Most people are careful to get the recommended tests to keep their heart healthy and detect cancer as they age.
But there’s another important screening that doesn’t get as much attention: the bone density test.
“Osteoporosis is a silent disease, meaning there would be no symptoms,” Arashdeep Litt, MD, internal medicine specialist with Corewell Health, said. “That is why it is very important to screen patients.”
Osteoporosis causes bones to become weak and more likely to break. It affects both men and women, although older women who are past menopause are most at risk, Dr. Litt said.
“This is actually very important for your health,” she said. “Osteoporosis can lead to significant disability.”
Bone fractures affect many activities in daily living, including the ability to live independently, she said.
The good news: There’s an easy and accessible screening method, as well as ways to help prevent osteoporosis at every life stage.
That screening tool is called a bone density test, or DEXA scan. It’s a low-radiation X-ray, typically of the hip and pelvis region, but sometimes the forearm. It measures how many grams of calcium and other minerals your bone contains.
“It’s as simple as laying on a table for an X-ray,” Dr. Litt said. “It’s very quick.”
So who should have a bone density scan?
It’s recommended for all women age 65 or older, as well as men ages 70-75.
It’s also recommended for people age 50 or older if they’ve lost a total height of about 1.5 inches, or 0.8 inches in one year.
Also for the over-50 age group, the test is recommended for those who have fractured a bone, taken some medications—such as long-term steroids—or experienced a drop in hormone levels. (Cancer treatments in women can drop estrogen levels, for example, while prostate cancer treatments in men can reduce testosterone levels).
Once you’ve had an initial bone density test, your doctor will determine when you need another, Dr. Litt said.
And what if your bone density test reveals bone loss? Take heart, because there are treatments.
“Not all is lost once you have osteoporosis,” Dr. Litt said. “There is a lot that can be done.”
It’s important to take steps to help prevent falls. This includes regular exercise and strength-building activities.
Treatment for osteoporosis includes lifestyle changes, as well as medications such as bisphosphonates, which can be taken orally and are designed to slow bone loss.
“They are great in that, once you stop taking them, they still continue to have bone loss benefits,” Dr. Litt said.
These medications are also available via annual intravenous treatments for patients who can’t tolerate the side effects, although side effects are very rare, she said.
Denosumab is another medication administered via injection every six months.
For severe osteoporosis, some medications not only slow bone loss but also help build back bone density, she said.
And while these treatments are available, Dr. Litt recommends everyone take proactive steps to prevent osteoporosis from ever coming your way.
Plenty of simple lifestyle changes can make a profound difference.
Get your calcium
The National Bone Health and Osteoporosis Foundation recommends that women age 50 and younger get 1,000 milligrams of calcium daily, while women age 51 and older get 1,200 milligrams.
Men age 70 and younger should get 1,000 milligrams of calcium daily, while age 71 and older should get 1,200 milligrams.
This includes calcium from your diet as well as vitamin supplements. High-calcium foods include dairy products such as milk, yogurt and cheese. Other good sources are green vegetables and foods fortified with calcium, such as juice, soy milk, cereals and breads.
Take vitamin D
To build and maintain strong bones and muscles, most adults age 50 and younger will need 400 to 800 international units (IU) daily, while those age 50 and older need 800 to 1,000 IU daily.
But some people need more vitamin D to maintain healthy blood levels. Dr. Litt recommends speaking with your primary care provider to determine the amount right for you.
Eat a protein-rich, balanced diet
Eating healthy—and consuming a proper amount of protein—is good for your bones. Dr. Litt recommends aiming for 25 to 30 grams of protein with each meal.
While all exercise can be great, weight-bearing exercises such as walking, running or biking are best for bone health. Dr. Litt recommends 30 minutes, five days a week.
She also likes patients to perform toning exercises two or three times a week for 10 to 15 minutes. This strengthens muscles, which protects bones.
“If you were to take a tumble, then you are strong enough to stop that fall, or your muscles can provide cushion for your bones,” she said.
Balance exercises can also help prevent falls as we age.
Whatever you are doing to prevent bone loss, don’t neglect following your doctor’s recommendations for a bone density test.
“The key is to get screened,” Dr. Litt said. “Osteoporosis can easily be treated, but it’s very important to not put this on the back burner.”