Q: My sister was recently diagnosed with osteoporosis and said I should be taking calcium and vitamin D supplements for my bones like she does. Should I really be taking these if I don’t have osteoporosis?
According to Osteoporosis Canada, it is estimated that over two million Canadians are affected by osteoporosis. It is often thought of as a silent disease because people usually don’t show any symptoms until they break a bone. This means there are plenty of people out there who have osteoporosis and are completely unaware.
Our bones constantly go through a process called remodelling, where old and damaged bone tissue gets broken down and replaced by new tissue. Remodelling keeps our bones healthy and allows them to heal after injury. When you have osteoporosis, bone breakdown happens faster than the development of new bone tissue. This weakens bones by making them less dense and more brittle causing people with osteoporosis to be more susceptible to fragility fractures. Fragility fractures result from things that normally wouldn’t hurt a healthy bone like twisting, bumping into furniture or a minor fall. The bones that most commonly experience this type of fracture are the hip, spine, wrist and shoulder.
Some of the risk factors of developing osteoporosis we have no control over, such as age or gender. Osteoporosis is more common in people 50 years of age or older, and women are at a higher risk than men, especially when postmenopausal. During menopause estrogen levels rapidly decline which speeds up bone loss. Family history is important, as you are more likely to develop osteoporosis if a parent or sibling has been diagnosed. Certain medical conditions such as thyroid disease, diabetes and rheumatoid arthritis can increase your risk, as well as long-term use of certain medications such as corticosteroids and proton pump inhibitors.
Risk factors that we have control over and can make changes to include alcohol consumption, as it limits our body’s ability to absorb calcium and vitamin D. Smoking tobacco slows our bone healing process and interferes with our calcium absorption. Having a lifestyle that lacks physical activity and weight-bearing exercises can also cause you to have weaker bones.
People who don’t get enough calcium and vitamin D throughout their life have an increased risk of developing osteoporosis as they age. A diet rich in calcium is necessary for building and maintaining strong bones. Vitamin D helps our body to absorb more calcium. Therefore, your sister’s recommendation for you to use supplements for your bone health is correct if you are not getting enough calcium and vitamin D from your diet.
The amount of calcium and vitamin D that you need varies based on your age and gender. It is possible to get the proper amount of calcium from your diet alone, but many people don’t consistently consume enough calcium each day and rely on taking a calcium supplement to meet the required amount. Vitamin D is more difficult to get from your diet, leading most people to get the full recommended amount from a supplement. You can speak to your pharmacist for help calculating how much calcium you need to take in a supplement form and what dose of vitamin D to take. Calcium supplements need to be separated away from certain medications so be sure to review all your current medications with your pharmacist.
If you have multiple risk factors for osteoporosis, have changes in your posture such as bending forward, have a loss of height or are experiencing lower back pain, schedule an appointment with your doctor or nurse practitioner to discuss your bone health. They may send you for a bone density test to predict your risk of fracturing a bone in the future and to confirm an osteoporosis diagnosis.
There are several different classes of prescription medications used to treat osteoporosis that can help reduce your fracture risk by either slowing down the bone breakdown process or by stimulating new bone formation. In addition to medications, it is important to support your bone health by exercising, eating properly, limiting alcohol consumption, quitting smoking and managing your fall risks. Keep areas clutter-free, well-lit, wear properly fitting footwear, and use canes and walkers if necessary.
Erin Thompson (BSc, BScPharm) is a graduate of Dalhousie University and a community pharmacist practicing at Shoppers Drug Mart in Quispamsis N.B. Her opinions expressed in this column are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment.