07/28/2022 by Dr. Goldi Jacques-Maynes
Don't Accept Osteoporosis as Inevitable
We're all familiar with stories about the old woman who falls and breaks her hip. What we're less familiar with are the devastating results of that hip-breaking fall.
If a woman aged 65 years or older is living independently and breaks her hip, one year later she has a:
- 50% chance of being unable to live independently
- 40% chance of being unable to walk independently
- 30% chance of no longer being able to get in and out of a bath
- 17% chance of death within the year
Anyone who's getting older—a.k.a. YOU—should be concerned about the effects of osteoporosis.
Why don’t we don’t take bone health as seriously as we take heart disease and breast cancer?
Did you know that the lifetime risk for breast cancer is 15% and the lifetime risk for hip fracture is 17%? Yet, statistically, women are more likely to get a mammogram than a screening for bone loss.
Did you also know that fractures from osteoporosis and low bone mass lead to as many hospitalizations as strokes and heart attacks?
The societal acceptance of osteoporosis makes me so mad!
Fractures from osteoporosis can be life-altering—causing pain, disability and loss of independence. But it doesn’t have to be this way.
There is a lot we can do to prevent the effects of osteoporosis. But as a society we expect old people to become frail. Why do we allow our beloved elders to suffer when there are preventative therapies and treatments for osteoporosis?
What exactly is osteoporosis?
The word osteoporosis means porous bone. Having osteoporosis means that you have less bone mass and less bone strength, making your bones weak and fragile. It’s a disease that increases the risk of breaking a bone, even after a minor fall or bump.
Who gets osteoporosis?
Osteoporosis affects men and women of all ages.
Did you know that your entire skeleton is replaced approximately every 10 years until your late 20’s? Bone is constantly remodeled: it’s reabsorbed and new bone is produced. Up until your late 20’s, you are increasing your peak bone mass. Then the bone loss begins.
After about 29 years of age, a woman reaches her peak bone mass and the balance tips in favor of bone loss. There is a slow and steady decline in bone mass of <0.4 percent per year.
Estrogen is a major player in bone formation. So when a woman enters the menopause transition, she could lose about 6% of her bone mass. But some women can lose a lot more!
Postmenopausal women should particularly pay attention. One of the major risk factors for osteoporosis is the decrease in estrogen that occurs with menopause.
Besides aging, what contributes to osteoporosis?
Age at menopause. An earlier menopause means more life lived after menopause, and more bone loss.
Alcohol. More than two 6 ounce glasses of wine a day is associated with an increased risk.
Anorexia Nervosa. Low body weight affects estrogen levels. When estrogen levels drop, a young woman often stops having a menstrual cycle, and that may affect her peak bone mass.
Female athletes. Athletes often have a low body weight, and low body weight affects estrogen levels. Estrogen level drops often stop the menstrual cycle, which may affect the body’s peak bone mass.
Genetics. This is the greatest contributor to bone health. If your family history includes insufficiency fractures, hip fractures, or vertebral fractures, you are at a higher risk.
Medical Conditions. Rheumatoid arthritis, type 2 diabetes, Cushing’s disease, and hyperparathyroidism.
Medications. Common medications like the contraceptive DMPA, steroids and aromatose inhibitors (medication for breast cancer).
Recreational Drugs. Heavy use of cannabis, or methamphetamines.
Nutrition. Calcium and vitamin D deficiency.
Caffeine. Caffeine may slightly reduce the amount of calcium absorbed from food. But when a postmenopausal woman is getting enough calcium from her diet, there’s no effect on bone health. It takes a combo of low calcium intake and daily consumption of three cups of coffee a day to increase bone loss.
Lack of Physical Activity. Stress on bone from weight bearing activities helps to maintain bone health. The cells that build bone, called osteoblasts, are actually stimulated by mechanical signals from exercise.
Risk of Falls. Falls to the side are very risky. Activities that work on strengthening muscles and balance are helpful to reduce falls.
Smoking. Women who smoke lose an additional 2% of bone density every 10 years after menopause.
How do calcium and vitamin D relate to bone mass?
Calcium is constantly flowing in and out of our bone as it is remodeled. Calcium is reabsorbed and new bone is produced. When the intake of calcium (thru food or supplements) isn’t enough to support remodeling, then your body will use existing bone as a source of calcium.
1000 mg of calcium a day is recommended for women under 50, 1200 mg a day for women over 50. Dietary sources of calcium include: dairy, almond milk, sardines, tofu, canned salmon with bones, turnip greens, chia seeds, kale, bok choi and figs.
Vitamin D helps with calcium absorption from the intestine. It's also important for muscle health. Strong muscles support bone remodeling. And weak muscle can contribute to falls.
600-1000 IU a day of vitamin D are recommended. Vitamin D3 and vitamin D2 are both converted to calcitriol in the liver. You can get vitamin D from supplements, diet and sun exposure. Dietary sources include: fatty fish, beef liver, butter and egg yolks.
How do you know if you have osteoporosis?
The disease has no obvious symptoms, so many people don’t know they have osteoporosis until they suffer a fracture. If you’ve had a "fragility fracture" (a fracture without any known cause) you should get the diagnosis of osteoporosis.
For most folks, a diagnosis of osteoporosis is made with a scan called a dual energy x-ray absorptiometry or DXA scan (often pronounced "dexa"). Screening is recommended at least once for all women over 65. If you are at a greater risk for osteoporosis you should not wait until the age of 65 to screen.
Self-screening for osteoporosis.
If you have one or more risk factors such as smoking or a family history, you can take an osteoporosis self-assessment tool (OST). There is one tool for men and another tool for women:
The Osteoporosis Self-assessment Tool (OST) is among the first tools established to predict osteoporosis in postmenopausal women. It can identify the population at risk for osteoporosis, but its performance varies according to ethnicity, gender, and age.
How does chiropractic help with osteoporosis?
Getting adjusted supports the health of your bones and prevention of osteoporosis. It also assists in the process of reversing it.
Adjustments stimulate the cells (osteoblasts) that are in charge of replacing bone. Chiropractic adjustments have a positive effect on the process of bone breakdown and replacement.
Gentle, low force treatments can be safe for people with diagnosed osteoporosis. If you have active osteoporosis, certain adjustments may be modified until the strength of the bones has improved.
Need chiropractic care to help strengthen your bones? Book your appointment online.
Can I take medications that reduce bone loss?
Before starting medications, I suggest women maximize lifestyle changes that may help. Quitting smoking, cutting back on alcohol, taking calcium and vitamin D, and doing weight bearing exercise should all be considered. I always advise investing in healthy lifestyle changes before trying pharmaceuticals!
If you feel you need medication, please talk to your medical doctor. As a chiropractor I can’t comment on medications or dosage, as this is beyond my scope of practice and training.
Want to learn more?
I recommend these sources:
Study cited on the National Library of Medicine website: Chiropractic spinal manipulative therapy for a geriatric patient with low back pain and comorbidities of cancer, compression fractures, and osteoporosis