100 Questions Answers About Osteoporosis and Osteopenia

ForewordONE. An Overview of Osteoporosis and Bone DevelopmentWhat is osteoporosis and what does it look like? How does osteopenia differ from osteoporosis?Why is it important to know about osteoporosis and osteopenia?How does osteoporosis occur?How is bone made? Do we stop making bone when we become adults?If we "lose bone," where does it go? Can it be replaced once it's lost?What roles do calcium and vitamin D play in developing bones?Are there other vitamins and minerals that contribute to bone development?Are there other substances that affect bone development? What about hormones?What does menopause have to do with osteoporosis? Are there different kinds of osteoporosis?Which bones are affected by osteoporosis?TWO. Risk Factors and TestingWho gets osteoporosis?What are the risk factors for osteoporosis?Can I change any of my risk factors?I have always worked hard to stay thin. Now that I have osteoporosis, I'm wondering if that was such a good idea. What's the connection between body weight and bones?Could I be taking any medications that affect bone health?Are there any illnesses or medical conditions that are associated with osteoporosis?How will I know if I have osteoporosis? Are there any signs or symptoms?If osteoporosis doesn't hurt, what impact does it have on my health?When should I be tested for osteoporosis? Will my tests be covered by insurance?If my clinician does not discuss screening for osteoporosis, at what age should I make sure that I am screened?Can my clinician tell if I have osteoporosis during my annual check-up?My clinician is concerned about my loss of height of1 inch in the past year. Does that mean I definitely have osteoporosis?How is osteoporosis diagnosed?What is the difference between a DXA and apDXA?Are there other tests that are used to diagnose osteoporosis?How do I know which type of test should be ordered?What if I live in a rural area and I cant get to a place with a DXA machine? Are there further tests that I would need?If I'm x-rayed for a broken bone, will osteoporosis, if I have it, show up on the x-ray? If it shows up on the x-ray, would I need further testing?I've heard that x-rays of my teeth can be an indicator for osteoporosis. Is that true?What should I do to prepare for the BMD tests? When my clinician orders the tests, how soon should they be done? If my provider can't schedule my tests for 6 weeks after they're ordered, is that OK?My test results were reported as a T-score to my clinician. What is a T-score?What is a Z-score?How will my clinician use my test results to determine whether I have osteoporosis?How soon are test results usually available? Should I get a copy of the results of the testing?If my BMD test results are normal, when should I be screened again? If my test results show either osteopenia or osteoporosis, when should my test be repeated?If my tests show osteoporosis in my hip, what is the likelihood that I have bone loss in other bones? Does osteoporosis ever affect the skull bone?What do my results say about my future risk for fracturing a bone?If my tests show I have bone loss, do I need to be referred to a specialist? Or can my primary care provider or my gynecology clinician manage my case?Are there blood and urine tests that can be used to determine if I have bone loss?THREE. Lifestyle Changes and TreatmentsAfter I'm diagnosed with osteoporosis or told that I have osteopenia, what happens next?What if I am told that I have osteopenia but not osteoporosis?I understand that exercise is important for the treatment of osteoporosis. Why?What types of exercises should I do, and how often?Are there any exercises that I should avoid? Yoga and tai chi are great exercises, but are they helpful for preventing or treating osteoporosis?I'm 60 years old and was recently diagnosed with osteoporosis. I've never exercised regularly, but I've heard that walking is the best exercise for someone like me. Is that true?I have been in postmenopause for 5years. I've always been faithful about exercise, weight-training, and taking my calcium, and yet I've recently been told that I have osteopenia. Why didn't doing these things prevent bone loss? What more can I do?My clinician has encouraged me to take calcium supplements. There are so many kinds of calcium. How do I know I'm taking the right kind and the right amount?What foods can I eat to assure that I'm getting enough calcium?When should I take calcium supplements? Is there any particular time of day that makes calcium more effective? Should I take it before meals, with meals, or between meals?I've also been told that I must increase my intake of vitamin D. Should I take a separate vitamin D supplement, or can I get enough through eating the right foods?Folate has also been in the news regarding its role in osteoporosis. What is folate? How much should I take, and why?I know there are other vitamins and minerals that are important to bone development. Will I get enough of everything if I take a daily vitamin?What are isoflavones? Are they effective for treating osteoporosis?Who should be treated for bone loss? What is the FRAX® algorithm and how is it used? What types of medications are usually prescribed for osteoporosis and osteopenia?Risk Factors Used for the WHO FRAX Online AlgorithmI was prescribed Fosamax (alendronate). What is that? What are the contraindications to taking it, and are there any side effects? I've heard that Fosamax can be very tough on the stomach. Is that true?What is Actonel (risedronate)? Is it like Fosamax (alendronate)?What is Boniva (ibandronate)? Is it also called Bonviva?I heard there is a medication given once a year called Reclast (zoledronic acid). Is it like other bisphosphonates?Didronel (etidronate) is usually prescribed for Paget's disease. Is it ever prescribed for osteoporosis?What is Evista® (raloxifene)? What is a SERM, and why is it effective in the treatment of osteoporosis?My clinician wants me to give myself injections of something called Forteo® (teriparatide), which I understand to be parathyroid hormone. Should I take it? How often would I receive an injection?I have a very small fracture in one of the bones in my back. I've been prescribed Miacalcin® (calcitonin) in a nasal spray. What is Miacalcin? Can a nasal spray be effective for treating a bone fracture? Is Fortical® (calcitonin) nasal spray the same as Miacalcin?I've reached menopause and my clinician wants to treat my hot flashes with estrogen because estrogen will also help prevent more bone loss. Is this true?What about the new low-dose hormone patch, Menostar® (estradiol), that is used to prevent osteoporosis?There is a lot of controversy about taking estrogen. Why is that? Should I accept the risks of being on it so that I can prevent further bone loss?Can I take prescription osteoporosis medications in combination with each other? Which medications could I use together to get more improvement in my bones?Are there any medications that are available without a prescription to treat osteoporosis?How long will I be treated for osteoporosis? How will I know if the treatments are working?I have early menopause. What does this mean for my bones, and will I need treatment?Are there any complementary or alternative therapies that are effective for osteoporosis or osteopenia? Can I have a massage, or will that hurt my bones?FOUR. Living with OsteoporosisWill the treatments help me make new bone, or will there always be holes? Will I be more likely to break a bone? Does a fracture look differently on a bone with osteoporosis?Which bones am I more likely to break?I am 45years old. I recently stumbled on a rug. I fell against the wall. I broke my wrist and my clinician is now concerned that I have osteoporosis. She called my fracture a "fragility fracture." What is that, and what does it have to do with osteoporosis?If I fracture a bone, will it change my treatment? Will a broken bone take longer to heal? Will a broken bone be repaired or casted differently?My clinician told me not to take up skiing or ice-skating now that I have bone loss. Why is that, and are there other activities I should avoid?Should I stop exercising if I break a bone?I always hear about older folks fracturing their hips. Is this because of osteoporosis or because of the frequency of falls? How are broken hips repaired?What are some ways to prevent falls?My clinician has advised that I use hip protectors. What are they, and why should I use them?It's hard not to think about my bones being weak. How do I keep osteoporosis from interfering with my life?In addition to osteoporosis, I have many health problems associated with midlife. I'm feeling very stressed. How can I keep from getting depressed?My mother has fractured vertebrae in her back several times. Is that common? How do I know if I fracture one of mine? How long will it take to heal?What is a "dowager's hump"? Can it be reversed?What is kyphoplasty? Would it help my spinal fractures?Besides adding calcium and vitamin D, should I be changing anything in my diet? I heard that drinking alcohol could increase my risk of osteoporosis. Do I have to stop drinking entirely?Are there any medications that I should adjust or stop taking while I'm being treated for osteoporosis?I have been taking steroids for the treatment of my lupus. Is there any way that I can reduce the dosage so that the steroids do not further weaken my bones?I recently overdid my weight-lifting. My knee is extremely swollen and painful. Am I more likely to have fractured a bone near my knee because I have osteoporosis?FIVE. Prevention and Going ForwardI'm worried that my daughter, who is 40, will get osteoporosis. How can she prevent this from happening to her?What about my granddaughter? She is only 16. Should I also worry about my grandson?My daughter's friend is only 26 and has recently been diagnosed with osteoporosis as a result of being treated for endometriosis. Is osteoporosis reversible at her age?I thought I heard that it is better to live in a warmer climate to prevent osteoporosis. Is that true?I'm 60years old. Is it really worth it to start exercising now? Will exercise at my age help prevent osteoporosis?What's the likelihood that I will die from osteoporosis?I have joint pain. Is that related to my osteoporosis? What can I do for the joint pain? Exercise seems to make the joint pain worse.What should I tell my family about osteoporosis? Will it curtail activities with them?My friends are all very health-conscious, and I believe they will think it's my fault that I have osteoporosis. My friends enjoy adventures like hiking, rock-climbing, and cross-country skiing. Must I decline their invitations to go with them?Osteoporosis seems to be featured in the news almost daily. What are some of the future treatments? Are there any new drugs that are being evaluated in clinical trials for the treatment of osteoporosis?Where can I go for more information?BibliographyGlossary
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