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What is Osteoporosis and Why it Matters · Flourish- A Prisma Health Podcast

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  Scott Webb (Host): Osteoporosis is very common, and my guest today is here to
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  tell us about osteoporosis and share the signs, symptoms, and treatment options.
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  Joining me today is Dr.
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  Brinda Basida.
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  She's a rheumatologist with Prisma Health.
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  This is Flourish, the podcast brought to you by Prisma Health.
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  I'm Scott Webb.
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  Doctor, it's great to have your time today.
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  We're going to talk about osteoporosis and what it is and how we deal with it.
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  So, let's start there, the obvious one.
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  What is osteoporosis?
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  And do we know what causes it?
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  Dr. Brinda D. Basida:
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  Well, osteoporosis is basically low bone mass and then some structural changes
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  in the bones that makes them weaker and, hence, more susceptible to fractures.
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  There are certain risk factors, but aging is the number one of all.
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  Women, post-menopausal women specifically, are also at high risk.
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  But there's no specific cause for osteoporosis, unless it's like a
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  genetically susceptible individuals.
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  Host: Sure.
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  All right.
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  So, mostly women, right?
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  Post-menopausal.
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  definitely age is a factor.
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  Are there maybe some health conditions that make someone more
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  likely to experience osteoporosis?
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  Dr. Brinda D. Basida:
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  Most of those common conditions that we typically are dealing with lately,
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  diabetes, chronic kidney disease, chronic liver disease, specifically
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  if somebody has had a prior fracture, they are the strongest predictors
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  of having a future fracture.
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  Or if their parents have had history of hip fractures or low BMI,
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  cigarette smoking, excessive alcohol consumption, chronic prednisone use,
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  all of these are high-risk factors.
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  Host: Some of the factors there.
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  And it makes me wonder, we touched on this a little bit, but about family
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  and the genetic component, if you will.
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  Is that a thing?
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  Is there a sort of a risk of osteoporosis running in families?
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  Dr. Brinda D. Basida:
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  Not really.
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  I wouldn't say this is more like a genetic condition.
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  But yes, if there is a history of maternal hip fracture, it has been
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  known that the chances of the children getting the fracture does increase.
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  It is actually one of the factors that is considered in the Frax tool, which
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  is calculating your probability of getting a fracture in the next ten years.
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  Host: Okay.
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  Yeah, it's interesting, just the sort of understanding.
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  It's like there could be a genetic component.
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  But for most, it's maybe not the case.
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  And we touched on this a little bit, that this mostly affects women.
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  But can men get osteoporosis or is it really just a women's
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  disease for the most part?
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  Dr. Brinda D. Basida:
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  That's a very good question.
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  Actually, studies so far or guidelines are heavily focused on women.
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  But there are no, like, specific guidelines on when
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  to screen men at or what age.
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  But typically ASBMR, which is the American Society of Bone and Mineral Research,
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  have suggested to screen men seventy or older or younger men with any of these
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  risk factors that we discussed previously.
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  Host: You mentioned the risk factors.
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  Wondering, what are maybe the signs or symptoms of osteoporosis, maybe when we
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  should see a doctor if we suspect that our symptoms might be caused by osteoporosis?
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  Just give us a sense of when we should be concerned.
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  Dr. Brinda D. Basida:
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  Usually, typically, any sort of fractures, especially after a certain age like
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  65 or above, needs to be evaluated for further screening for osteoporosis.
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  But sometimes you could have painless, you know, fractures in the spine, and
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  these are non-traumatic fractures.
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  And the way most of the times we see them is a decrease in their height,
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  and that's mainly because their thoracic vertebrae are fracturing.
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  And there's a loss of height.
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  So, that's one of the very common symptoms or like finding we see in osteoporosis.
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  But of course, any sort of fractures, whether it's hip fractures, wrist
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  fractures, humerus, femur fractures, those are all concerning to screen further.
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  Host: Yeah.
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  And maybe I'm inventing this in my head, but I feel like I've heard this
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  before, that the type of fractures where you wouldn't expect to have
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  experienced a fracture, right?
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  You may have suffered some kind of injury or bumping your arm into
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  the door or something like that, and you wouldn't expect for there
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  to be a fracture, but we get one.
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  Is that maybe sort of a sign that it's osteoporosis?
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  Dr. Brinda D. Basida:
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  Absolutely.
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  So, this is called like a fragility fracture.
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  So, fragility fractures are the fractures that you get from having
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  a fall from a standing height.
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  And those are like low impact fractures basically.
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  So, those are the ones that needs to be looked into.
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  Host: For sure.
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  So, what can we do, doctor, to help ourselves to prevent osteoporosis?
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  Do we need to drink more milk, take vitamin D supplements?
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  From you, from an expert, like, what can we do to help ourselves?
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  Dr. Brinda D. Basida:
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  Obviously, getting some sort of calcium vitamin D supplements.
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  In fact, RDA recommends about 1000 to 1200 milligrams daily of calcium
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  supplements or vitamin D of 600 to 800 international units daily.
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  Those are good habits to have incorporated in your
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  day-to-day food or supplements.
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  But apart from that, doing resistance and balance exercises.
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  Preventing falls is a major factor there.
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  And then, smoking cessation, limiting alcohol use, some of these things
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  can help prevent that bone loss.
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  Host: For sure.
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  Yeah, and I just want to finish up here, Doctor.
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  I know we used to tease my grandma that it seemed like she was shrinking.
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  You know, as she got older, it seemed like she was shrinking,
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  and I'm connecting the dots.
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  You were talking about fractures in the back.
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  And so, is that a thing?
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  Do people actually shrink, as they get older, or is it probably the
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  osteoporosis causing the fractures and the sort of shrinkage in the spine?
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  Like, take us through this.
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  Am I just imagining this, or does it just seem like folks tend to get
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  a little shorter as they get older?
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  Dr. Brinda D. Basida:
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  So, the reason behind the, you know, height loss is because of the fractures.
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  The spine is not standing as tall as it should, and it's kind
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  of dipping down, and that's why there's a loss of height as we age.
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  But I wanted to also mention, you know, there are medications
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  to treat osteoporosis.
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  There's no specific medication that can prevent it, specifically.
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  But once it is identified, there are medications to prevent it further,
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  like prevent further fractures.
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  And we usually recommend getting a DEXA scan done.
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  I think insurance approves approves after age of 65 for women and then
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  every two years after, to kind of look who are susceptible for these
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  kind of osteoporotic fractures.
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  There are scores on that DEXA scan which will differentiate who is
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  at risk or who has osteoporosis.
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  And that way, they can get appropriate medical management.
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  Host: Sure.
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  Well, that's perfect.
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  As you were saying, there are some things we can do to help ourselves,
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  things that doctors can do to help us, like get a DEXA scan, take possibly
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  some medications, things like that.
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  Unfortunately, osteoporosis is just a fact of life, especially for many women.
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  So, I appreciate your time.
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  Thanks so much.
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  Dr. Brinda D. Basida:
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  Thank you so much.
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  Host: For more information and other podcasts just like this one, head
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  on over to prismahealth.org/podcast.
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  This has been Flourish, a podcast brought to you by Prisma Health.
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  I'm Scott Webb.
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  Stay well.