HARLINGEN — “I can feel it. I can feel it in my bones.”
These words evoke feelings of excitement and anticipation, but there’s one ailment that can creep into your bones without you knowing it until years later. And if you did suspect its presence, there would be no excitement.
The very mention of osteoporosis can cast a shadow of foreboding, with fears of fractures from falls or other accidents.
Osteoporosis, which is the loss of bone mass, affects women more than men, says Dr. Susan Hunter, an obstetrician/gynecologist affiliated with several hospitals including Valley Baptist Medical Center and Harlingen Medical Center.
Women often experience osteoporosis after menopause because their bodies stop producing estrogen, a hormone which helps keep bones strong. The decrease in this hormone can lead to osteoporosis, which causes bones to become weak and brittle.
Dr. Diana Lozano, an internist at Valley Medical Associates, said osteoporosis is common in the U.S., but not as prevalent as it is in other parts of the world.
“It has a lot to do with diet and exercise,” she said.
About 30 percent of the U.S. population has the condition, she said. It’s more prevalent among Asians and Caucasians, indicating a genetic link.
Hunter said the body stops building bone when people are in their mid-30s, and the slow depletion of bone cells begins. The rate of bone loss depends on numerous factors.
“What happens is that over our lives there’s a constant battle of the tilting of the scales between building bone and reabsorbing bone,” Hunter said.
Two kinds of bone are involved in this sort of back and forth process. Cells that build bone are called osteoblasts, which she referred to as builder-uppers. Osteoclasts — chewer-uppers — eat up bone.
“The purpose of having both of those go on all the time is that little micro fractures and things like that are getting repaired,” Hunter said.
A healthy, active lifestyle in a person’s youth can make a big difference later, Lozano said.
“If you’re really athletic when you’re young, eat right and get enough calcium in your bones, the rate of bone loss will be less,” she said.
Other factors such as smoking or consuming more than two drinks per day can also weaken bones.
Certain lifestyles or medical conditions early in life also can contribute to the condition years later, Hunter said.
“If up to your 30s something has caused you not to build bone well, you had no or low calcium intake, vitamin D deficiency, you were immobile for whatever reason and you didn’t build very good bone, you start with a low bone mass,” Hunter said. “So you are going to be more likely to develop osteoporosis early, especially as a woman.”
One risk factor relates exclusively to men who stop producing enough testosterone.
“Testosterone is the reason that men’s bones are stronger,” Hunter said. “The testosterone promotes muscle mass and they are heavier in general. And the bones respond to load.”
She said when men use their bones and muscles regularly, their bodies respond by making the bones thicker and stronger. This makes men less susceptible to the condition. However, the same factors such as vitamin D deficiency, poor calcium intake and the use of steroids can put men at risk.
Hunter said doctors begin testing people for bone mass when they reach age 65. The test is a simple X-ray that checks the density of the spine and hip. If the patient is diagnosed with osteoporosis, physicians try to determine its cause, such as poor diet, menopause, steroid use and immobility. They then try to treat or correct that cause, Hunter said.
“You’re going to want to caution the patient about falls,” Hunter said. “We typically warn people about night lights, loose rugs, slipping in the shower, to give them less opportunity to fall and break a bone.”
Lozano said the most common broken bones late in life are the spine, the wrist, and the hip.
Doctors have suggested that people do weight-bearing exercises for 30 minutes five days a week.
Physicians also recommend a diet rich in calcium such as milk or other dairy products. Green leafy vegetables also have some calcium. That’s part of a diet everyone should be eating even in their younger years.
Osteoporosis, it seems, is a long journey whose fate is often determined before it even begins, in the early years even back to childhood. Therefore, pediatricians, primary care givers and obstetricians/gynecologists are encouraged to promote weight-bearing exercises, and a proper diet that includes calcium and vitamin D.
