Bone Health
Osteoporosis is the most common type of metabolic bone disease which is characterized by reductions in both bone mineral and bone matrix. Therefore, the bone is of normal composition but decreased amount. Osteoporosis is not painful unless it results in a fracture. ..usually a fracture of the wrist, vertebrae, ribs, hip, pelvis or arm which can occur with such minimal activity as sneezing or bending over to make the bed. Bone density peaks in the late 20s and begins to decline in the 3rd to 5th decade in both sexes. There are many factors which could contribute to accelerated bone loss such as:
- Advancing age
- Previous fracture
- Glucocorticoid therapy
- Parental history of hip fracture
- Low body weight
- Current cigarette smoking
- Excessive alcohol consumption
- Rheumatoid arthritis
- Hypogonadism or premature menopause
- Malabsorption, chronic liver disease, inflammatory bowel disease
Many studies have demonstrated that low bone density at any site can predict osteoporotic fracture, although hip measurements are superior to spine in predicting hip as well as overall osteoporotic fracture.
Bone density is crucial to one’s good health and longevity. Test for your baseline @age 50 unless you have one of the risk factors noted above (then earlier testing may be necessary.)
If you have a normal baseline measurement. Should you be retested?
- In the presence of risk factors that may cause ongoing bone loss (eg, glucocorticoid use, hyperparathyroidism), we perform follow-up measurements approximately every one to two years, as long as the risk factor persists. We perform follow-up measurements approximately every two years in high-risk women during the first five years of menopause, when bone resorption is most prominent.
- In women with no risk factors for accelerated bone loss we will typically perform a follow-up DXA in three to five years
Dr. Kelly Cobb is a board certified internal medicine physician and a partner at Nouriche.
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