Osteoporosis: Expert answers to FAQs

Nov 2, 2010 at 12:40 p.m. ET

If you've recently joined the ranks of the 10 million people in the US diagnosed with osteoporosis (a loss of bone tissue and thinning of bones that increases the risk of fractures), you may wonder how and why this happened, especially if you exercise and eat well. We asked osteoporosis expert Dr. Kathryn Diemer, from the Washington University School of Medicine in St. Louis, to answer our most perplexing osteoporosis and bone-building questions.

Woman drinking milk

Preventing osteoporosis

SheKnows: If women do everything right — don't smoke, eat yogurt, exercise and take calcium supplements can we still be diagnosed with osteoporosis?

Dr. Diemer: Unfortunately, yes, but it doesn't mean you've done anything wrong. If you weren't doing all these things, you'd likely be much worse and could have even suffered a fracture by now. A major contributing factor is simply genetics.

Calcium recommendations

SheKnows: I hear all kinds of recommendations about calcium. How much do women need for bone health?

Dr Diemer: Calcium needs vary throughout your lifetime, but for post-menopausal women the recommendation is about 1,200 mg a day. It's preferable to take in most of your calcium through your diet rather than supplements, as it may be more beneficial. But with so many women watching their weight, dietary sources are unlikely to be enough.

Dietary sources of calcium:

  • 1 cup of yogurt = 450 mg calcium
  • 1 cup of milk = 300 mg calcium
  • 1/2 cup of cottage cheese = 65 mg

Vitamin D is key for bone health

SheKnows: And what about all the hype over vitamin D? Is vitamin D really that important for bones?

Dr Diemer: Absolutely. We recommend 1,000 to 2,000 IUs a day, although it's amazing how many women still have low levels of vitamin D in their bodies even when taking the recommended amounts. Again, it's largely genetics. Ask your doctor for a blood test to determine if you have adequate levels of vitamin D in your system. He or she may recommend more.

Osteoporosis medications

SheKnows: Lastly, what about all the new prescription osteoporosis medications? How does a doctor determine which one is best for me?

Dr Diemer: They all work well to reduce the incidence of vertebral fractures. The oral biphosphonates such as Fosamax and Boniva have been proven to reduce the incidence of fractures by approximately 50 percent. They're all effective to slightly varying degrees. Often tolerability determines who goes on a biphosphate since some people experience heartburn with them. Plus, if you have a hard time remembering to take a weekly or monthly pill, you may want to try a medication such as Reclast, a once-yearly injection for osteoporosis. It may be a better option for those who have difficulty following a pill-taking schedule. It's the only yearly treatment approved to reduce the risk of fractures in the areas most often affected by osteoporosis, including the hip, spine and wrists. Talk to your doctor about the best approach for you.

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