Q: Why is osteoporosis called a "silent disease"?

A: Osteoporosis is sometimes called a "silent disease" because it can occur gradually over many years without your knowledge. Often the very first symptom of osteoporosis is a broken bone, also called a fracture that usually happens at the hip, spine or wrist. Osteoporosis thins and weakens your bones, making them fragile and more likely to break. But the good news is that osteoporosis can be prevented and treated. Early detection is important; therefore, you should discuss your concerns with your health care professional soon.

Q: Can't I just take a multi-vitamin to prevent osteoporosis?

A: No! Most multi-vitamins contain only minimal quantities of calcium. Calcium carbonate and calcium citrate are available over-the-counter as supplements if your diet is low in this essential mineral. Girls age nine to 18 need 1,300 mg/calcium/daily (the equivalent of three, eight-ounce glasses of milk plus trace sources found elsewhere in the diet will be enough). The average woman age 19 to 50 needs 1,000 mg/calcium/daily for the average woman. And women 50 and older should be getting 1,200 mg/calcium/daily. In addition, be sure your diet (or supplement) also provides between 400 IU (international units) and 600 IU of vitamin D, which helps your body absorb calcium. Taking the recommended daily amount of calcium and vitamin D can cut your risk of fracture by as much as half, particularly in older women. Calcium is found in other dairy products besides milk. Yogurt and cheese also contain calcium. Fortified orange and other juices and many types of grains are other sources.

Q: If I've already reached the age of menopause, isn't it too late to do anything about osteoporosis?

A: It's never too late to make lifestyle changes and receive the appropriate treatments for osteoporosis. Although you can't restore all the bone that has already been lost, you can build some new bone and prevent bone loss with a diet rich in calcium and vitamin D, a program of weight-bearing exercise, and, in some cases, medications.

Q: Isn't it true that we get shorter as we age?

A: Substantial loss of height and a stooped posture are not normal results of growing older and can be signs of multiple fractures in the spine or back. Height loss of one to one and one-half inches can be due to degenerative risk disease and not necessarily osteoporosis related. Frequently, individuals don't know they have osteoporosis until their bones become so weak that a sudden strain, bump or fall causes a fracture or vertebra to collapse. It is these collapsed vertebra that lead to loss of height, stooped posture and other spinal deformities.

Q: If I have one or more of the risk factors for osteoporosis, does that mean that I probably have the disease but don't know it?

A: Not necessarily. Your health care professional will take into account a number of factors in determining your likelihood of developing osteoporosis. These include your personal health history, your individual osteoporosis risks, your lifestyle - including whether you exercise and are getting adequate calcium - and possibly the results of a bone mineral density (BMD) test. This quick test measures bone strength, predicts if your bones are at risk for fracture, may be helpful in monitoring the effects of treatment if the test is conducted at intervals of a year or more, and can help predict your future risk for osteoporosis. If you are concerned about your risks, be sure to discuss osteoporosis with your health care professional. Bone density tests are the single best way to predict your risk of fracture.