Imagine breaking a bone from a minor fall. Sadly, it’s an all-too-common reality for older women — and even older men — throughout North Idaho. And that’s because conditions like osteoporosis, a disease that breaks down the density and quality of your bones, have no symptoms. In fact, people typically don’t know they have osteoporosis until they break a bone.
“Bone density is an underappreciated disorder,” says Tanya Blaty, DO, a fellowship-trained endocrinologist with Northwest Bone Health in Post Falls. “But thanks to state-of-the-art imaging tests and new, breakthrough treatments, people at risk for osteoporosis can take steps now to stop bone loss and improve their quality of life.”
Am I at risk for osteoporosis in North Idaho?
In general, women aged 65 and older and men 70 or older in North Idaho are at risk for osteoporosis. But that risk can start in some women as soon as age 50, especially for women who experience early menopause.
Some of the most common risks for osteoporosis according to the National Institutes for Health include:
- Gender. Women have lower peak bone mass and smaller bones than men.
- Age. As both women and men age, bone resorption, the process by which bone is broken down, happens faster, while new bone growth is slower.
- Stature. Slender, thin-boned women and men are at greater risk for osteoporosis.
- Race. Caucasian and Asian women and white men are at elevated risk.
- Family history. Your risk for osteoporosis increases if your parents have a history of hip fractures or conditions like osteopenia (mild thinning of bone) or osteoporosis (more significant thinning of bone).
- Hormone levels. Low estrogen due to menopause or hormone disorders can raise the risk of osteoporosis in women; low testosterone levels can do the same for men.
- Diet. Your risks go up if you don’t get enough calcium, vitamin D or protein.
- Medical conditions. Risks elevate for people with certain types of endocrine and hormonal diseases, conditions of the GI tract, rheumatoid arthritis, certain cancers, HIV/AIDS, and anorexia.
- Medications. Corticosteroids and other medications can affect bone health.
- Lifestyle choices. Smoking, chronic drinking, or a sedentary lifestyle will reduce bone density in many adults.
What osteoporosis tests can let me know if I have it?
For most people, knowing your exact osteoporosis risk starts by having a conversation with your doctor. “One of the best times to start the discussion is during your ‘welcome to Medicare’ physical exam at age 65,” says Dr. Blaty, who is one of the only doctors in the Inland Northwest that specializes in treating osteopenia and osteoporosis.
Additionally, Northwest Imaging Center features a state-of-the-art device called a DEXA scanner that helps determine the condition of your bones. During the quick procedure, you lie down on a table. A technologist will use the DEXA machine — a special type of X-ray that emits very little radiation — to take pictures of your hips, back, and sometimes your wrists. All women 65 and older and men 70 and older can get a DEXA scan with a doctor’s order.
Breakthrough osteoporosis therapies
If you already live with osteoporosis or are at high risk, you’ll want to know how to maintain proper bone health. The good news is that new osteoporosis medications have been developed over the past two decades that reduce bone resorption significantly and, in some cases, can even stimulate the formation of new bones. Three types of osteoporosis medications are available locally in Post Falls, including:
Oral osteoporosis medications (oral bisphosphonates)
These prescription medications slow down bone resorption, which can improve bone density and reduce the risk of fractures. They’re recommended for people with mild-to-moderate osteoporosis, including postmenopausal women, older men, and adults with a history of fractures. These oral medications include::
- Fosamax® (alendronate) – Taken once weekly or daily.
- Actonel® (risedronate) – Taken once weekly or daily.
- Boniva® (ibandronate) – Taken once daily or monthly (typically early in the morning, an hour before your first meal)
IV osteoporosis medications (IV bisphosphonates)
These medications stop the development of bone-removing cells before they can cause more damage. They’re delivered intravenously and are typically prescribed for people with severe osteoporosis, a high risk for fractures, or people who cannot tolerate oral medications well. IV therapies for osteoporosis include:
- Reclast® (zoledronic acid) – Delivered in a 15-minute infusion session once a year.
- Aredia® (pamidronate disodium) – Delivered in a four-hour infusion session every three-to-four weeks.
- Zometa (zoledronic acid) – Delivered in a 15-minute infusion session every three-to-four weeks.
Of these three, Reclast is the most commonly prescribed. Zometa is typically prescribed specifically for people who also have bone disease related to cancer or cancer treatment.
Injections for osteoporosis
The newest types of osteoporosis medications, injectables are recommended for people with severe osteoporosis and those who cannot tolerate oral or IV therapies well. Options include:
- Prolia® – A monoclonal antibody, Prolia inhibits bone resorption. It’s usually given twice a year.
- FORTEO® and TYMLOS® – Both of these injectable mediations are synthetic forms of parathyroid hormone that stimulate the formation of new bones. They are typically administered once daily.
- Evenity® – The newest injectable therapy on the market, Evenity is the only osteoporosis treatment with dual action, helping to both reduce bone resorption and promote bone growth. Patients typically administer Evenity once a month for 12 months.
Can I build stronger bones without medication?
If you already have osteoporosis or osteopenia, you cannot build back bone density without medications. However, you can prevent both conditions and reduce the amount of further bone loss with some simple lifestyle changes.
“Some smart steps to take include weight-bearing exercise such as walking or jogging [if you can tolerate it], getting the right amount of calcium and vitamin D in your diet, quitting smoking, and avoiding drinking too much exercise,” Dr. Blaty says.
Which osteoporosis medication is right for me?
People in the Inland Northwest who think they might need osteoporosis medication should schedule an appointment with Dr. Blaty at Northwest Bone Health. She and her team will sit down with you and get to know your personal risk factors for osteoporosis or osteopenia. They will also schedule you for a DEXA scan if needed, and create a personalized care plan to meet your needs that may include lifestyle modifications and/or medical treatments.
Should you require osteoporosis medication, Dr. Blaty and her team will discuss all your options, explain the potential side effects of any treatments, and recommend an approach that will work best for you.