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Keeping an Eye on Your Bones

Many of us start to think about osteoporosis as we approach our senior years. After all, that's when bone loss occurs, right?

Wrong. Doctors tend to treat patients with osteoporosis in their 60s, 70s, and older -- but bone loss begins much earlier. Our bone mass peaks around age 20. Bone loss can begin once peak bone mass is reached. Those at high risk are more likely to lose bone mass early.

When bone loss goes unchecked for years, the result is fractures -- often of the hip, spine, wrist, or leg bones. Menopause speeds the process. That's why 80 percent of the more than 10 million Americans with osteoporosis are women past menopause. In the first few years after menopause, bone loss accelerates; after that, it continues, but at a slower rate. Osteoporosis can strike men, too, but usually at a later age because they start with more bone. One in four men over 50 will end up with a fracture related to osteoporosis.

To learn who needs help, the U.S. Preventive Services Task Force urges routine osteoporosis screening for all healthy women 65 and older. High-risk women should seek screening at age 60 or as advised by your doctor.

The best screening method is a dual-energy X-ray absorptiometry (DEXA) scan. Medicare covers this non-invasive test for women 65 and older once every two years if they have certain risk factors for osteoporosis or are taking medicine to treat osteoporosis.

Several medications have been approved to treat osteoporosis, including calcitonin, bisphosphonates such as alendronate and risedronate, parathyroid hormone, and selective estrogen-receptor modulators such as raloxifene. According to the Task Force, each of these treatments has potential benefits and harms.

Prevention includes getting enough calcium and vitamin D. Weight-bearing exercise helps, too.

Who's at high risk?

  • Women older than 65

  • White or Asian women

  • Women with small bones

  • Women who are sedentary

  • Post-menopausal women

  • People with a family history of osteoporosis

  • Smokers

  • Adults who are very thin

  • People who break bones after age 45 because of "low trauma," such as a fall while standing

  • Long-term corticosteroid users

  • People who drink alcohol to excess

  • People with overactive thyroids

  • People with an inadequate intake of calcium and protein

  • People taking certain medications, such as phenytoin, gonadotropin-releasing hormone, antacids containing aluminum, cancer treatments, and thyroid hormone

Your calcium needs

The National Academy of Sciences and the National Osteoporosis Foundation recommend:

Age: Birth to 6 months

Daily calcium need: 210 mg

Age: 6 months to 1 year

Daily calcium need: 270

Age: 1 to 3

Daily calcium need: 500 mg

Age: 4 to 8

Daily calcium need: 800 mg

Age: 9 to 18

Daily calcium need: 1,300 mg

Age: 19 to 49

Daily calcium need: 1,000 mg

Age: 50 and older 

Daily calcium need: 1,200 mg