Exerciseinclude weight bearing and resistance
exercises; walking helps the lower spine, hips,
and legs; hand weights help the arms; overhead
weights help the shoulders and upper spine)
Do not smoke
Limit intake of salt, caffeine, soda, and alcohol;
instead drink calcium-rich milk or calcium-forti-
fied juice
Prevent fallsuse nightlights in case you need
to get up at night, clear hallways and stairs, re-
move cords and wires from walking paths, use
nonskid mats in showers/tubs, remove scatter
and throw rugs, and clear ice and snow from
walking paths
Take medicine to avoid more bone loss exactly as
your clinician recommends.
Should I be treated for bone loss?
If your T-score is in the osteoporosis range (2.5
or lower) most clinicians will recommend treat-
ment. If your T-score is in the osteopenia range
(1.0 to 2.5) then using the WHO FRAX Tool might
be helpful. This tool was made to help decide when
medicine for osteopenia should be started. Infor-
mation about 11 risk factors and your raw bone
density are entered into an online site. The tool
calculates your 10-year risk for breaking your hip
or having any major fractured bone from osteo-
porosis. Your clinician can use this information
together with your health history, physical exam,
and lab test results to decide if medication is good
for you.
Osteoporosis is a bone disease that causes loss of
strength and density, making bones likely to break
(or fracture). It is sometimes called a silent dis-
ease because most people do not know they have
it until they have a fracture.
Bone tissue is always involved in a normal
process called bone turnover. This process allows
old bone tissue to be broken down and new bone
tissue to be made. In children, new bone forms
faster than old bone is broken down. In adults,
the reverse is true, old bone is broken down faster
than new bone is formed. After women experience
menopause and as men age, the activity of the
cells that break down old bone start to exceed the
activity of the cells that build new bone. Over
time, this imbalance in turnover forms tiny holes
GuidetoCare
for patients
Osteoporosis
F
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d
H
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Normal bone
Osteoporosis
This teaching aid may be photocopied by healthcare
professionals for use in their clinical practice.
Attach your business card here,
then copy.
Should I get a bone density test?
The National Osteoporosis Foundation recommends
you have a bone density test if you:
are a woman age 65 or over or a man age 70 or
over
are a postmenopausal woman under age 65 or a
man age 50 to 69 and have risk factors for bone
loss
are a perimenopausal woman and have specific
risks for fracture (weigh under 127 lbs, take
medicine that is linked with bone loss, and so on)
have had a fractured bone at the age 50 or over
are taking medicine or have health problems
that raise your risk for bone loss (for example,
asthma, corticosteroid use, and so on)
are thinking about taking medicine for osteo-
porosis
are a postmenopausal woman who is stopping
estrogen or hormone therapy
What do the results mean?
DXA test results include T-scores, which compare
your bone density with the bone density of young
adults of your same sex, and Z-scores, which com-
pare your bone density with the bone density of
others of your same age and sex.
T-scores and Z-scores are reported as having a
positive or negative rating, with zero considered
normal. The World Health Organization has classified
T-scores of 1.0 and above as normal, of 1.0 to
2.5 as osteopenia or bone loss, and of 2.5 and
lower as osteoporosis.
What can I do to prevent bone loss?
There are several things you can do to help im-
prove your bone strength:
Calciumeat calcium rich foods (dairy, calcium
fortified grains) and use supplements to get at
least 1,200 mg/day
Vitamin Duse supplements to get 800 to
1,000 international units per day
in bone tissue, leaving it
fragile and easy to break.
What is osteopenia?
Osteopenia is similar to os-
teoporosis. With osteopenia,
some bone strength and
density is lost, but not as
much as when a person has
osteoporosis. Osteopenia is
called bone loss rather
than osteopenia by some
clinicians. This is because
not everyone agrees about exactly how to treat
bone loss that is not at the level of osteoporosis.
It is best to keep your bones as strong as possi-
ble. Some ways to help prevent bone loss are
listed below.
Why is it important to know if I have bone loss?
People with bone loss are at high risk for having a
fractured bone. Fractured bones can cause pain,
depression, isolation (especially if it gets hard to
move around), and even death. It is important to
know if you have bone loss so that you can change
your diet or activity level, as well as take medicine
to help increase your bone mass.
How will I know?
A bone density test is often prescribed to mea-
sure bone loss. The most common test is called
a Dual Energy X-ray Absorptiometry test, or a
DXA test. This test is painless and takes about
15 minutes to complete. You lie on a table similar
to an X-ray table and the bone density machine
moves over your spine and hip areas to read your
bone density. A report is sent to your clinician
with your bone density levels.
On the day of your test, wear loose, comfort-
able clothes and avoid clothing with metal zip-
pers or clasps, underwire bra, or metal jewelry.
Do not take calcium supplements 24 hours prior
to the test. You should not have a DXA test if you
are pregnant or have had a contrast dye study
in the past 2 weeks. Most DXA machines can
only accommodate people who weigh under
250 pounds.
Your clinician will also talk with you and exam-
ine you to see if there are any signs of health
problems that might cause bone loss. If any are
found, they may be able to be treated to reduce
effects on your bones.
F
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Peak bone strength
Normal
strong bones
Bone
Resorption
MENOPAUSE
Age in years
20 30 40 50 60 70 80 90
B
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t
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t
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How much
calcium do I need?
Children
800 mg (4-8 years)
Teenagers
1,300 mg (9-18 years)
Adults
1,000 mg (19-50 years)
Adults
1,200 mg (51 or older)
Women
1,300 mg (14-18 years)
(pregnant or nursing)
Women
1,000 mg (19-50 years)
(pregnant or nursing)