{"id":877,"date":"2026-04-26T06:34:12","date_gmt":"2026-04-26T06:34:12","guid":{"rendered":"https:\/\/ulemnrme.a2hosted.com\/wordpress\/?page_id=877"},"modified":"2026-05-30T22:31:14","modified_gmt":"2026-05-30T22:31:14","slug":"bone","status":"publish","type":"page","link":"https:\/\/diaendo.com\/index.php\/bone\/","title":{"rendered":"Bone Health &#038; Osteoporosis"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_bh_hdr{background-color: #149d79 !important; padding-top: 28px !important; padding-bottom: 24px !important;}\u201d][vc_column][vc_custom_heading text=\u201dPatient Education  \u00b7  Endocrinology\u201d font_container=\u201dtag:p|font_size:11px|text_align:left|color:%23ffffff\u201d use_theme_fonts=\u201dyes\u201d][vc_custom_heading text=\u201dBone Health, Osteopenia & Osteoporosis\u201d font_container=\u201dtag:h1|font_size:44px|text_align:left|color:%23ffffff|line_height:1.1\u2033 use_theme_fonts=\u201dyes\u201d][vc_custom_heading text=\u201dA guide to understanding, diagnosing, and treating bone loss \u2014 written for our patients.\u201d font_container=\u201dtag:p|font_size:15px|text_align:left|color:%23ffffff\u201d use_theme_fonts=\u201dyes\u201d][\/vc_column][\/vc_row][vc_row][vc_column width=\u201d1\/1\u2033][vc_column_text]<\/p>\n<style>.de-toc{background:transparent;border:none;border-radius:0;padding:0;box-shadow:none;margin:0 0 6px;}.de-toc-label{font-size:.74rem;font-weight:700;letter-spacing:.12em;text-transform:uppercase;color:#149d79;margin:0 0 12px;text-align:center;}.de-toc-inner{display:flex;flex-wrap:wrap;gap:10px;justify-content:center;}.de-toc-pill{display:inline-block;font-size:.86rem;font-weight:600;line-height:1;padding:9px 16px;border:1.5px solid #149d79;border-radius:999px;color:#149d79;text-decoration:none !important;white-space:nowrap;transition:background .15s ease,color .15s ease;}.de-toc-pill:hover{background:#149d79;color:#fff !important;}.de-section{scroll-margin-top:30px;}@media(max-width:680px){.de-toc-inner{justify-content:flex-start;overflow-x:auto;flex-wrap:nowrap;-webkit-overflow-scrolling:touch;}.de-toc-pill{font-size:.8rem;padding:8px 13px;}}<\/style>\n<div class=\"de-toc\">\n<p class=\"de-toc-label\">On this page<\/p>\n<div class=\"de-toc-inner\"><a class=\"de-toc-pill\" href=\"#sec-understanding-the-condition\">Understanding the Condition<\/a><a class=\"de-toc-pill\" href=\"#sec-risk-and-symptoms\">Risk & Symptoms<\/a><a class=\"de-toc-pill\" href=\"#sec-diagnosis\">Diagnosis<\/a><a class=\"de-toc-pill\" href=\"#sec-prevention-and-lifestyle\">Prevention & Lifestyle<\/a><a class=\"de-toc-pill\" href=\"#sec-pharmacologic-treatment\">Pharmacologic Treatment<\/a><\/div>\n<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<p>[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_bh_intro{background-color: #ffffff !important; padding-top: 20px !important; padding-bottom: 4px !important;}\u201d][vc_column][vc_column_text]<\/p>\n<p class=\"de-intro\">If you have questions about your bone health or would like to discuss testing or treatment, we invite you to <a href=\"\/contact\">contact our office<\/a>. All care is individualized to your specific history, risk profile, and goals.<\/p>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<p>[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_bh_s1{background-color: #ffffff !important; padding-top: 24px !important; padding-bottom: 48px !important;}\u201d][vc_column][vc_column_text]<\/p>\n<p class=\"de-section\" id=\"sec-understanding-the-condition\">Understanding the Condition<\/p>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">What is osteoporosis, and why does it matter?<\/p>\n<div class=\"de-a\">\n<p>Osteoporosis is a skeletal condition in which bone mass decreases and internal bone structure deteriorates, making bones significantly more prone to fracture. Trabecular bone \u2014 the spongy inner lattice \u2014 becomes thinner and less connected; the outer cortical shell loses density and thickness. The hip, spine, and wrist are most vulnerable.<\/p>\n<p>Approximately <strong>40% of women and 25% of men over age 50<\/strong> will sustain an osteoporosis-related fracture in their lifetime, often with serious consequences for mobility and independence.<\/p>\n<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">How does bone loss happen?<\/p>\n<div class=\"de-a\">\n<p>Bone is living tissue in continuous renewal. Osteoclasts break down old bone while osteoblasts build new bone \u2014 a process called remodeling. Bone mass peaks between ages 20\u201325, after which the balance gradually shifts toward net loss. Menopause dramatically accelerates this in women due to falling estrogen; men lose bone more gradually as testosterone declines. Osteoporosis develops when resorption chronically outpaces formation.<\/p>\n<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">What is osteopenia \u2014 is it serious?<\/p>\n<div class=\"de-a\">\n<p>Osteopenia refers to bone density that is below normal but not yet in the osteoporotic range. It represents an important window for intervention. With the right combination of nutrition, exercise, and when appropriate, medication, further bone loss can be halted and fracture risk meaningfully reduced.<\/p>\n<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">What hormones affect bone health?<\/p>\n<div class=\"de-a\">\n<p>Several hormonal imbalances contribute to bone loss. Estrogen deficiency \u2014 whether from menopause, surgical removal of the ovaries, or suppression from excessive exercise or caloric restriction \u2014 is the most common driver in women. Excess cortisol, as in Cushing\u2019s syndrome or with long-term corticosteroid therapy, accelerates bone resorption significantly. Because so many hormonal conditions intersect with bone health, endocrinologic evaluation is central to proper osteoporosis care.<\/p>\n<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<p>[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_bh_s2{background-color: #f5f7f6 !important; padding-top: 24px !important; padding-bottom: 48px !important;}\u201d][vc_column][vc_column_text]<\/p>\n<p class=\"de-section\" id=\"sec-risk-and-symptoms\">Risk & Symptoms<\/p>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">Am I at risk?<\/p>\n<div class=\"de-a\">[\/vc_column_text][vc_row_inner][vc_column_inner width=\u201d1\/2\u2033][vc_column_text]<\/p>\n<div class=\"de-card\">\n<h4>Non-Modifiable<\/h4>\n<ul>\n<li>Advanced age<\/li>\n<li>Female sex<\/li>\n<li>Family history of osteoporosis or hip fracture<\/li>\n<li>Small body frame<\/li>\n<li>Postmenopausal status<\/li>\n<li>Caucasian or Asian ethnicity<\/li>\n<li>Prior fragility fracture<\/li>\n<\/ul>\n<\/div>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\u201d1\/2\u2033][vc_column_text]<\/p>\n<div class=\"de-card\">\n<h4>Modifiable & Medical<\/h4>\n<ul>\n<li>Low calcium, vitamin D, or vitamin C intake<\/li>\n<li>Sedentary lifestyle<\/li>\n<li>Low body weight<\/li>\n<li>Smoking or excessive alcohol<\/li>\n<li>Amenorrhea or hypogonadism<\/li>\n<li>Long-term corticosteroids<\/li>\n<li>Certain anti-seizure medications<\/li>\n<\/ul>\n<\/div>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_column_text]<\/p><\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">What are the signs and symptoms?<\/p>\n<div class=\"de-a\">\n<p>Osteoporosis is often called a \u201csilent disease\u201d \u2014 bone loss advances without symptoms until a fracture occurs. Warning signs include a fragility fracture, loss of more than one inch of adult height, chronic back pain, or progressive forward curvature of the upper spine.<\/p>\n<div class=\"de-warn\"><strong>Hip fractures carry serious consequences.<\/strong> Roughly 50% of patients lose independent mobility and approximately 25% require long-term care.<\/div>\n<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<p>[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_bh_s3{background-color: #ffffff !important; padding-top: 24px !important; padding-bottom: 48px !important;}\u201d][vc_column][vc_column_text]<\/p>\n<p class=\"de-section\" id=\"sec-diagnosis\">Diagnosis<\/p>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">How is osteoporosis diagnosed?<\/p>\n<div class=\"de-a\">\n<p>The standard diagnostic tool is a DEXA scan, which measures bone density and reports results as a T-score:<\/p>\n<table>\n<thead>\n<tr>\n<th>T-Score<\/th>\n<th>Classification<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>Better than \u22121.0<\/td>\n<td>Normal<\/td>\n<\/tr>\n<tr>\n<td>\u22121.0 to \u22122.5<\/td>\n<td>Osteopenia<\/td>\n<\/tr>\n<tr>\n<td>Below \u22122.5<\/td>\n<td>Osteoporosis<\/td>\n<\/tr>\n<tr>\n<td>Below \u22122.5 with fragility fracture<\/td>\n<td>Severe osteoporosis<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">What is a FRAX score?<\/p>\n<div class=\"de-a\">\n<p>The FRAX algorithm estimates your 10-year probability of a major osteoporotic or hip fracture by combining bone density with clinical risk factors. Some patients whose bone density falls in the osteopenia range still warrant treatment when their overall fracture probability is high.<\/p>\n<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">Can we look beyond bone density to assess bone quality?<\/p>\n<div class=\"de-a\">\n<p><strong>Trabecular Bone Score (TBS)<\/strong> is derived from the same DEXA scan images and assesses bone microarchitecture independently of density. <strong>Quantitative CT (QCT)<\/strong> provides true three-dimensional volumetric bone density, useful when DEXA results may be confounded by degenerative changes.<\/p>\n<div class=\"de-callout\">These tools are especially valuable when fracture risk seems discordant with bone density \u2014 for example, in patients with diabetes or glucocorticoid-induced bone disease.<\/div>\n<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">Who should have a bone density test?<\/p>\n<div class=\"de-a\">\n<ul style=\"list-style:none;padding:0;\">\n<li style=\"padding:5px 0 5px 16px;position:relative;font-size:14.5px;color:#444;border-top:1px solid #d0dbd7;\"><span style=\"position:absolute;left:0;color:#5ec4a7;\">\u2013<\/span>All women \u2265 65 and men \u2265 70<\/li>\n<li style=\"padding:5px 0 5px 16px;position:relative;font-size:14.5px;color:#444;border-top:1px solid #d0dbd7;\"><span style=\"position:absolute;left:0;color:#5ec4a7;\">\u2013<\/span>Postmenopausal women under 65 with clinical risk factors<\/li>\n<li style=\"padding:5px 0 5px 16px;position:relative;font-size:14.5px;color:#444;border-top:1px solid #d0dbd7;\"><span style=\"position:absolute;left:0;color:#5ec4a7;\">\u2013<\/span>Adults with conditions or medications known to cause bone loss<\/li>\n<li style=\"padding:5px 0 5px 16px;position:relative;font-size:14.5px;color:#444;border-top:1px solid #d0dbd7;border-bottom:1px solid #d0dbd7;\"><span style=\"position:absolute;left:0;color:#5ec4a7;\">\u2013<\/span>Anyone with a fragility fracture after age 50<\/li>\n<\/ul>\n<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<p>[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_bh_s4{background-color: #f5f7f6 !important; padding-top: 24px !important; padding-bottom: 48px !important;}\u201d][vc_column][vc_column_text]<\/p>\n<p class=\"de-section\" id=\"sec-prevention-and-lifestyle\">Prevention & Lifestyle<\/p>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">What should I eat to protect my bones?<\/p>\n<div class=\"de-a\">\n<p>Nutrition is foundational to bone health \u2014 medications work poorly without it.<\/p>\n<div class=\"de-nutrient\"><span class=\"de-nutrient-label\">Calcium<\/span><span class=\"de-nutrient-desc\">The recommended daily intake is 1,000\u20131,200 mg. We recommend <strong>calcium citrate<\/strong> as our preferred supplement. <\/p>\n<div class=\"de-warn\" style=\"margin-top:10px;\">We do not recommend AlgaeCal, OsCal, or similar branded calcium products. These are significantly more expensive and lack meaningful clinical evidence of superiority.<\/div>\n<p><\/span><\/div>\n<div class=\"de-nutrient\"><span class=\"de-nutrient-label\">Vitamin D<\/span><span class=\"de-nutrient-desc\">Essential for calcium absorption and bone metabolism. Most adults need at least 1,000 IU daily; many require considerably more. We can measure your vitamin D level and tailor supplementation precisely.<\/span><\/div>\n<div class=\"de-nutrient\"><span class=\"de-nutrient-label\">Vitamin C<\/span><span class=\"de-nutrient-desc\">A critical but often overlooked bone nutrient. Vitamin C is an essential cofactor for collagen synthesis. Good sources include citrus, strawberries, kiwi, bell peppers, and broccoli.<\/span><\/div>\n<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">What kind of exercise helps?<\/p>\n<div class=\"de-a\">\n<p>Weight-bearing and resistance exercises stimulate bone formation, build muscle, and reduce fall risk. The right type and intensity must match your age, fitness level, and bone health status. Please speak with us before starting a new exercise regimen.<\/p>\n<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">How can I prevent fractures at home?<\/p>\n<div class=\"de-a\">\n<p>For older adults, fall prevention is as important as treating bone loss itself. Key measures include removing loose rugs and floor clutter, installing grab bars in bathrooms, ensuring adequate lighting in hallways and stairwells, and wearing flat rubber-soled footwear when unsteady.<\/p>\n<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<p>[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_bh_s5{background-color: #ffffff !important; padding-top: 24px !important; padding-bottom: 64px !important;}\u201d][vc_column][vc_column_text]<\/p>\n<p class=\"de-section\" id=\"sec-pharmacologic-treatment\">Pharmacologic Treatment<\/p>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">What medications are used to treat osteoporosis?<\/p>\n<div class=\"de-a\">\n<p>Treatment is guided by overall fracture risk \u2014 not bone density alone.<\/p>\n<p class=\"de-drug-name\">Bisphosphonates <span>Alendronate \u00b7 Risedronate \u00b7 Zoledronic Acid<\/span><\/p>\n<p class=\"de-drug-desc\">The most widely used class. They inhibit bone resorption and reduce vertebral, non-vertebral, and hip fracture risk. Approved for postmenopausal and glucocorticoid-induced osteoporosis in both men and women.<\/p>\n<p class=\"de-drug-name\">Denosumab <span>Prolia\u00ae<\/span><\/p>\n<p class=\"de-drug-desc\">A potent RANK ligand inhibitor administered as a subcutaneous injection every six months.<\/p>\n<div class=\"de-warn\" style=\"margin-top:10px;\"><strong>Please never discontinue Prolia without speaking with us first.<\/strong> Cessation must always be followed by sequential antiresorptive therapy.<\/div>\n<p class=\"de-drug-name\">Teriparatide & Abaloparatide <span>Forteo\u00ae \u00b7 Tymlos\u00ae<\/span><\/p>\n<p class=\"de-drug-desc\">PTH analog agents that actively stimulate new bone formation. Reserved for patients with severe osteoporosis at high fracture risk. Administered as daily self-injections for a maximum of two years.<\/p>\n<p class=\"de-drug-name\">Romosozumab <span>Evenity\u00ae<\/span><\/p>\n<p class=\"de-drug-desc\">A sclerostin inhibitor that simultaneously increases bone formation and decreases resorption. Given monthly for 12 doses, after which transition to an antiresorptive agent is required.<\/p>\n<p class=\"de-drug-name\">Estrogen \/ Hormone Replacement Therapy<\/p>\n<p class=\"de-drug-desc\">Estrogen consistently reduces fracture risk. Its benefit-to-risk profile is most favorable when initiated within five years of menopause.<\/p>\n<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">What about strontium supplements?<\/p>\n<div class=\"de-a\">\n<div class=\"de-warn\"><strong>We recommend against strontium.<\/strong> Strontium is a heavy metal that deposits in bone and artificially inflates DEXA readings \u2014 not because bone has strengthened, but because strontium is denser than the calcium it displaces. There is no clinical evidence that over-the-counter strontium supplements reduce fracture risk.<\/div>\n<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">Does osteoporosis affect men differently?<\/p>\n<div class=\"de-a\">\n<p>Osteoporosis in men is significantly underdiagnosed. Alendronate, risedronate, zoledronic acid, and teriparatide are all FDA-approved for men and produce results comparable to those seen in women. We evaluate the full hormonal picture as part of every osteoporosis workup in our male patients.<\/p>\n<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_bh_hdr{background-color: #149d79 !important; padding-top: 28px !important; padding-bottom: 24px !important;}\u201d][vc_column][vc_custom_heading text=\u201dPatient Education \u00b7 Endocrinology\u201d font_container=\u201dtag:p|font_size:11px|text_align:left|color:%23ffffff\u201d use_theme_fonts=\u201dyes\u201d][vc_custom_heading text=\u201dBone Health, Osteopenia &#038; Osteoporosis\u201d font_container=\u201dtag:h1|font_size:44px|text_align:left|color:%23ffffff|line_height:1.1\u2033 use_theme_fonts=\u201dyes\u201d][vc_custom_heading text=\u201dA guide to understanding, diagnosing, and treating bone loss \u2014 written for our patients.\u201d font_container=\u201dtag:p|font_size:15px|text_align:left|color:%23ffffff\u201d use_theme_fonts=\u201dyes\u201d][\/vc_column][\/vc_row][vc_row][vc_column width=\u201d1\/1\u2033][vc_column_text] On this page Understanding the ConditionRisk &#038; SymptomsDiagnosisPrevention &#038; LifestylePharmacologic Treatment [\/vc_column_text][\/vc_column][\/vc_row] [vc_row full_width=\u201dstretch_row\u201d&hellip;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_gspb_post_css":"","footnotes":""},"class_list":["post-877","page","type-page","status-publish","hentry","description-off"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Bone Health &amp; Osteoporosis - Diaendo<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Bone Health &amp; Osteoporosis - Diaendo\" \/>\n<meta property=\"og:description\" content=\"[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_bh_hdr{background-color: #149d79 !important; 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