Frequently asked questions

There has been no single cause identified for osteoporosis. There are a number of factors that can contribute to this condition. Your doctor will test your bone mineral density based on the indicators in the chart below:

* At least three months cumulative therapy in the previous year at prednisone-equivalent dose ≥ 7.5 mg daily.
^† For example, aromatase inhibitors or androgen deprivation therapy.

In women, bone loss can occur quite rapidly in the first 5 to 10 years following menopause.

Bone is constantly changing. There are special cells in the body called osteoclasts whose primary function is to remove bone. There is another type of cell called osteoblasts. These are bone-forming cells. In normal bone, there is a balance between the actions of these two cells. In osteoporotic bone, osteoclasts remove bone faster than the osteoblasts can form new bone. The result is a net bone loss.

Osteopenia and osteoporosis differ in the amount of bone lost. Your doctor may have referred to your BMD in terms of a “T-score,” which is a relative comparison of your measured BMD to that of a normal young adult.

Osteopenia is defined as a T-score between -1.0 and -2.5.

Osteoporosis is defined as a T-score below –2.5.

Osteoporosis and osteoarthritis are often confused. A simple way to remember the difference is that osteoporosis is a disease that affects the bones. Osteoarthritis is a disease affecting joints and their surrounding tissue.

Osteoarthritis:

• Most often affects the hips, knees, fingers, feet or spine.
• Can be painful.
• Can be attributed to factors such as heredity, obesity and overuse or injury of joint.

Osteoporosis:

• The most important health-related outcome associated with osteoporosis is fractures or bone breaks.
• Common sites for osteoporotic fractures to occur include the wrist, hip and spine.
• These fractures may or may not be associated with pain.
• Osteoporosis cannot be attributed to one single cause.

Adequate vitamin D and calcium intake through diet or supplements is very important to help prevent osteoporosis. They may be taken alone or taken together with osteoporosis medications as part of an osteoporosis treatment regimen.

Calcium plays an important role in building strong bones in childhood. It also helps maintain bone density in adulthood. Vitamin D is important because it helps the body absorb calcium.

* For those who don't have osteoporosis and don't have a condition that interferes with vitamin D absorption
(IU = International Units)

If your mother has suffered an osteoporotic fracture, particularly if she suffered a broken hip, this is considered to be a major risk factor for osteoporosis.

Physical activity is not only good for your bones, but it also helps improve coordination and balance which, in turn, can help reduce the risk of falling.

Other things you can do to help prevent falls include:

• Making sure that your home is well lit so you can see where you are going at all times
• Having your eyes tested yearly by an optometrist
• Minimizing potential hazards around your home
• Using a walking aid if needed for balance
• Consider installing handrails by stairs, baths, toilet
• Choosing shoes that offer good foot support
• Trying to keep furniture in its usual place, remove cords, loose wires and clutter. Ensure that rugs and mats are securely fixed and smooth

It is important that you first discuss your bone health concerns with your family doctor. Your doctor will recommend that you see a specialist if he or she feels this is necessary. The types of specialists that you could be referred to could include: Endocrinologists, Internists, Rheumatologists, and Geriatricians.

There are several vegetables that contain calcium including: broccoli, watercress, kale, okra, red kidney beans, chick peas, green beans, and baked beans.

In addition, nuts such as almonds, hazelnuts, and walnuts also contain calcium. Fish such as salmon and sardines are also rich in calcium.

Breads and grains such as plain pasta, white rice, white and wholewheat bread also contain calcium as do fruits such as apricots, figs, currants and oranges.

Taking calcium supplements is also an important way to ensure you get the proper recommended daily amount.