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Early Planning Key to Osteoporosis Prevention

Dr. Errol Rushovich of the Center for Bone Health Notes Importance of Vitamin D

Osteoporosis is more and more being considered a disease that spans a lifetime, starting with not building enough bone as a teenager, and then leading into the risk factors that mean losing bone through the stages of life.

The North American Menopause Society (NAMS) has updated its 2002 evidence-based position statement on the diagnosis, prevention, and treatment of postmenopausal osteoporosis and has published the new guidelines in the May/June 2006 issue of Menopause.

A medical history, physical examination, and diagnostic tests to evaluate major risk factors, including advanced age, genetics, lifestyle factors (such as low calcium and vitamin D intake, smoking), thinness, and menopausal status are all important tools for osteoporosis evaluation among postmenopausal women. The most frequently occurring risk factors for osteoporotic fracture are advanced age, low bone mineral density, and previous fracture as an adult.

Mercy Medical Center's Dr. Errol Rushovich, Director of the Center for Bone Health, Division of Endocrinology in The Weinberg Center for Women's Health and Medicine, said helping people avoid falls is just one of the suggestions to prevent osteoporosis related fractures.

"As one gets older, one gets more frail and there are many factors," Rushovich said. "A fall is really a key component of someone having a fracture."

He said you have to look at all the risk factors for osteoporosis: family history, fracture history, low body weight, smoking, excess alcohol, taking steroids, diet and exercise.

Many doctors believe there is an expanding role for vitamin D. The new guidelines suggest 700 to 800 international units of it daily -- up from 400.

"Vitamin D is an evolving story," Rushovich said. "It's quite clear that many people are vitamin D deficient and if you're vitamin D deficient, you don't absorb calcium as well."

There is some disagreement about when and at what level of bone loss does treatment get stepped up to prescription drugs.

For more information, contact the Center for Bone Health, Division of Endocrinology at 410-332-9258.