How To Avoid Osteoporosis

Those people with rheumatoid arthritis who take corticosteroids, even at low doses, are at risk for osteoporosis, the thinning of our bones that can make them crumble or break. Steroids diminish your body’s ability to absorb calcium from the intestines and hamper the manufacture of new bone.

Osteoporosis primarily affects the bones of the hip, wrists, and spine. It results in about 1.3 million fractures a year, including spinal fractures in one-third of women older than 65. Preventive measures are particularly important because there are no early warning signs of osteoporosis: The first indications may be a decrease in height or the formation of a dowager’s hump as bone in the spine collapses.

Your body borrows calcium daily from your bones for your blood to use. But it also redeposits calcium regularly from the food you eat, so new bone is continually being formed. Around age 40 to 44, the regrowth begins to slow down, and we begin to lose more bone than we manufacture. Add steroids to the mix, and the loss accelerates.

To make matters worse, as we get older, it also gets harder for our bodies to absorb calcium just when we tend to be eating less and in general taking in less calcium in our diets.

Extra vitamin D and calcium, however, can prevent or slow osteoporosis. Most women need 1,500 milligrams of calcium per day, and men need 1,000. The daily requirement for vitamin D is 400 international units (IU), but double that for people older than 50. (Based on blood tests, however, your doctor may recommend a higher dose.)

In a study on rheumatoid arthritis, people on corticosteroids who took supplements of 1,000 milligrams of calcium and 500 IU of vitamin D daily had an increase in bone mineral thickness in their lower spines. Those who didn’t get the supplements had a 3 percent bone loss each year. (The supplements had no effect on bone thickness in people who didn’t take corticosteroids.)

Nutritionists generally recommend trying to get your nutrients through food rather than supplements, however. This is both because you’re less likely to overdose on foods and because nutrients may work better when they’re in a “package deal” all wrapped up with other essential nutrients in healthy food. Here are good dietary ways to shore up your stores of calcium and its vital bone-building partner, vitamin D.

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