Bone Loss Risks, Osteoporosis - circle of health

August 2008 - Vol 3 Issue 8

Are You Losing It?
Assessing your bone loss risks
by Michelle Gibeault Traub, R.D.

Most illnesses provide a warning. Maybe you feel pain, or perhaps a bit of fatigue. Whatever the signal, you just know something is not quite right. So, imagine an illness creeping up on you slowly without any noticeable symptoms. That is exactly what happens with the gradual bone loss that eventually leads to osteoporosis. It generally comes on slowly and progresses over time until bones are so fragile that they break without warning. However, there are numerous risk factors that can alert you to potential trouble.

Stress Lowers Bone Density

Stress at work. Stress at home. At some point you might just feel like you are losing control. But, the truth is you could be losing a lot more than that – bone tissue to be exact. Stress raises cortisol levels. High cortisol levels are in turn related to lower bone mineral density. While we can’t always prevent stressful situations, developing coping mechanisms can help minimize the body’s stress response. Helpful stress management techniques include deep breathing, meditation, yoga, aromatherapy, and regular exercise.

Are You Losing Fat or Bone?

Weight loss is generally a cause for celebration. But, unfortunately when your body becomes lighter, it actually puts less force on bones which causes bone density to decrease. You can counter this effect by making sure to include plenty of calcium and vitamin D in your daily diet through dairy products, vegetarian calcium sources, and calcium supplements. In addition, by simply incorporating weight-bearing exercise you can be sure that your bones stay dense and strong. (Review examples of Weight-bearing Exercise).

Medications Cause Bone Loss

Some prescription drugs actually cause bone loss, yet many people are not aware of this nasty side effect. It is up to you to become an educated patient by discussing medication side effects with your physician or pharmacist and carefully reading the information provided with your prescription (see also “Take Charge of Your Health”). The following are some of the most popular medications that can harm bone health:

Glucocorticoids such as cortisone and prednisone

Aluminum-containing antacids

Antiseizure medications (only some) such as Dilantin® or Phenobarbital

Lithium

Medroxyprogesterone acetate for contraception (Depo-Provera®)

Methotrexate

Proton pump inhibitors (PPIs) such as Nexium®, Prilosec® and Prevacid®

Selective serotonin reuptake inhibitors (SSRIs) such as Lexapro®, Prozac® and Zoloft®

Tamoxifen® (premenopausal use)

Thiazolidenediones (Actos® and Avandia®)

Thyroid hormones in excess

If you take any of these medications it is probably because your overall health depends on them. That doesn’t mean that your bone health has to suffer. It is simply a red flag that you must be extra diligent about keeping your bones strong by eating a diet rich in calcium and vitamin D and incorporating regular bone-building exercise.

For more information, see “Piling on the Pills:How medications impact bone health” and The National Osteoporosis Foundation web site which provides a comprehensive list of Osteoporosis risk factors at Who’s At Risk?

References

Reynolds RM, et al. Cortisol secretion and rate of bone loss in a population-based cohort of elderly men and women. Calcif Tissue Int. 2005 Sep;77(3):134-8. Epub 2005 Sep 8

National Osteoporosis Foundation. Who’s At Risk www.nof.org. retrieved 8/18/08 LINK (Opens in new window)