at Weill Cornell Medical College, all in New York, separate osteoporosis facts from fiction. Here's what they had to say.
You'll know you have osteoporosis because of the pain you feel in your bones.
Myth: Ironically, the onset of osteoporosis is one thing you can't feel in your bones. Throughout life, your bones are continually dissolving and rebuilding; they reach peak strength in early adulthood. It's common to begin losing bone at midlife, when the rate of bone breakdown starts to exceed the rate at which bones are rebuilt. During this time, we may still look and feel just fine—until an unexpected fracture or loss of height serves as a wake-up call that something's amiss. Fortunately, doctors now can rely on bone density scanning as a highly reliable tool to predict who's likely to develop osteoporosis, so risk-reducing treatments can be administered early for best results.
Only old people need to worry about osteoporosis.
Myth: Although bone fracture and height loss usually appear in later life, 80% of osteoporosis risk is genetically based. Because of this, it's never too early to adopt a "bone-building" lifestyle, especially if you have a family history of osteoporosis. To keep your bones as healthy as possible, consume enough calcium, get sufficient vitamin D through diet and sun exposure, exercise frequently, and avoid smoking and excessive alcohol consumption.
Osteoporosis isn't as serious as other conditions, such as heart disease and cancer.
Myth: Osteoporosis can be deadly. Low-impact fractures (those that result from very little trauma) can trigger a cascade of health problems, including neurological, cardiovascular and even psychological conditions. Pain and diminished mobility resulting from fractures and their consequences can markedly reduce a person's quality of life. Only 15% of elderly hip-fracture victims resume their previous levels of mobility and independence; worse yet, many die within a year.
Men don't get osteoporosis.
Myth: Men's bones generally are stronger and less susceptible to fracture than women's bones. But for every four women with osteoporosis, there's one man with the disease. Male osteoporosis often flies under the radar because, unlike women, men don't face a dramatic estrogen drop due to menopause. In women, a drop in estrogen can result in rapid bone loss. But low levels of testosterone—and estrogen—can make older men vulnerable to fractures, as well.
Everyone is equally at risk for osteoporosis as they age.
Myth: Risk is especially high in slender, fair-skinned Caucasians. Risks are also greater in women with lower lifetime estrogen exposure due to late onset of periods, cessation of menstruation due to eating disorders or early menopause. People who undergo hormone-altering treatments for certain cancers—such as breast and prostate—also can be at increased risk.
It's possible to halt or reverse bone loss.
Fact: Enormous strides in osteoporosis treatment have been made over the past 10 to 15 years. It is now possible to stop, or even reverse, bone loss. Anti-resorptive medications, including short-term hormone-replacement therapy, can help preserve existing bone mass. New agents actually can build new bone, helping to ensure that your feet will stay firmly planted on the ground for as long as possible.