Rheumatoid arthritis.
Steroids.
Sedentary lifestyle.
Being low on vitamin D.

All are risk factors for developing osteoporosis. Although being a postmenopausal woman tends to be one of the more familiar risk factors, men, children and young adults are vulnerable, too. If you feel as if a heavy sack of doom just snuck onto your shoulders, you're not alone.

What is osteoporosis? What can you do to prevent it? What can you do if you have it? Pam Flores from our Osteoporosis site is here to answer all these questions.

What is osteopenia and osteoporosis?
Osteopenia is a normal age-related form of bone loss. Osteopenia is the pre-cursor to osteoporosis and it's not a disease. If your DXA scan - explained in the next question - shows that you have osteopenia, your score will be between (-1.0 and -2.5).

Osteoporosis is an abnormal loss of protein and mineral content resulting in weak bone that is prone to fracture, generally in post-menopausal woman, but also men and younger women. Osteoporosis, is diagnosed with a DXA score below (-2.5) and it's a disease of low bone density or porous bone.

How are osteopenia and osteoporosis diagnosed?

Both osteopenia and osteoporosis can be diagnosed with a dual energy x-ray absorptiometric (DXA) scan. This test is very simple and takes no more than 15 minutes to complete at an imaging center. For follow-up scans always use the same scanner and technician, if you can, due to the variability of these tests.

What is it like to live with these conditions?

Both osteopenia and osteoporosis are silent diseases meaning they have no outward symptoms, until you've fracture a bone. Once a fracture occurs, then it can be very painful.

Stress is normal with this diagnosis, but with time it will dissipate.

If you decide to take one of the FDA approved medications, there can be side effects, but not all patients will experience them.

We are often told that diet can play a role in preventing osteoporosis. What do you need to include in your diet to strengthen your bones? What if you can't have dairy products due to e.g., lactose intolerance or milk allergy?

A diet rich in fruits, vegetables, protein, dairy and bone building supplements are crucial to our bone health.

If you are lactose intolerant or have a milk allergy, substitute green leafy vegetables, high in calcium, to offset the exclusion of dairy products. Also, many foods are now fortified with calcium and D, so look for those that you like which could include, cereals, fruit juices, yogurt (if tolerated) and many other fortified food items.

Vitamin D is important for a number of bodily processes, including heart health. As well, recent studies have shown that people living with RA often have a vitamin D deficiency and that there is a connection between chronic pain and low vitamin D. Many rheumatologists are therefore prescribing increased doses of vitamin D for their patients. What role does this vitamin play in preventing/managing osteoporosis and what can you do to increase it?