How does osteoporosis affect bones? Who is at risk? How does osteoporosis impact your life? FAQ
Understanding bone mineral density Assess your fracture risk Who diagnoses osteoporosis?

You may have questions about osteoporosis. Here are answers to some of the more frequently asked questions. The yellow stars beside the topics indicate the top three clicked-on topics.

star  What causes osteoporosis?

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

Bone is constantly changing. Two types of cells are primarily responsible for this: osteoclasts and osteoblasts. Osteoclasts are responsible for removing bone, whereas osteoblasts form new bone. In normal bone, there is a balance between the actions of these two cells. However, in osteoporotic bone, osteoclasts remove bone faster than the osteoblasts can form new bone. The result is a net bone loss.

There has been no single cause identified for osteoporosis, but there are a number of factors that can contribute to it. Your doctor should assess women and men over the age of 50 for risk factors for osteoporosis and fracture based on the indicators specified by Osteoporosis Canada which include testing your bone mineral density (BMD).

Learn more about the indicators andassess your risk for fracture - and don't forget to share this with your doctor at your next appointment.

star  What is the difference between osteoporosis and osteopenia?

Osteopenia (now known as "low bone mass") and osteoporosis differ in the amount of bone lost. Your doctor may have referred to your bone mineral density or BMD in terms of a "T-score", which is a relative comparison of your measured BMD to that of a normal young adult.Your bone density score is only one of the factors that determine your risk of fracture.

Osteopenia (low bone mass) is defined as a T-score between -1.0 and -2.5.

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

star  What is the difference between osteoporosis and osteoarthritis?

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.

  • 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.

  • The most important health-related outcome associated with osteoporosis is fractures or broken bones.
  • 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.
 Why are vitamin D and calcium so important?

Adequate vitamin D and calcium intake through diet or supplements is very important to help prevent osteoporosis. They may be taken alone or 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.

Osteoporosis Canada recommends the following intake of calcium and vitamin D (total through diet and supplementation) on a daily basis:

Age Calcium
Vitamin D
19-50 1000 mg 400 - 1000 IU
50+ 1200 mg 800 - 2000 IU
Pregnant or
lactating women
1000 mg 400 IU
* For those who don't have osteoporosis and don't have a condition that interferes with vitamin D absorption
UI = International Units

 If my mother had osteoporosis, should I worry?

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.

Additionally, a family history of osteoporotic fractures is also a key predictor of fractures.

 What can I do to prevent falls?

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

 If I am overweight, am I less likely to get osteoporosis?

It is important, regardless of your weight, to work with your doctor to determine your risk of developing osteoporosis and/or osteoporotic fractures. Although women under weight or with low bone mass index (BMI) are at higher risk of osteoporotic fracture, being overweight does not necessarily mean you are protected against fractures if you have osteoporosis.

 Should I be seeing a specialist?

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. Considerations may be more severe osteoporosis or other conditions you may have that might cause bone loss. The types of specialists that you could be referred to could include: Endocrinologists, Internists, Rheumatologists, and Geriatricians.

 Is there a cure for osteoporosis?

There is no cure for osteoporosis at this time. Please talk to your doctor to discuss an appropriate treatment option to help prevent fractures and other risks associated with osteoporosis.

 Which foods provide a high source of dietary calcium, besides milk-based products?

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 whole wheat 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 if you aren't getting enough in your diet.

To submit your own question to to be answered by Dr. Marla Shapiro in her Bone Matters column,click here

Here are additional links to resources you may find valuable in helping manage your postmenopausal osteoporosis.

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