10 Warning Signs Your Bones Are Thinning -- and What You Can Do Now
Find out the symptoms of osteopenia, the precursor to osteoporosis, and what you can do to help thinning bones.
We all know an older person with osteoporosis -- it's one of the most common problems of aging, striking more than half of all adults over age 50. And we all hope osteoporosis doesn't happen to us, since weak bones can lead to fractures, and fractures, in turn, lead to all sorts of scary consequences.
But how do you know if your bones are sturdy enough to keep you safe? It's tricky, because osteopenia -- the process of bone thinning that precedes full-blown osteoporosis -- can happen without obvious symptoms. Here are the top 10 warning signs of thinning bones, along with tips about how you can respond:
1. You've had more than one fracture in the past two years, or you've had a fracture that seemed unusually severe for the circumstances.
Kim Noles of Pennsylvania found out she had osteopenia, or mild osteoporosis, when she fractured her ankle simply by stepping the wrong way off a curb. Your bones need to be strong enough to sustain some impact, and if they aren't, you'll want to know more about what's behind that.
What you can do: Get a bone density test, also called a DXA scan or densitometry, which is a specialized type of X-ray that measures the amount of calcium and other key bone-hardening minerals within each bone segment. Doctors consider bone density tests a fairly accurate predictor of fracture risk, because they show whether your bones are dense and solid or porous (which makes them fragile).
2. You're naturally thin or small-framed.
Unfortunately, if your bones are small and thin to begin with, you have less bone to lose. People with small, delicate frames are likely to develop osteoporosis at a younger age. This doesn't mean that heavy or big-boned people don't get osteoporosis; just that people who are thin or small-boned don't have as far to go before they're at risk for fracture.
We reach peak bone mass and stop building bone when we're between 20 and 25 years old, and somewhere between 30 and 40 we start losing bone. The rate of bone loss depends on our genetics and on how vigilant we are about diet, exercise, and other factors that keep our bones strong.
What you can do: If you're under age 40, do everything you can in your 30s to build bone: Eat a diet high in dairy and other calcium-rich foods and get plenty of high-impact exercise, which is anything that involves running or jumping. If you're 40 or older, continue to eat nutritiously, add a calcium-magnesium-vitamin D supplement, and do strength-training exercise in addition to impact exercise. Strength training has been shown to prevent bone loss.
3. You take prednisone or other corticosteroids to treat an autoimmune condition.
Taking cortisone drugs over a long period of time interferes with hormone levels in a way that leaches calcium, vitamin D, and other nutrients from your bones. People who have autoimmune diseases such as Crohn's disease, lupus, or rheumatoid arthritis have osteoporosis at a much higher rate than the average person because of the corticosteroids used to treat these conditions.
This warning sign is most especially likely to matter to women, because they're more likely to get autoimmune diseases to begin with. They're also more prone because normal estrogen levels are necessary for maintaining healthy bone. Taking a thyroid hormone for low thyroid or taking antidepressants in the SSRI class is also linked to higher levels of bone loss, though experts aren't sure why yet.
What you can do: If you need to take corticosteroids to treat a health condition, the resulting risk to your bones requires a doctor's careful supervision. Most doctors now have patients get a bone density scan soon after going on corticosteroids, to make sure they have the bone mass necessary to withstand the effect of the drugs. Your doctor can also order a 24-hour urine calcium analysis and a vitamin D test to check your level of that bone-strengthening nutrient.
If you're on corticosteroids long-term, you should probably have your spine X-rayed, as sometimes tiny fractures result that you may not feel at first. Many doctors will also prescribe biphosphonates, which are bone-building drugs.