by Lynda Lippin

Created on: May 31, 2008

Osteoporosis means porous bones. In the Greek it translates as "passages through bones." (This makes perfect sense if you look at the images of osteoporotic bone as opposed to normal bone.) Osteoporosis is a silent disease in that there is no physical sensation associated with it. Some people experience back, neck, or joint pain with fractures, but most do not. Even so, Americans experience 1.5 million osteoporotic fractures per year.

Throughout our lives our bones constantly change. This process is actually called bone remodeling, where old bone is resorbed into the body with the help of cells called osteoclasts at the same time that new bone is being laid down by osteoblasts. The human skeleton reaches its maximum bone mass (amount of bone tissue) and density (how tightly it is packed) around ages 20-30, after which bone removal begins to occur faster than bone production.

Bone density is measured by comparison to that of this healthy young adult; this is called a T-Score. Normal Bone Density is defined by the World Health Organization as density within -1 standard deviation (SD) of the 20-30 year old norm (10-15% bone loss). Osteopenia, or low bone density, is defined as within -1 to -2.5 SD (15-25% bone loss). Osteoporosis is defined as lower than -2.5 SD (over 25% bone loss). You may also have heard of a Z-Score, which is a comparison to the average bone density of individuals in your age group. Primary osteoporosis is caused by either a natural estrogen deficiency or age; secondary osteoporosis is caused by certain medical conditions (see box). Osteopenia should be treated like osteoporosis in terms of preventing future loss. Once you have been diagnosed with osteoporosis, you have a documented severe and established loss of bone.

Note here that while bone density testing is typically done at several sites such as the hip, wrist, or spine, these findings should be generalized to your entire skeletal system. Many clients have told me that I shouldn't worry about their spines because their osteoporosis was only in their hip-WRONG! If you are losing bone you should be worried, period.

All sources are in agreement that getting enough calcium, magnesium, and Vitamin D combined with proper exercise is necessary to prevent osteoporosis. Even once you have a diagnosis, these factors will help decrease your likelihood of fracture and prevent further bone loss. On the medication front, biphosphonates such as Fosomax and Actonel have been shown to increase bone density and reverse bone loss.

Our bones hold 99% of our body's total calcium. If we do not ingest enough calcium to assist the bone remodeling process our system takes it out of the bones themselves. Therefore, adults over 50 should take 1200-1500 mg of calcium per day along with 600-750 mg of magnesium and 400-600 mg of Vitamin D to assist absorption. As our bodies do not hold on to the calcium we don't use, it is better to spread your calcium supplements over the course of the day. And always take your pills with 8 ounces of water.

In addition to nutrition and medication, the best thing we can do for our bones is exercise on them. Wolff's law states that bone becomes stronger in response to increased stress i.e., exercise. Weight bearing activities such as walking and dancing are done upright and require our bones to fully resist the forces of gravity.

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