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5. Am I likely to develop vitamin D deficiency in winter -- and why is vitamin D essential for calcium absorption?

Our bodies create vitamin D from sunshine -- 10 to 15 minutes of sun a day is all that is needed. During winter, we spend less time outdoors, and we’re bundled up against the cold. So some experts think the risk of vitamin D deficiency is higher in winter.

But year-round, many of us don’t get the vitamin D we need. The Institute of Medicine recommends:

  • 600 IU (international units) a day for adults through age 70
  • 800 IU a day for adults ages 70 and older

Vitamin D plays a vital role in getting calcium into the bloodstream from the intestines and the kidneys. Without enough vitamin D, a lot of the calcium you take in from food or supplements could pass out of the body as waste.  If you don’t get outdoors much or get vitamin D from fortified foods, ask your health care provider about taking vitamin D supplements. 

6. Can genetics predispose me to low bone density and osteoporosis?

Your genes can play a big role in your risk of developing osteoporosis. For instance, studies show that if your parents had a history of bone fractures, you're more likely to have weaker bones and a higher risk of fractures yourself.  

Your risk of getting osteoporosis is also higher if other family members, like aunts or siblings, had it too. A genetic risk for osteoporosis can be inherited from either your mother or father.

If osteoporosis does run in your family, talk to your health care provider. You may need to take extra steps to prevent it.

7. Why would I have low bone density if I haven't gone through menopause?

Although the drop in estrogen levels during menopause can result in dramatically thinning of bone and increases  your risk of osteoporosis, it isn't the sole cause of the disease. Many other factors -- like your genes, some diseases and treatments, eating disorders, excessive exercising and weight loss , smoking, excess alcohol, and deficiencies of calcium and vitamin D -- can play an important role. Remember that men can get osteoporosis too, even though they don't go through menopause.

8. What is a bone density test and what do the scores mean?

A bone mineral density test is the typical way of diagnosing osteoporosis and helps to predicting your risk of fractures. It's a kind of X-ray that reveals the hardness of your bones. The most common type is called a dual-energy X-ray absorptiometry (DXA or DEXA). Usually, the scans look at the weight-bearing ability of your hip and spine, this information is then used to help estimate your risk of fractures. Your doctor will calculate your risk of future fractures with a tool known as a FRAX score and determine whether you would benefit from treatments .

A normal bone density is a T-score of plus one (+1) to a score of a minus one (-1). A low bone mass (osteopenia) is a bone density T-score of -1 to -2.5. Osteoporosis is defined as a bone density score of -2.5 or below.

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