Five Questions to Ask Your Doctor About Osteoporosis

PJ Hamel Health Guide
  • You’re getting older, and starting to take those Sally Field Boniva ads more seriously. Or you’re taking drugs that may compromise your bone health. What are the five things you need to ask your doctor about bone health?


    Do I really need to worry about osteoporosis? How do I determine if I’m at risk?

    First, answer these three simple questions:

    •Are you female?

    •Are you over age 60?

    •Have you been through menopause?


    If you answer “yes” to two of those three questions, then you’re at enough potential risk to find out more.


    Other common factors that may increase your risk for osteoporosis include a small/slight build; a family history of osteoporosis; your ethnicity; your level of exercise; and a personal history of smoking and drinking. Certain drugs increase your osteoporosis risk, as well.

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    For more on determining your personal risk of osteoporosis, read our expert patient Pam Flores’ post, Are You at Risk for Osteoporosis?


    Do I need a DEXA scan?

    The first step in assessing bone health is a DEXA scan. An acronym for Dual Energy X-ray Absorptiometry, this screening test measures how thick/heavy/tightly packed with minerals your bones are. The more tightly packed – the denser your bones – the stronger they are, and the less likely to break.


    When bone density falls below a certain level, you’re said by some doctors to have osteopenia. When it falls to another, lower level, you have osteoporosis, a disease that puts you at risk for fractures of all kinds – most seriously, hip and spinal fractures.

    If you’re any woman approaching age 65; a younger, post-menopausal women with osteoporosis risk factors (e.g., family history); or anyone with known osteoporosis risk factors, ask your doctor about a baseline DEXA scan. This first screening will tell you where on the scale of bone health you fall, which in turn will inform next steps. If your scores are high, congratulations, keep up the good work; if they indicate osteopenia, it’s time to make some lifestyle changes; if you have osteoporosis, you’ll need to start taking drugs.


    What kinds of exercises should I do to help keep my bones strong?

    Exercise. It’s a mantra we hear more and more these days, especially as we grow older. And for good reason: exercise can literally slow the aging process, keeping you fitter and younger-feeling than your couch potato friends.


    But all exercise isn’t created equal. While swimming and yoga may be great for flexibility and strength, they’re not always the most effective way to keep your bones strong.


    How can exercise help with bone health? And which kind is best? Our post, Can Exercise Prevent Osteoporosis?, offers a good summary of exercise’s effect on your bones. And Weight-Bearing Exercise: Understanding at Last outlines the best types of exercise for healthy people seeking to attain and maintain bone health.


    Looking at my current lifestyle, what can I reasonably change to lessen my risk?

  • Well, clearly there are things you CAN’T change, like being female, growing older, and having a family history of osteoporosis.

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    But thankfully there are a number of things you can do to reduce your risk of osteoporosis, including regular exercise, as outlined above; making sure your vitamin D and calcium levels are up to snuff; carefully examining any prescription drugs you take, and asking about alternatives if they tend to lower bone density; and cutting back or eliminating tobacco and alcohol from your life.


    Ask your doctor to test your calcium and vitamin D levels; if they’re low, ask what foods to eat, and what supplements to take. Review with him/her any factors (beyond those you can’t control) for reducing your osteoporosis risk. And then decide what parts of your lifestyle you can reasonably change.


    Don’t try to make too many major changes too quickly; you’ll just set yourself up for failure. If you’re a smoker, try to at least cut back, if not eliminate. If you don’t exercise at all, start small: park your car farther away in the parking lot; take the stairs to the second or third floor of the mall, rather than the escalator. Whatever you do is a plus; the smaller and more immediate the goals you set, the more likely you are to attain them, and move to the next level.


    Do you treat osteopenia?

    This seems like a strange question – why would any responsible doctor NOT treat osteopenia?


    Because recent studies suggest that osteopenia (bone density levels that are lower than normal, but not low enough to signal osteoporosis) may be better left untreated – at least by traditional osteoporosis drugs, which can be difficult to take. Instead, changes in diet and lifestyle may be enough to keep your bones relatively healthy.


    If you’re someone who likes to avoid drugs (and their possible side effects and interactions) as much as possible, find a doctor who chooses to deal with osteopenia as an opportunity to improve your lifestyle, rather than a disease requiring drugs. You’ll be happier in the long run – and probably just as likely to avoid osteoporosis as your girlfriend taking Boniva.



Published On: March 10, 2012