Women, start caring for your bones early

Time is takes its toll on our bones.

After women’s bodies reach peak bone mass, between the ages of 20 and 30, things start going south. Beginning at around age 40, and then accelerated by menopause and the accompanying loss of estrogen, our bodies start losing bone faster than they can manufacture it.

And you know the result. You may have seen it in your mother or grandmother. Loss of bone mass leads to shortened stature and fractures of the spine, hip, wrist, pelvis and other vulnerable areas. The stooped appearance known as “dowager’s hump” — I hate that term and prefer the proper name, kyphosis — can be a symptom not just of poor posture, but also of bone loss.

This bone loss is known as osteoporosis — literally, porous bones. The precursor to osteoporosis is osteopenia, a condition in which bones are weakened.

If you’re 50 or older, you probably know all about this. You may be taking calcium and vitamin D supplements as well as medications to help your body build bone, such as ibandronate (brand name Boniva).

Starting at age 65, Medicare will pay for bone scans every two years to assess the state of your skeletal structure. Before 65, employer-based insurance will likely pay for a bone scan because of estrogen deficiency post-menopause, if you’ve had a fracture, or if you’re taking a medication known to thin bones. Among these are certain drugs to treat asthma, cancer, epilepsy and depression.

I think, though, that it’s a mistake to wait until you’re 50 to start worrying about your bones — especially since you can’t really know if anything is wrong until you’re 65! Rather, I encourage teen girls and young adult women to start caring for their bones earlier so they can retain bone mass, strength and mobility as they get older.

Your body needs calcium, the building block of bone, along with vitamin D, which helps the body absorb calcium, from an early age, and the need keeps growing with age. Your doctor or your child’s pediatrician is the best source of information for how much is the right amount, but it’s generally recommended that children have vitamin D supplements because it’s hard to get enough from food.

Puberty is when a girl’s bone growth really kicks in. Half of total body calcium stores in women are made during puberty, which is also a time of great bone growth as girls get taller. Experts say about 1,300 mg of calcium a day, plus a vitamin D supplement, are optimal. By age 20, a young woman has 90% of the bone she’ll need.

Between 20 and 30, the need for calcium and vitamin D lessens a bit, but getting the recommended calcium and vitamin D daily allowance is especially important when you are pregnant or breastfeeding. Without it, a fetus may pull calcium out of the mother's bones in order to build its own skeleton. A nursing baby also requires calcium, and a mother can lose bone mass during the time she breastfeeds.

All through your life, your body is continually removing old bone and replacing it with fresh bone, a process known as remodeling. Up until about age 40, all the bone removed is replaced, but that slows down after age 40. Medications typically slow down some of this bone loss and let your body catch up — as long as it’s getting enough calcium and vitamin D.

What else can you do? It’s great that so many young girls take part in vigorous sports, such as soccer, field hockey, lacrosse and basketball, because all of that weight-bearing exercise helps build bone. The challenge is keeping up that weight-bearing exercise as we get older.

As far as calcium, it’s available in many tasty forms from many enriched foods these days, including dairy, soy and almond milks; Greek yogurt; and juices with added calcium. Green leafy vegetables also contain calcium.

As a private patient advocate, I’ve found there are few things sadder than an older woman who struggling to recover from a fractured hip due to bone loss. I know it’s hard to focus on something now that might not affect you for decades down the road, but if you start caring for your bones the way you take care of your skin, teeth and hair, you will reap the benefits later on.

So stop rolling your eyes and have a glass of milk!

• Teri (Dreher) Frykenberg is a board-certified patient advocate. A critical care registered nurse for 30+ years, she is founder of NShore Patient Advocates (www.NorthShoreRN.com). Her book, “How to Be a Healthcare Advocate for Yourself & Your Loved Ones,” is available on Amazon. She is offering a free phone consultation to Daily Herald readers; email her at teri@northshorern.com.