Uncover Your Genetic Risk for Osteoporosis and Take Early Action

My mother has early-onset osteoporosis. As do all my aunts on her side of the family. I never really thought much about my possible genetic risk for osteoporosis until I had blood tests that revealed low estrogen. It turns out that estrogen is super important for bone density in women as they age. I’ll tell you the truth: I panicked a little when I first learned about this. I started thinking about all the fun things I like to do, like hiking, paragliding, horseback riding, and taking long motorcycle trips, and thought, are those days over? Do I now need to resign to a life of water aerobics and fear of slipping in the shower? 

While there certainly is a genetic risk for osteoporosis, just how much of a role does it play? Or are there things we can do for osteoporosis prevention? Let’s look at what science has to say. 

Genetic Risk For Osteoporosis

Genetics has a significant impact on a person’s bone strength, bone properties, and risk of osteoporosis. Bone mineral density (BMD) variations are mainly inherited, with genes affecting up to 80% of them. Genetics affects bone health in a complex way, and extensive studies have helped us understand how genetic networks are related to bone health. However, they have also shown that there is much more to learn.

Peak bone mass is critical because it influences the risk of developing osteoporosis. It’s estimated that up to 90% of bone mass in the lower back and 70% in the hip area is genetically determined. Despite many studies showing that genetics play a big role in osteoporosis, there aren’t precise risk estimates available for genetic counseling. We also don’t know how much family-related cases differ from non-family-related ones.

The good news is, though, that genetic and clinical data can be used together to create a genetic risk for osteoporosis profile, helping people develop preventive strategies and care. For osteoporosis, this data, along with X-rays and clinical information, can help determine the need for treatments to improve bone density. Treatments may include estrogen, calcium, and vitamin D supplements, as well as weight-bearing exercises, smoking cessation, and certain medications.

If you are concerned about early osteoporosis detection, a visit to your doctor is a great idea. When you visit your doctor, remember to mention:

• Any past broken bones.
• Your lifestyle habits, like diet, exercise, drinking, and smoking history.
• Medical conditions or medications that might lead to weak bones and higher fracture risk.
• Family history of osteoporosis and other illnesses.
• For women, your menstrual history.

The doctor might also do a physical exam, checking for:

• Changes in height and weight.
• Changes in posture.
• Balance and how you walk.
• Muscle strength, like if you can stand up from sitting without using your arms.

Your doctor might suggest an osteoporosis screening like a bone mineral density (BMD) test, usually on your spine and hip. This test can:

• Diagnose osteoporosis.
• Spot low bone density before it becomes osteoporosis.
• Help predict future fracture risk.
• Determine which form of therapy will work best for you.

How can I get diagnosed with osteoporosis?

Doctors usually diagnose osteoporosis through a routine osteoporosis screening and a thorough discussion of family history and lifestyle factors.

When should I start getting bone density screenings?

It’s recommended that women over 65, men over 70, and younger people with risk factors or a family history have an osteoporosis screening.

Importance of Early Lifestyle Interventions

Osteoporosis prevention starts in childhood. Many children, especially teens, might not get enough nutrients that help build strong bones, like vitamin D. To safely get the Vitamin D they need, supplements might be helpful but talk to your doctor to see if Vitamin D supplements are necessary.

Can vitamin D reverse osteoporosis?

Osteoporosis can’t be reversed, but taking calcium and vitamin D can help lower the risk of bone fractures and other issues.

Physical activity is important for people of all ages, starting in childhood. Weight-bearing exercises are crucial for building strong bones during the teen years. Activities like walking, running, soccer, and basketball are great examples of activities teens may like that are also helpful for building strong bones.

The main three things you can do as a parent of a child or teenager to reduce the risk of osteoporosis in later life are:

• Make sure your kids are getting enough calcium and Vitamin D.
• Encourage them to exercise regularly with activities like walking, running, or team sports.
• Encourage them to avoid smoking.

Teenage girls, in particular, might try to stay skinny by not eating enough or working out too much. This can make them lose weight, change their hormones, and stop their periods, a condition called amenorrhea. When this happens, the lack of estrogen can make their bones weaker when they should be getting stronger. It’s important to see a doctor if there are any changes in your or your daughter’s menstrual cycle.

Will I get osteoporosis if my mom has it?

Osteoporosis doesn’t have just one cause. The chances of getting it are connected to factors that can weaken bones. For example, if you have a genetic risk for osteoporosis and it runs in your family, or if a parent has had a hip fracture, you’re at a higher risk, but that doesn’t mean you are definitely going to inherit it. 

What Can I Do For the Best Chance of Osteoporosis Prevention?

If you’re like me and feel like you have missed the window for building bone density and osteoporosis prevention, relax. Your genes may affect your height and bone strength, but what you eat and how much you exercise are important for keeping your bones at a healthy density for your age. We all lose bone mass as we age, but as for how much we lose, a lot of that is in our hands with our lifestyle factors. 

Adults should do at least two and a half hours of moderate exercise, like biking or brisk walking, each week. Along with aerobic exercise, adults should do muscle-strengthening activities at least twice a week. This means working out all the major muscle groups: legs, hips, back, abdomen, chest, arms, and shoulders. If you have osteoporosis, it’s smart to talk to your doctor before starting a new exercise routine to ensure it’s safe for you.

Vitamin D is important for bones as it helps your body absorb calcium. Adults should get 15 micrograms of vitamin D daily, and many people are quite deficient in the nutrient. Checking your vitamin D status can be done with a simple blood test. Some things you can include in your diet for vitamin D are:

• Oily fish like salmon, sardines, herring, and mackerel
• Red meat
• Liver
• Egg yolks
• Fortified foods like some spreads and breakfast cereals

It might be hard to get enough vitamin D from food alone, and the best natural source is getting out in the sun for 20 minutes a day, but that isn’t always possible, depending on where you live. If this is the case, then supplementation might be a good idea!

Some other lifestyle factors that are really important for healthy bones are: 

• Quit smoking, as it raises the risk of osteoporosis.
• Limit alcohol intake. Better yet, give it up altogether, as science has recently proven that there is no safe amount. If you must drink, don’t drink more than 14 units weekly, and avoid binge drinking.
• Get some sun: Sunlight helps your body produce vitamin D, which assists in absorbing calcium. This strengthens your bones and teeth, helping prevent osteoporosis. It’s good to spend a little time in the sun each day. During the fall and winter, you’ll need to rely on food or supplements for vitamin D since the sun isn’t strong enough to provide it.
• Talk to a doctor about getting the best drugs for your specific case. While they are not cures, many medications can slow down the condition’s progress and give you many more years of healthy bones. Some of these include:
  • Prolia, which is particularly suited to address the development of osteoporosis in premenopause.
  • Evista, which can prevent the progress of osteoporosis in postmenopausal women
  • Evenity, which increases bone formation and decreases bone breakdown, helping strengthen bones and reducing the risk of fractures.