Frequently Asked Questions

  1. What is osteoporosis?
    Osteoporosis literally means "porous bones”, which can occur for several reasons. If you did not build bone sufficiently during your bone building years (between the ages of 9 and 18), you are at a lower threshold as you age. Inadequate intake of calcium and vitamin D as a child or as an adult or both will lead to osteoporosis.With the falling levels of estrogen (in women) and testosterone (in men) and its associated bone loss, you may have bone density below a normal level. Some medications, although necessary, can also cause bone depletion.
  2. What should I have done during my teenage years, can I do anything now?
    In order to build strong bones you need sufficient calcium, vitamin D and weight bearing exercise. Your bones should be above the -2 T-score level, if it is -2 or below you should consult with a doctor who can write a prescription if necessary and tell you other things you can do to improve your bone health.
  3. My mother broke her hip and my sister was just diagnosed with osteoporosis. Should I be worried?
    62% of your bone density is a result of genetics so there is certainly a strong genetic factor in determining if you may get osteoporosis. It is one of the main risk factors. The only way you can find out is by having a bone density test.Medical Consultation
  4. I feel fine, I am healthy and exercise daily, do I have to worry about osteoporosis?
    Since you build all the bone you are ever going to have by the time you are 30. Much of your bone health depends on your genes and how well you built your bone density during your teenage years. A bone density test will tell you if you have to worry about osteoporosis and fractures.
    • Bone Density Testing
    • Normal = T-Score greater than -1
    • Low Bone Mass = T-score from -1.1 to -2.4
    • Osteoporosis = T-score of -2.5 and lower
    • Severe Osteoporosis = T-score of osteoporosis + fracture
  5. Since I am a man do I have to worry about osteoporosis?
    Studies show that one out of every two women and one out of every four men has an osteoporotic fracture past 50. Men also die more often than women following a hip fracture. With that being said men most certainly should be concerned about osteoporosis.
  6. My doctor suggested a bone density test should I be concerned that there is an x-ray involved?
    The radiation that you would get from a bone density test is about .1 mrm, about the same that you would get flying from California to New York. Naturally we absorb about 1 mrm of radiation per day if we are living at sea level and 2-3 times that much if we live at higher elevations like Denver (elevation 5,000).
  7. I was told by my doctor told me that I didn't need a bone density test because I am so sturdy. Is this true?
    There is only one way to determine how healthy your bones are and that is to have a bone density test. Medicare pays for bone density tests every 24 months for women over 65 and for men over 70. Other insurance companies will pay for a bone density test if you have risk factors for osteoporosis.
  8. What is the best kind of calcium and vitamin D?Bowl of Cereal
    Take the kind of calcium that you can remember take on a regular basis; it is a lifelong requirement so you should choose a supplement that is compatible with your lifestyle. Put your tablets where you will remember to take them with meals. You can keep chewable calcium in your car or on your desk at work.
  9. I heard that you should take calcium at bedtime so your body can assimilate it while you sleep, is this true?
    If taken properly it doesn't matter when you take calcium as long as you don't exceed a dose of 600 mg. at a time. You should also make sure to take the supplement with something in your stomach. Taking calcium with food will help your stomach produce the acid needed to break calcium down for absorption.
  10. I read that taking certain medications can prevent your body from absorbing calcium supplements. Is this the case?
    Some medications like proton pump inhibitors* reduce stomach acids. These are usually prescribed because the individual's stomach acid levels are too high; the medication reduces the acids to a normal level. Below is a list of proton pump inhibitors if you are on these drugs you might consider calcium citrate rather than calcium carbonate.

    *Clinically used proton pump inhibitors:
    • Omeprazole (brand names: Losec, Prilosec, Zegerid, ocid, Lomac, Omepral, Omez)
    • Lansoprazole (brand names: Prevacid, Zoton, Inhibitol, Levant, Lupizole)
    • Dexlansoprazole (brand name: Kapidex)
    • Esomeprazole (brand names: Nexium, Esotrex)
    • Pantoprazole (brand names: Protonix, Somac, Pantoloc, Pantozol, Zurcal, Pan)
    • Rabeprazole (brand names: Rabecid, Aciphex, Pariet, Rabeloc. Dorafem)
  11. I heard that people with celiac disease and ulcerative colitis don't absorb calcium. What can we do to make sure we get the right amount of calcium?
    Doctors are discovering more individuals with these gastrointestinal issues that affect calcium absorption. If you are one of these individuals, you must maximize your calcium citrate and vitamin D3 intake. Talk to your doctor about the best form of calcium for you.
  12. Is it possible to take too much calcium?
    Anything below 2,000 mg. per day is generally safe for most people with normal absorption, but may not be necessary if you are also getting calcium through food. There have been reports of patients who have developed severe hypercalcemia from taking an excessive amount of calcium supplements (4,000 mg per day). If you have gastrointestinal absorption defects you may require more than the limit mentioned, you should talk with your doctor to determine how much calcium you should consume per day.
  13. Is it possible to take too much Vitamin D?
    The recommended dose of vitamin D per day is 1,000-2,000 IUs per day. There are cases of vitamin D intoxication causing hypercalcemia and renal failure at high daily doses exceeding 50,000 IUs. it is important that precautions be taken to keep such preparations of vitamin D out of the hands of children as it can be very dangerous if they were to ingest them.
  14. Will taking too much calcium cause me to have kidney stones?
    Generally you do not get kidney stones by taking too much calcium supplements. Calcium containing kidney stones are most common in people with a congenital disorder called idiopathic hypercalciuria. With this condition, the kidney excretes excessive amounts of calcium that tends to crystallize in the urine with oxalate and form calcium oxalate stones. If you have had kidney stones it would be a good idea to check with your doctor so that he/she can recommend the right type of calcium.
  15. Should I take magnesium with my calcium supplement?
    Many of the foods that we eat are already rich in magnesium, which is good for bone health so supplementing it is not essential but at the same time it will do no harm if taken in modest quantities.One thing that is important to be aware of is loop diuretics such as furosamide (Lasix) which can deplete the body of magnesium if it is not supplemented.
  16. Calcium constipates me so I stopped taking it, is there anything else I can do?
    Since calcium is important for good bone health and to avoid fractures you should keep taking it. Drinking more water or taking a different type of calcium may be all you need to do. Calcium with magnesium may also be another option for you and may cause less constipation.
  17. I am on medications for osteoporosis; should I still take a calcium supplement?
    Osteoporosis treatment regimens must also include calcium and vitamin D. Some medications are even formulated to include calcium, which is the mineral deposited into your bone while the medication works. You should check with your doctor to make sure you are getting the right amount of calcium and vitamin D.
  18. I have a hard time swallowing the large calcium pill, what should I do?Osteoporosis
    Try eating more dairy products, they have the most concentrated amounts of calcium. Other options include calcium chews which can provide you with the right amount of calcium. However, if you are on blood thinners, you should ask your doctor before using certain calcium chews as some of them contain vitamin K which will interfere with the blood thinner.
  19. I am concerned about my bones but I don’t like milk and do not want to take supplements. I am eating a lot of greens, specifically spinach and broccoli; do I need to do more?
    Green leafy vegetables are very good for you, but not the best source of calcium. They contain phytic and oxalic acids that bind with the calcium and makes the body unable to absorb it. Additionally, these vegetables are high in fiber and move through the body quickly reducing the body’s ability to extract the calcium.
  20. Since I spend time in the sun I do not have to worry about vitamin D, right?
    There are a number of good reasons to supplement vitamin D if you are in the sun often you are probably using sunscreen which can screen out the UV rays that convert precursors of vitamin D to vitamin D in your skin. People with darker skin do not process vitamin D as well as those with lighter skin. In northern latitudes for much of the year, vitamin D is screened out by the atmosphere due to the low angle of the sun. So even if you are in the sun a lot you should make sure you are getting the right amount of vitamin D (1,000-2,000 IUs/day).
  21. Is it enough to just take calcium with vitamin D in it, and a multi-vitamin?
    American Bone Health recommends 1,000-2,000 IUs daily of vitamin D.Most calcium and multivitamins do not have enough vitamin D in them.
  22. Can I have to take Vitamin D without food?
    Vitamin D can be taken anytime with or without food.
  23. After having a bone density test my doctor said my bones were "just fine." What does that mean and should I be doing anything special?
    You can request a copy of your report and have it sent to you to see just how strong your bones are first hand. It is always a good idea to follow good bone health practices as part of your lifelong health regimen.
  24. I had a bone density test and was told I have osteopenia. What is that?
    Osteopenia is also known as LOW BONE MASS, it is a status classification used to describe bones that are thinner than normal, but have not reached the point of osteoporosis. Osteopenia is being referred to as LOW BONE MASS more and more since osteopenia suggests that you have lost bone density. It is possible that you may have never built bone that was any stronger. If you are older with a low bone density, your doctor may consider a bone medication to prevent fractures.
  25. How accurate is a peripheral scan that I had at a health fair?
    Many health fairs or pharmacies offer screening using peripheral machines either by an ultrasound or X-ray. Osteoporosis is a systemic disease, and as such peripheral scans can be a good indicator of the bones in the rest of your body. However, you should have a properhip and spine bone density test on a table DXA prior to beginning any treatment so that your physician can follow your progress.
  26. Can a peripheral screening be used as a baseline test before beginning treatment?
    Peripheral tests are a screening tool only. The sites usually screened include the heel, forearm, and fingers which are metabolically less active, making them unsuitable for following treatment.
  27. How often should I get a bone density test?
    That depends on a number of factors including your age, menopausal status, medications you are taking and what type of osteoporosis treatment, if any you have started. Generally, doctor’s follow-up with bone density tests every two years since changes in bone density are usually slow.
  28. Do I have to fast or watch what I eat before a bone density test?
    Many testing centers simply ask that you not take calcium supplements at least 24 hours before your test as to not obscure the view of one of your vertebral bodies.
  29. I have heard you can have a blood test to determine bone status, is that what a bone density text (DXA) is?
    A DXA is a low dose X-ray that is fast and painless not a blood test. Your doctor may order a bone turnover marker which is a blood test used to determine how rapidly you are losing bone.
  30. What osteoporosis treatments do you recommend?
    Depending on your T-score and other risk factors, there are a number of good treatments both for the prevention and treatment of osteoporosis. You can get a prescription from your doctor for the following treatments to prevent and treat osteoporosis; SERMS (brand name Evista¨) may be considered, a bisphosphonate (brand names Fosamax¨, Actonel¨, Boniva¨, Reclast¨), for particularly fragile bones, parathyroid hormone (brand name Forteo¨).
  31. I don't want to take any hormones or medications can I take a herbal or natural supplement instead?
    Other than calcium and vitamin D there have been no studies to show that herbal or natural supplements have any effect on bone mineral density. It is also difficult to determine how much of any ingredient you may be getting in many herbal or natural remedies. Studies are required to determine if there is sufficient evidence to recommend these supplements.