I am the director of the Osteoporosis Program at the University of Vermont Medical Center. So, I am honored and excited to bring awareness to this important issue in our community. Unfortunately, fractures are quite common.
Fractures: On the Rise in the United States
Estimates in the U.S. are that for women over age 50, 1 out of every two women will sustain a fracture. Men are also at risk with 1 out of every four men developing a fracture in their lifetime. Once someone has a fracture, their risk for future fractures becomes higher. Fractures can cause not only pain and loss of mobility but can also result in loss of independence and possibly an increased risk for death. The goal is to prevent fractures before they happen to maintain good health.
Osteoporosis: How to “Bone Up” on Bone Health
Receiving adequate amounts of calcium and vitamin D daily between diet and supplements is vital. The goal for daily calcium intake is around 1200 mg from all sources, diet and supplements. It is better for absorption to obtain calcium from diet rather than supplements. Daily intake should not exceed 2000 mg daily as this could cause issues such as kidney stones. Vitamin D is more difficult to obtain from food and many people need supplements. We receive some vitamin D from the sun, but also need to practice skin safety. One should aim for 1200 units of vitamin D daily. Some people need more if they have low vitamin D levels.
Protein is also needed for building muscle strength.
Performing regular weight bearing activity along with practicing fall prevention is of great importance.
Avoiding tobacco, excessive amounts of alcohol and medications that can cause bone loss are also measures of great value. Prednisone can cause significant bone loss and an increase in fracture risk. People who will be on prednisone long-term — three months or more — should discuss bone health regularly with their providers.
Despite all of this advice, many people still have low bone density and remain at an increased risk of fracture.
Osteoporosis: How We Treat it at the UVM Medical Center
We have the most medications that we’ve ever had to treat osteoporosis and to prevent fracture. Sadly, many people fear very rare side effects and decline effective treatments. By choosing not to take a medication, people put themselves at risk for fractures and potentially serious consequences.
I completely understand not wanting to take a medication if not needed. With osteoporosis, a person cannot feel bone loss, and therefore feel well, until they break something. My hope is to inspire people to become proactive about their bone health and overall well-being.
Any medication, prescription or over the counter, should be considered in terms of potential risks and benefits in regards to whether or not to take it.
Throughout the month, I plan to review the different medications that we have available to prevent fractures along with their possible risks and benefits. Hopefully this may lead to helping people feeling empowered in their quest for good bone health.
Jennifer J. Kelly, DO, is an endocrinologist and director of the Metabolic Bone Program and the Osteoporosis Program at the University of Vermont Medical Center. She is also an associate professor at the Larner College of Medicine at UVM.