We was reading today that Gwyneth Paltrow, only 37 and suffering from osteopenia is now trying to focus her celebrity attention on the incidence of low bone density among younger women.
Unfortunately, this “silent disease” is usually not diagnosed on time and people should recognize whether they have risk factors for osteoporosis and should take personal responsibility for their bone health.
Osteoporosis, which literally means "porous bone", is a disease in which the density and quality of bone are reduced. As the bones become more porous and fragile, the risk of fracture is greatly increased. The loss of bone occurs "silently" and progressively. Often there are no symptoms until the first fracture occurs.
The diagnosis of osteopenia, or low bone density, is usually made after receiving a DXA (“Dual Energy X-ray Absorptiometry”) scan. Such scans are rarely done on women younger than age 50. The exception to this rule would be if the woman has a medical condition known to interfere with bone density. Health issues with known bone impacts can include: high thyroid hormone levels, type 1 diabetes, Cushing’s disease, rheumatoid arthritis, excess cortisol and a greater than three-month use of oral (not inhaled) corticosteroids.
Some of us have had low bone density much of our lives, usually the result of genetics. Other contributing factors can include:
· Being thin with a body mass index (BMI) less than 21 (e.g., 5’6” and 128 pounds). (Check your own BMI with the WebMD BMI Plus Calculator.)
· Current smoker
· Daily alcohol intake of more than 8oz. wine, 2 oz. of liquor or 24 oz. of beer
Not everyone with low bone density goes on to develop osteoporosis and bad fractures. Bone density is just one factor involved in fracture risk. Some women with low bone density never have a fracture. This might be attributable to good micro-architecture of the bone, or developing muscular strength to help stabilize bones and thus prevent falls.
The age of the woman with low bone density also matters. Two women with the same degree of osteopenia, one aged 50 and the other 70, will have different risks of hip fracture. If there were no added risk factors, and both women had the same osteopenia DXA score of -1.5, the 50-year-old would have a 10-year risk of hip fracture of 0.4%. The 70-year-old would have a 10-year risk of 1.4%. Alas, there is not as much data about low DXA scores in younger women, but we assume that a 40-year-old would have an even smaller risk. This is why most younger women are not started on prescription medications for osteopenia.
Generally, prescription medication to prevent bone loss is reserved for older women and/or those with DXA scores lower than -2.5. Adequate vitamin D intake is something that most of us can improve upon. While the current RDA for Vitamin D is 400 mg/day, most experts believe that the RDA should be at least 800 mg/day for adults.
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