Osteoporosis: The Genetic Factor

Susan Hume, 54, of Shelton, Conn. (pop. 38,101), always has prided herself on the care she takes of her body.

Susan Hume, 54, of Shelton, Conn. (pop. 38,101), always has prided herself on the care she takes of her body. Small and thin, she keeps herself fit with dancing and works out with weights several days a week. She is a vegetarian, although she does eat fish, and she’s always been relatively healthy. So when a bone scan two years ago led to a diagnosis of osteopenia—low bone mass—she nearly fell off the medical examining table with shock. “I just assumed my bone scan would be stellar,” she said. “I’ve worked out all my life!”

And though the diagnosis may have taken her by surprise, Hume certainly is not alone in her diagnosis. The National Osteoporosis Foundation estimates that about 55 percent of people age 50 and older face the threat of osteoporosis—men as well as women—and 34 million already have osteopenia.

Unfortunately, despite her good exercise habits, Hume had several characteristics that increase her risk for osteopenia and its more serious cousin, osteoporosis: She is Caucasian, petite and thin; she smoked during her teens and 30s; and for years she skipped meals and ate poorly, the result of a stressful job and little interest in food. And though Hume may not have thought much about her bones when she was young, her osteopenia diagnosis makes sense to Dr. Tim D. Spector, a rheumatologist who notes that bone actually is living tissue that is greatly affected by diet and exercise—especially early in life.

To find her greatest risk factor, though, Hume had to look no further than her family tree: Her 89-year-old mother has osteoporosis, as did her paternal grandmother—hereditary facts that don’t bode well for Hume. According to the National Osteoporosis Foundation, research suggests that if either of your parents had osteoporosis or have a history of broken bones, your risk is greatly increased.

Susan’s sister, Samantha Hume, 51, of Fairfield, Conn. (pop. 57,340), didn’t wait for the family’s history of osteoporosis to catch up with her. Her wake-up call came several years ago when their mother broke her hip. “It got me thinking back to my father’s mother and how she always tried to stand up straight but could not because she had (developed a hump) from osteoporosis,” Samantha says.

Someday, Dr. Spector says, there will be a simple test for genetic factors that increase your risk of osteoporosis. If you’re deemed to have a higher risk, doctors will simply start you on vitamin D and calcium supplements, even medication, before any bone loss occurs. But that day hasn’t arrived yet.

“While we know that there are genetic components to osteoporosis, a lot of studies have contradicted one another,” said Dr. Bradley T. Tinkle, director of the Skeletal Dysplasia Center at Cincinnati Children’s Hospital Medical Center. Nonetheless, “If you have older relatives in your family who had osteoporosis then you should be wary and understand that you likely have some genetic predisposition for weakened bones.”

Once you’ve determined that bone disease runs in your family, be proactive. That’s what Susan Hume did. Under the advice and guidance of her doctor, she immediately began taking daily supplements of vitamin D and calcium. She also loaded her diet with calcium-rich greens and fish such as salmon and sardines.

She hasn’t returned yet for a follow-up bone scan, but hopes that when she does in six months, the scan will show no further bone loss, maybe even some gain. And although Samantha’s bones remain strong, she takes supplemental calcium and vitamin D and follows a high-calcium diet like her sister. Considering her family tree, she knows better than to take any chances.

Story by Debra Gordon of Williamsburg, Va.

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