written by Dr. Kara Menzer
Are you thinking about your bone density?
You should be, and here’s why:
Healthy bones are strong bones! When bones lose density, they become fragile and can break. Underneath a microscope, bones with osteoporosis have holes like a honeycomb. Fractures from osteoporosis are a leading cause of disability and can even be life-threatening (1). No one wants a hip fracture!
Though osteoporosis most commonly affects individuals over age 50, building and protecting our bones is a critical part of preventative medicine at every year of life. Childhood, adolescence, and early adulthood are the times we rapidly grow new bone. Most people will reach their peak bone mass between the ages of 25 and 30. By the time we reach age 40, we slowly begin to lose bone mass. At older ages, it is imperative we protect the bone mass we have, slow progression of bone loss, and continue supporting new bone growth.
How much bone mass we have in later life is directly determined by how much bone we build when we’re young.
How common is low bone density?
Low bone density is very common — approximately 50% of women over age 50 have low bone density and 18% have osteoporosis. Approximately 18% of men over age 50 have low bone density, and 2% have osteoporosis (2).
How do I know if I have low bone density?
Osteoporosis is considered a “silent” disease because generally a person has no symptoms, even with severe osteoporosis, unless there is a fracture. Preventing or slowing progression of bone loss at every stage of life is important.
Bone density is tested with a special X-ray test called Dual X-ray Absorptiometry (DEXA). Guidelines from multiple organizations, including the National Osteoporosis Foundation (NOF), recommend beginning DEXA screening for osteoporosis at age 65 in women and men at age 70 with no risk factors (3). However, many younger individuals are at increased risk of low bone density, and it may be recommended to start screening earlier depending on personal risk.
Who is at increased risk for low bone density?
Low estrogen: When estrogen production declines or is blocked, such as with menopause, after a surgery that removes the ovaries, taking certain anti-estrogen medications or having premature ovarian failure, the risk of osteoporosis dramatically increases
Low testosterone: New research shows that low testosterone levels are strongly associated with low bone density even in relatively young men (4).
Other Endocrinology (hormone) disorders: Hyperthyroidism, hypogonadism (low production of testosterone, estradiol and/or progesterone), hyperparathyroidism, diabetes mellitus (type 1 or type 2), growth hormone deficiency
Malabsorption disorders: Celiac disease, inflammatory bowel disease like Crohn’s disease and ulcerative colitis, gastrointestinal surgeries including gastric bypass surgeries.
Autoimmune disease: Such as systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis
Low mineral intake or absorption: Calcium deficiency, vitamin D deficiency, eating disorders
Tobacco use and alcoholism are both risk factors for osteoporosis.
Family history: Having a parent or sibling with osteoporosis puts you at greater risk, especially if your mother or father fractured a hip.
Heavy metal exposure: Toxic metals accumulate in our bodies’ bones and can also disrupt the hormones needed for bone health. Lead and cadmium are particularly known for causing osteoporosis (5).
Medication side effects: Many medications can affect bone density including corticosteroid medications such as prednisone and proton pump inhibitors such as omeprazole.
What can I do to naturally protect my bones?