Risk Factors and Tests for Osteoporosis

Both women and men can and do develop osteoporosis. However, women have a greater risk, since they have less bone tissue naturally and lose  bone mass more rapidly than men do. Women can lose up to 20 percent of their bone mass in the five to seven years following menopause.

Risk factors:

• History of bone fracture after age 50
• Low bone mass
• Family history of osteoporosis
• Being thin or having a small frame
• Estrogen deficiency
• Abnormal absence of menstrual periods
• Anorexia nervosa
• Low calcium intake
• Vitamin D deficiency
• Use of medications such as corticosteroids and anticonvulsants
• Inactive lifestyle
• Cigarette smoking
• Excessive use of alcohol
• Being Caucasian or Asian (although African Americans and Hispanic Americans are at significant risk as well)
• In men:  low testosterone levels

Getting tested

There are two different tests for bone loss:

Peripheral heel screeningis a type of ultrasound offered by many pharmacies and doctors’ offices for about $30.  It’s sometimes available free at health centers and fairs.

DEXA(dual X-ray absorptometry) is performed in an X-ray lab with equipment that scans the hip, femur and spine. DEXA costs about $150 and requires a doctor’s prescription. Radiation exposure is low—about the same as a cross-country airplane trip.

DEXA is much more useful than a heel screening, because it gives detailed information and scans the areas where fractures are most likely. The biggest deterrent to getting DEXA is that many health insurers don’t cover it as a screening test.   According to the National Osteoporosis Foundation, Medicare covers bone density testing for people 65 and
over with the following circumstances:

• Estrogen-deficient women at clinical risk for osteoporosis

• People with vertebral abnormalities

• People receiving, or planning to receive, long-term steroid therapy

• People with primary hyperparathyroidism

• People being monitored to assess the response or efficacy of anapproved osteoporosis drug therapy Medicare covers repeat testing every two years for people in the first two of those categories.

Source: National Osteoporosis Foundation

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