Knowing the risk factors and taking steps to minimize bone loss early can help you avoid this debilitating disease.

According to the National Osteoporosis Foundation, an estimated 10 million Americans have osteoporosis, a bone disease in which the person affected loses too much bone, makes too little bone or both. Of that number, about 80 percent are women.

As pharmacists, we can be a first line of defense. We frequently encounter women who are at risk for osteoporosis. By asking simple questions, we can help determine the patients risk factors and develop a plan for prevention.

Calcium intake, regardless of age, is vitally important to any plan. Generally, I recommend at least 1000 milligrams calcium and 400IU vitamin D for those under 50. If over 50, 1200 milligrams calcium and 800IU vitamin D are advisable.

An assessment of your calcium intake and risk factors by a pharmacist or doctor may lead to additional proactive recommendations such as a bone mineral density test. Your physician will use these results to determine bone strength and risk of a bone fracture.

If you’re being treated for osteoporosis, you should tell your pharmacist what medications you are taking in order to determine your appropriate supplement needs. It is important to know their limitations and side effects. Bisphosphonates are the most common drugs used to treat and prevent osteoporosis. While these drugs can slow the loss of bone density, they are not a cure. They are commonly taken once a week or month with strict instructions on when and how to take them. The most common side effects are heartburn, upset stomach or even gastric ulcers. Any esophageal or stomach burning or pain after administration should be reported to your physician right away.

Another category of treatment drugs is selective estrogen receptor modulators (SERMs), which are hormone-like drugs developed to reap the benefits of estrogen. Hot flashes and an increased risk of blood clots are common side effects.

As helpful as some prescriptions are, my focus is on taking steps to prevent or minimize the risk of developing osteoporosis. To do this, remain as active as possible strong muscles help create strong bones.Also, avoid smoking and be sure to eat a diet high in calcium. Or if you’re lactose intolerant, be sure to take a calcium supplement. If you have a family history of osteoporosis, let your doctor know so that it may be determined if further screening is needed.

For people in high-risk categories or who have been diagnosed and are currently being treated with prescriptions, it is critical to take your medication, even though you may not feel any different. Set an alarm, mark your calendar or do whatever it takes to remember that weekly dose. Also watch out for symptoms such as back pain, which may indicate a developing problem. An unexpected fracture will make staying active difficult while increasing your risks.

Remember, the goal is to prevent and reduce bone loss early.

Osteoporosis risk categories

Women over 50

Post-menopausal women with decreased estrogen

Poor diet low in calcium-rich foods

Excessive alcohol consumption and smoking

Women who are lactose intolerant and must look for other ways to get calcium

Sedentary lifestyle leading to decreased muscle tone, a contributor to weak bones