Scott Webb (Host): Osteoporosis is very common, and my guest today is here to tell us about osteoporosis and share the signs, symptoms, and treatment options. Joining me today is Dr. Brinda Basida. She's a rheumatologist with Prisma Health.

This is Flourish, the podcast brought to you by Prisma Health. I'm Scott Webb. Doctor, it's great to have your time today. We're going to talk about osteoporosis and what it is and how we deal with it. So, let's start there, the obvious one. What is osteoporosis? And do we know what causes it?

Dr. Brinda D. Basida: Well, osteoporosis is basically low bone mass and then some structural changes in the bones that makes them weaker and, hence, more susceptible to fractures. There are certain risk factors, but aging is the number one of all. Women, post-menopausal women specifically, are also at high risk. But there's no specific cause for osteoporosis, unless it's like a genetically susceptible individuals.

Host: Sure. All right. So, mostly women, right? Post-menopausal. definitely age is a factor. Are there maybe some health conditions that make someone more likely to experience osteoporosis?

Dr. Brinda D. Basida: Most of those common conditions that we typically are dealing with lately, diabetes, chronic kidney disease, chronic liver disease, specifically if somebody has had a prior fracture, they are the strongest predictors of having a future fracture. Or if their parents have had history of hip fractures or low BMI, cigarette smoking, excessive alcohol consumption, chronic prednisone use, all of these are high-risk factors.

Host: Some of the factors there. And it makes me wonder, we touched on this a little bit, but about family and the genetic component, if you will. Is that a thing? Is there a sort of a risk of osteoporosis running in families?

Dr. Brinda D. Basida: Not really. I wouldn't say this is more like a genetic condition. But yes, if there is a history of maternal hip fracture, it has been known that the chances of the children getting the fracture does increase. It is actually one of the factors that is considered in the Frax tool, which is calculating your probability of getting a fracture in the next ten years.

Host: Okay. Yeah, it's interesting, just the sort of understanding. It's like there could be a genetic component. But for most, it's maybe not the case. And we touched on this a little bit, that this mostly affects women. But can men get osteoporosis or is it really just a women's disease for the most part?

Dr. Brinda D. Basida: That's a very good question. Actually, studies so far or guidelines are heavily focused on women. But there are no, like, specific guidelines on when to screen men at or what age. But typically ASBMR, which is the American Society of Bone and Mineral Research, have suggested to screen men seventy or older or younger men with any of these risk factors that we discussed previously.

Host: You mentioned the risk factors. Wondering, what are maybe the signs or symptoms of osteoporosis, maybe when we should see a doctor if we suspect that our symptoms might be caused by osteoporosis? Just give us a sense of when we should be concerned.

Dr. Brinda D. Basida: Usually, typically, any sort of fractures, especially after a certain age like 65 or above, needs to be evaluated for further screening for osteoporosis. But sometimes you could have painless, you know, fractures in the spine, and these are non-traumatic fractures. And the way most of the times we see them is a decrease in their height, and that's mainly because their thoracic vertebrae are fracturing. And there's a loss of height. So, that's one of the very common symptoms or like finding we see in osteoporosis. But of course, any sort of fractures, whether it's hip fractures, wrist fractures, humerus, femur fractures, those are all concerning to screen further.

Host: Yeah. And maybe I'm inventing this in my head, but I feel like I've heard this before, that the type of fractures where you wouldn't expect to have experienced a fracture, right? You may have suffered some kind of injury or bumping your arm into the door or something like that, and you wouldn't expect for there to be a fracture, but we get one. Is that maybe sort of a sign that it's osteoporosis?

Dr. Brinda D. Basida: Absolutely. So, this is called like a fragility fracture. So, fragility fractures are the fractures that you get from having a fall from a standing height. And those are like low impact fractures basically. So, those are the ones that needs to be looked into.

Host: For sure. So, what can we do, doctor, to help ourselves to prevent osteoporosis? Do we need to drink more milk, take vitamin D supplements? From you, from an expert, like, what can we do to help ourselves?

Dr. Brinda D. Basida: Obviously, getting some sort of calcium vitamin D supplements. In fact, RDA recommends about 1000 to 1200 milligrams daily of calcium supplements or vitamin D of 600 to 800 international units daily. Those are good habits to have incorporated in your day-to-day food or supplements.

But apart from that, doing resistance and balance exercises. Preventing falls is a major factor there. And then, smoking cessation, limiting alcohol use, some of these things can help prevent that bone loss.

Host: For sure. Yeah, and I just want to finish up here, Doctor. I know we used to tease my grandma that it seemed like she was shrinking. You know, as she got older, it seemed like she was shrinking, and I'm connecting the dots. You were talking about fractures in the back. And so, is that a thing? Do people actually shrink as they get older, or is it probably the osteoporosis causing the fractures and the sort of shrinkage in the spine? Like, take us through this. Am I just imagining this, or does it just seem like folks tend to get a little shorter as they get older?

Dr. Brinda D. Basida: So, the reason behind the, you know, height loss is because of the fractures. The spine is not standing as tall as it should, and it's kind of dipping down, and that's why there's a loss of height as we age.

But I wanted to also mention, you know, there are medications to treat osteoporosis. There's no specific medication that can prevent it, specifically. But once it is identified, there are medications to prevent it further, like prevent further fractures. And we usually recommend getting a DEXA scan done. I think insurance approves approves after age of 65 for women and then every two years after, to kind of look who are susceptible for these kind of osteoporotic fractures. There are scores on that DEXA scan which will differentiate who is at risk or who has osteoporosis. And that way, they can get appropriate medical management.

Host: Sure. Well, that's perfect. As you were saying, there are some things we can do to help ourselves, things that doctors can do to help us, like get a DEXA scan, take possibly some medications, things like that. Unfortunately, osteoporosis is just a fact of life, especially for many women. So, I appreciate your time. Thanks so much.

Dr. Brinda D. Basida: Thank you so much.

Host: For more information and other podcasts just like this one, head on over to prismahealth.org/podcast. This has been Flourish, a podcast brought to you by Prisma Health. I'm Scott Webb. Stay well.