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DEAR MAYO CLINIC: My mother is in her 80s and was just diagnosed with atrial fibrillation. Her doctor recommended a blood thinner, but I have read that blood thinners can be dangerous. What are the risks?
ANSWER: Atrial fibrillation is an irregular and rapid heart rate that often results in poor blood flow to the body. Symptoms often include heart palpitations, shortness of breath and weakness. During atrial fibrillation, the heart’s two upper chambers, called atria, beat rapidly, chaotically, and out of sync with the two lower chambers, or ventricles. This abnormal heart rhythm may cause blood to pool in the atria and form clots. A blood clot that forms may break off and travel from your heart to your brain. There, it may block blood flow, causing a stroke. Blood clots from atrial fibrillation also may lodge in other blood vessels, cutting off blood flow to the kidney, leg, colon or other parts of the body.
medications, sometimes called blood thinners, can greatly lower the risk of
stroke and other damage due to blood clots in people with atrial fibrillation.
By delaying blood clotting, anticoagulants make it hard for clots to form and
prevent existing clots from growing.
years, the standard anticoagulant used for atrial fibrillation was warfarin (Coumadin,
Jantoven). Although effective at preventing blood clots, warfarin is a powerful
medication that can have serious side effects, including a low risk of bleeding
within the brain and elsewhere in the body. If the warfarin level in blood is
too high, bleeding is more likely to occur. If the level is too low, clotting
is more likely to occur. Many medications interact with warfarin and may
increase or decrease the blood level. As a result, people taking warfarin
require regular blood tests to ensure the correct dose.
Newer drugs called “direct-acting oral anticoagulants,” or DOACs, such as apixaban (Eliquis), rivaroxaban (Xarelto) and others, are another option. These drugs are shorter acting than warfarin and don’t require blood test monitoring for bleeding or clotting risk. They’re typically taken once or twice a day, and have fewer drug and food interactions than warfarin.
Today, direct-acting oral anticoagulants are often the first choice for anticoagulant therapy. But warfarin is still the right choice at times. In people with atrial fibrillation caused by valvular heart disease, as well as in those with prosthetic heart valves, mitral stenosis or valve damage that may lead to a valve replacement in the near future, warfarin is still the standard of care. Direct-acting oral anticoagulants aren’t recommended for people with severe liver disease or those taking certain medications.
anticoagulants, your mother’s health care provider will aim for a targeted dose,
factoring in her clotting risk and any other health concerns she may have.
Taking warfarin means regular monitoring to ensure that her blood clotting time
remains within a certain range. Traditionally, this required monthly blood
tests in her health care provider’s office. However, many medical facilities,
including Mayo Clinic, also offer a home monitoring program once a patient has
reached a stable dosage for at least three months.
signs of complications while taking any anticoagulants are urine that’s red or
dark brown; stool that’s red, dark brown or black; bleeding gums; severe
headache or stomach pain that doesn’t go away; feeling weak, faint or dizzy;
and frequent bruising or blood blisters.
If your mother decides to take an anticoagulant, it’s important she stick to her medication as prescribed. Abruptly stopping an anticoagulant can increase stroke risk. In addition, she should wear a medical alert bracelet or keep an anticoagulant alert card with her at all times in case of an emergency. (adapted from Mayo Clinic Health Letter) — Dr. Martha Grogan, Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
- Infographic: Living with atrial fibrillation published 8/29/18
- Blood thinner study: Mayo Clinic Radio Health Minute published 1/25/18
- Mayo Clinic Minute: Research shows newer blood thinners have lower risk of kidney function decline published 11/20/17
- 1 in 6 taking blood-thinning drugs may not be getting right dose published 6/5/17
3 days ago · Mayo Clinic Q and A: Treating vocal cord cancer
DEAR MAYO CLINIC: My brother was diagnosed with stage 0 squamous cell carcinoma in situ in one of his vocal cords. He has been through several endoscopic surgeries, but the carcinoma keeps coming back. His doctors do not recommend radiation therapy. Are more surgeries the answer, or are other treatments available?
ANSWER: For your brother’s condition, surgically removing the affected tissue is the best approach. Radiation therapy is not likely the answer for carcinoma in situ. That’s because the treatment carries more lasting side effects than surgery. And because of those side effects, radiation therapy cannot be used multiple times in this sensitive area, so typically radiation is reserved for more invasive cancer that involves more of the voice box.
The voice box sits just below your throat. It’s made of cartilage and contains your vocal cords, which vibrate to make sound when you talk. Cancer that begins in the vocal cords is a form of throat cancer that’s called “glottis cancer.” “Carcinoma in situ” is a term used to describe cancer at its earliest stage — stage 0. This form of cancer is confined within the cells and has not spread beyond them.
Carcinoma in situ within the vocal cords often is treated
surgically using endoscopy. The procedure involves inserting a hollow endoscope
into the mouth, and then passing special surgical tools or a laser through the
scope. Using these tools, the surgeon can scrape off, cut out or — if a laser
is used — vaporize the affected cells.
In a case such as your brother’s, where carcinoma in situ recurs,
the endoscopy procedure can be repeated as many times as necessary, as long as
the cancer continues to be limited to a small area. If the cancer spreads,
radiation therapy may be appropriate at that time.
Endoscopy is the preferred treatment versus radiation therapy
for carcinoma in situ that affects the vocal cords because the surgery poses
fewer risks. Many people who receive radiation therapy in the neck and throat
develop painful sores in the mouth and throat that can make eating
and drinking difficult. This can lead to weight loss and malnutrition. The
sores heal with time after the radiation therapy is complete, but some people
continue to have problems swallowing after the treatment is finished and the sores
Chemotherapy is not recommended for carcinoma in situ because
in almost all cases the side effects outweigh any benefits a patient may see
from that type of treatment.
In addition to endoscopy, treatment for carcinoma in situ also includes avoiding anything that could irritate the vocal cords and potentially contribute to the development of the carcinoma. For example, many throat cancers, including glottis cancer, are closely linked to smoking. Not everyone who develops this type of cancer is a smoker. But for those who are, quitting smoking is crucial. Not only does smoking increase the risk of the cancer coming back, it can make cancer treatment less effective. Smoking also makes it harder for the body to heal after treatment.
Excessive alcohol use can contribute to the development of throat cancer, too, especially if it’s combined with smoking or chewing tobacco. People diagnosed with throat cancer are strongly encouraged to avoid drinking any form of alcohol. It’s important for individuals diagnosed with carcinoma in situ that affects a vocal cord to work closely with their medical team to develop a treatment plan and set up a schedule to regularly monitor their condition. That way, if the cancer recurs or spreads, it can be treated promptly. — Dr. Eric Moore, Otolaryngology — Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
- Magic Mouthwash effective treatment for mouth sore pain caused by radiation therapy published 4/16/19
- Living With Cancer: Throat cancer — risk factors and prevention published 8/31/18
- Mayo Clinic Minute: The rise of HPV-related throat cancer published 7/18/18
- Living With Cancer: Understanding squamous cell carcinoma published 7/6/18
- Living With Cancer: What is radiation therapy? published 2/2/18
- Living With Cancer: Understanding throat cancer published 12/22/17
- Sharing Mayo Clinic: Throat cancer treatment gives dentist new perspective published 11/26/17
- Halving radiation therapy for HPV-related throat cancer offers fewer side effects and similar outcomes, Mayo study finds published 9/25/17
- Mayo Clinic Q and A: Throat cancer symptoms published 6/20/17
- Mayo Clinic Minute: Vaccinate against throat cancer? published 6/15/17
DEAR MAYO CLINIC: Do spray sunscreens work as well as sunscreen lotions, and do I need to buy different sunscreen for my kids than what I use myself?
ANSWER: Sunscreen that is marketed for children is OK to use, but children 6 months and older can use the same sunscreen as adults. Babies younger than 6 months should not wear sunscreen but should instead be kept out of direct sunlight and dressed in protective clothing.
Whatever kind you use, make sure it is a broad-spectrum sunscreen with a sun protection factor, or SPF, of at least 15. “Broad-spectrum” means the sunscreen protects against both types of ultraviolet rays: UVA and UVB, which both cause skin damage. UVA is the long wavelength of light that penetrates to the deep layers of skin. UVA leads to skin damage over time. UVB is the shorter wavelength of light that penetrates the surface of the skin and causes sunburn.
SPF is the measure of how well a
sunscreen protects against UVB rays. An SPF factor of 15 is the minimum needed
to prevent skin damage from UVB. A sunscreen with an
SPF higher than 50 provides only a small increase in UVB protection when
compared to SPF 30 or SPF 50. That means sunscreens with a very high SPF, such
as SPF 100, may not be worth the added cost when compared to how much
protection they offer. People who have sensitive skin or are allergy
prone should use sunscreens that have zinc oxide and titanium dioxide as the
people do not put on enough sunscreen. The key to getting the full amount of
SPF protection from sunscreen is to apply it generously and frequently. About
two tablespoons of sunscreen — or about enough to fit in a shot glass — is only
enough for your face, your neck and the back of your hands. Reapply sunscreen
at least every two hours, or more often if you’ve been sweating or swimming. A
sunscreen may be water resistant, but no sunscreen is waterproof.
in a spray is just as effective as sunscreen in a lotion. That said, sprays can
be hard to put on evenly, and it can be difficult to get enough sunscreen on using
a spray. Lotion is more predictable because you can see and feel where it goes.
Because of that, lotion tends to be a better choice for reliable sun
protection. When using sunscreen in a spray, be careful not to inhale
the fumes. Hold your breath while applying the spray, and don’t spray directly
onto your face or neck. Instead, spray the sunscreen onto your hands and then
rub the sunscreen onto your face and neck.
sunscreen anytime you’re outside, even if the sun isn’t shining. UV light penetrates through the clouds, and
it reflects off water, snow and other surfaces. When reflected, the rays become
even stronger, making sunscreen even more important.
If you don’t want to worry about reapplying sunscreen,
universal protective factor (UPF) clothing can be useful, particularly for active children who don’t care to stand still for another round of sunscreen. Many of these clothing items offer an SPF of 50. That’s higher than a standard shirt or hat with a tight weave, which usually has an SPF around 15. UPF clothing also is made to get wet, so a child can comfortably wear it in the water.
For consistent sun protection that you don’t need to reapply, UPF clothing, is a good choice. But don’t rely on sunscreen, or even clothing, alone. Avoid being out in direct sunlight in the middle of the day when the sun’s rays are strongest. When you’re going somewhere that shade may be scarce, bring an umbrella to use as a shield from the sun. Pack a broad-brimmed hat and sunglasses for you and your children. Using these tools, your entire family can stay sun safe. — Dr. Dawn Davis, Dermatology, Mayo Clinic, Rochester, Minnesota
- Mayo Clinic Minute: 3 things you might not know about sunscreen published 2/27/19
- Sun protection is for all seasons: Mayo Clinic Radio Health Minute published 1/31/19
- Two sunscreen rules: Mayo Clinic Radio Health Minute published 8/2/18
- Consumer Health: What to do after the sunburn published 7/13/18
- Home Remedies: Treating your sunburn published 7/4/18
- Shining a light on SPF in sunscreen: Mayo Clinic Radio Health Minute published 6/11/18
- Consumer Health: Sunscreen 101 published 6/8/18
- Mayo Clinic Minute: Uncovering ultraviolet protection factor (UPF) in clothing published 5/25/18
- Have fun but be safe in the sun published 5/24/18
- Mayo Clinic Minute: Shining a light on SPF in sunscreen published 5/24/18
- Mayo Clinic Minute: Sun safety during spring break published 3/22/18
DEAR MAYO CLINIC: How long does it take to become immune from measles once one has gotten the measles vaccine? And given the current outbreak, would it be beneficial for me to get a booster vaccine even though I was vaccinated against measles as a child?
ANSWER: The measles vaccine takes effect within weeks of receiving it, and once a person has developed immunity to measles, it lasts a lifetime. Measles is an extremely contagious illness that can lead to serious and sometime fatal complications. The measles vaccine is safe and highly effective at preventing this illness.
All children 18 and younger should receive
two doses of the measles vaccine. It’s recommended that the first dose be given
when a child is 12–15 months old. Children younger than 1 year don’t develop a
good response to the vaccine because their mother’s immunity not only protects
them from getting the disease, but also from responding to the vaccine. The
second dose is recommended before a child starts school, around ages 4–6.
Immunity to measles develops in 10–14
days after the first dose. Studies have found that 93% of recipients receive
full immunity with the first dose. A second dose ensures that more than 97% are
immune. The measles vaccine does not wear off over time. So even during an outbreak,
you don’t need another dose of the measles vaccine if you already have evidence
of immunity to the illness.
Evidence of immunity includes
written documentation of adequate vaccination. For low-risk adults who are 19
or older, adequate vaccination is one or more doses of the measles vaccine on
or after the first birthday. Adults who are at higher risk for measles,
including college students, health care personnel and international travelers,
need two doses of the vaccine at least 28 days apart to be vaccinated adequately.
In addition, almost everyone born
before 1957 has immunity to measles and does not require additional vaccination.
That’s because the measles vaccine was first produced in the early 1960s. Before
that, measles was common, so it’s likely people who were children before 1957 had measles and as a result have immunity
the measles vaccines given in the 1960s does not count. Current and past valid
measles-containing vaccines are live, attenuated vaccines. The “killed” or
inactivated version used from 1963 through 1967 does not count. If you received
unspecified measles vaccine doses during those years, it’s not possible to know
which version was used and you should discuss this with your health care
an adult 19 or older, if you’re unsure about your vaccination status or your
immunity to measles, talk to your health care provider. Records showing the
dates of your measles vaccination serve as proof of immunity. For those who
lack records, getting a dose of the vaccine is safe, even if you were
previously vaccinated. Alternatively, a
blood test can confirm if you already have immunity as the result of vaccination
Having immunity to measles is crucial because the illness can lead to serious medical complications, particularly in young children. Complications can include bacterial ear infections, bronchitis, laryngitis, croup and pneumonia.
Measles is highly contagious. It’s caused by a virus that replicates in the nose and throat. When someone infected with measles coughs, sneezes or talks, infected droplets spray into the air, where other people can inhale them. The infected droplets stay in the air or they may land on a surface, where they remain infectious for several hours. You can contract the virus simply by breathing the air in the room or touching your mouth, nose or eyes after touching an infected surface. About 90 percent of people who don’t have immunity to measles and are exposed to the virus will become infected.
Not all people can receive the measles vaccine. These include infants younger than 12 months, pregnant women, and those whose immune systems don’t work properly. Those people depend on everyone else who can get the vaccine to do so. That way, the vaccine not only protects the people who receive it, it also safeguards the health of vulnerable individuals in the community. — Dr. Robert Jacobson, Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
- More measles cases: CDC says largest outbreak since measles eliminated in 2000 published 4/25/19
- Infectious Diseases A-Z: The 3 Cs of measles published 4/22/19
- Infectious Diseases A-Z: Why the measles virus is so contagious published 4/9/19
- Infectious Diseases A-Z: Battling a myth about measles vaccine published 4/1/19
- Infectious Diseases A-Z: Measles outbreaks continue in the US published 2/25/19
- Consumer Health: Measles — contagious and preventable published 2/1/19
Tue, May 7 10:34am · Mayo Clinic Q and A: Congenital heart defect can affect health of mother and baby
DEAR MAYO CLINIC: My husband and I are hoping to start a family soon, but I have a congenital heart defect — a bicuspid aortic valve. I’m concerned how that will affect my pregnancy. What do I need to consider before getting pregnant? What are the risks?
ANSWER: A congenital heart defect can affect your health — and potentially the health of your baby — during pregnancy. But the presence of a congenital heart defect doesn’t necessarily mean you should not get pregnant.
A good first step for you would be to find a cardiologist who is board-certified in adult congenital heart disease and has experience in evaluating and managing heart patients considering pregnancy. He or she can review your current health and medical history, and talk with you about potential pregnancy risks and how you may be able to manage them. In addition, he or she can discuss with you the likelihood that your child will have a congenital heart defect.
Congenital heart defects — abnormalities in the structure of the heart that are present at birth — are common, affecting about 1 in 100 live births. Due to advances in care, most individuals born with congenital heart defects who may not have survived 40 years ago are now living and thriving as healthy, productive adults with families of their own.
For women with congenital heart defects — even those successfully treated when they were children — pregnancy can present health challenges. Pregnancy places extra stress on the heart and circulatory system. During pregnancy, a woman’s blood volume increases by 30 to 50 percent, the heart pumps more blood each minute, and the heart rate increases. Labor and delivery add to the heart’s workload. After delivery, it takes several weeks for the stresses on the heart to ease and heart function to return to normal.
When one of the heart valves is abnormal, as in your situation, it may be harder for the body to tolerate the increased blood flow associated with pregnancy. In some cases, there may be a higher risk of infection in the lining of the heart or in the heart valves during pregnancy.
Women with a bicuspid aortic valve — in which the valve has only two leaflets rather than three — also may have dilatation of the ascending aorta, which can present unique concerns when pregnancy is being considered. That condition can be detected during an echocardiogram performed as part of your prepregnancy evaluation.
Research has shown that bicuspid aortic valves often run in families. That means you may need additional monitoring and ultrasound scans during pregnancy to check your baby’s heart valves as he or she develops.
To evaluate your risks and help you plan for pregnancy, consult with a physician who specializes in adults with congenital heart defects. Ideally, this would be someone with experience and expertise working with pregnant women who have heart disease — a subspecialty known as maternal cardiology. This physician should work closely with a maternal fetal medicine specialist, an obstetrician who is trained to evaluate and care for patients like you.
The health care organization you choose should have specialists in genetics and cardiac surgery — in addition to cardiology, obstetrics and pediatrics — who will work together to provide a full spectrum of care throughout pregnancy for you and your baby.
As you consider becoming pregnant, be aware, too, that some congenital heart defects can affect fertility. So that’s another topic to discuss with your cardiologist. If fertility is a concern, he or she can help you identify options and fertility specialists in your area, if needed.
Many women with congenital heart defects have successful pregnancies. But it’s important to understand your individual risks and to work with a health care team that’s well-equipped to deal with any complications that may arise during pregnancy. — Dr. Naser Ammash, Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
- Women’s Wellness: Congenital heart disease and pregnancy published 2/21/19
- Sharing Mayo Clinic: A personalized approach to heart health published 7/15/18
- Mayo Clinic Radio: Congenital heart defects published 4/26/18
- Women’s Wellness: Know the risks of heart conditions and pregnancy published 3/1/18
Fri, May 3 12:00pm · Mayo Clinic Q and A: Depression in older adults
DEAR MAYO CLINIC: My mother is 84 and still lives at home. Over the past couple of months, she has been sleeping more and doesn’t have a lot of energy or an appetite. She has wondered out loud if she is depressed, but she’s never had depression before. Could that be the problem, or should we be concerned about something else causing her symptoms? Should she see her doctor about this?
ANSWER: It would be a good idea for your mother to see her health care provider at this time. Her symptoms might be related to depression, or they may signal another underlying medical condition. Either way, it’s likely that an evaluation can help uncover the source of the problem, and treatment could help her feel better.
Depression is a mood disorder that often causes persistent feelings of sadness, as well as other symptoms, such as sleeping too much or too little, lack of energy and lack of appetite. While your mother hasn’t suffered with depression before, it definitely is possible to develop depression for the first time at her age. Depression is not a normal part of growing older, and symptoms that could point to it need to be addressed.
Depression often goes undiagnosed and untreated later in life, and some older adults may be reluctant to seek help for it. Depression in this age group also can be more challenging to diagnose because its symptoms tend to be different or less obvious in older adults than in those who are younger. For example, it is much more common for people later in life to experience only physical symptoms of depression without feeling sad or having low mood.
Various changes that happen as people age make them more prone to depression than they may have been in their younger years. The most common is chronic pain that arises as a result of health conditions such as osteoarthritis. The toll that chronic illnesses such as diabetes, cardiovascular disease and cancer can take on a person’s daily life also can affect the development of depression.
Another factor that can contribute to depression later in life is the struggle many people experience with changes in their identity, roles and social groups that come with advancing age. People who have always been productive, responsible, active members of their communities and families may start to feel like they are no longer needed or valued. The deaths of friends and family members can lead to feelings of grief and loss, as well as shrinking opportunities for social interaction and a growing sense of isolation.
Before your mother’s symptoms are attributed to depression alone, however, it is important that she see her health care provider to be evaluated for other underlying medical issues that could be causing her symptoms. Common health concerns in older adults that may trigger the kind of symptoms your mother is experiencing include anemia, urinary tract infections, thyroid problems, chronic pain or even malnutrition. In some cases, certain medications can contribute to symptoms of depression, so a review of your mother’s current medications also would be worthwhile.
If no underlying medical condition is found and your mother is diagnosed with depression, several effective treatment options are available, including medication and psychotherapy. Healthy lifestyle choices, such as regular exercise, good sleep habits, engaging social interaction and a balanced diet may help, too. — Dr. Janette Leal, Psychiatry, Mayo Clinic, Rochester, Minnesota
- Women’s Wellness: Understanding the depression gender gap published 1/31/19
- Mayo Clinic Q and A: Transcranial magnetic stimulation may ease depression symptoms published 9/18/18
- Home Remedies: Can fish oil supplements treat depression? published 6/6/18
- Home Remedies: Are natural remedies effective for depression? published 10/11/17
DEAR MAYO CLINIC: Three months ago, I had surgery on my left wrist to treat carpal tunnel syndrome. Since then, I am in much more pain than before surgery, and two of my fingers are completely numb. I cannot even button a button, and tying my shoes is a chore. What would cause the pain to worsen after surgery? Could another surgery remedy the problem, or is this my new normal?
ANSWER: Your condition as it stands now shouldn’t be considered a new normal. It’s possible your symptoms are part of the recovery from surgery, and they may improve with time. It would be a good idea, however, to meet with your surgeon now, so he or she can reassess your condition and decide if you need additional tests or treatment.
Carpal tunnel syndrome is caused by compression of the median nerve within the carpal tunnel — a narrow passageway on the palm side of your wrist. The median nerve runs from your forearm through the carpal tunnel and into your hand. It controls the sensations you feel on the palm side of your thumb and fingers, except the little finger. Carpal tunnel syndrome often causes numbness and tingling in the hand and arm. Surgery to treat it involves relieving pressure on the median nerve by cutting the ligament that crosses over it.
Research shows that symptoms improve for more than 90% of patients following carpal tunnel surgery. However, the number who experience complete relief of symptoms after surgery may be only 50%. Patients whose symptoms are severe before surgery show the most improvement afterward, but this group also tends to have the most residual symptoms after the procedure.
At three months following carpal tunnel surgery, your numbness and pain still could be byproducts of the procedure. Many people find the incision causes pain and irritation as it heals. In addition, a condition called ‘pillar pain,’ which is a localized reaction to the surgery, can lead to discomfort. Both generally improve over several months.
Working with a hand therapist can be particularly useful during this uncomfortable period of recovery. The therapist can follow your progress by measuring the strength and sensation in your fingers, hand and arm, as well as provide advice about how to make your hand and arm more comfortable.
It’s helpful to note, too, that nerves typically improve after surgery at a rate of about 1 inch per month. When sensation returns, it happens gradually. In general, full recovery after carpal tunnel syndrome may take up to a year.
Whether your pain and numbness are part of the healing process or whether they signal the need for more intervention depends somewhat on how your current symptoms compare to the symptoms you had before surgery. For example, you mention that two of your fingers are completely numb. If the numbness is significantly worse than it was before surgery, or if it’s affecting different parts of your hand, then closer assessment is appropriate at this time.
It is a possibility that another problem is playing a role here. Various diseases, such as inflammatory arthritis, can first appear as carpal tunnel syndrome before it becomes evident that another process actually is triggering the condition. An ultrasound may reveal a new or additional diagnosis at the wrist. The scan also can help your surgeon determine if decompression of the median nerve is complete. If not, then another procedure may be useful.
In some cases, numbness following carpal tunnel surgery happens due to a problem farther up the arm, or in the shoulder, neck or brain. If your surgeon suspects that could be the case for you, you may be referred to another specialist, such as a neurologist, for further assessment. — Dr. Mary Jurisson, Physical Medicine and Rehabilitation, and Dr. Nicholas Pulos, Orthopedic Surgery — both of Mayo Clinic, Rochester, Minnesota
- Carpal tunnel syndrome: Mayo Clinic Radio Health Minute published 1/10/19
- Carpal tunnel surgery: Mayo Clinic Radio Health Minute published 7/27/18
- Mayo Clinic Minute: Symptoms, solutions for carpal tunnel syndrome published 9/25/17
- Mayo Clinic Q and A: Carpal tunnel syndrome may require surgery published 5/20/17
Fri, Apr 26 12:00pm · Mayo Clinic Q and A: Understanding -- and preventing -- osteoporosis
DEAR MAYO CLINIC: Does having low peak bone mass in my late 20s mean that osteoporosis is inevitable someday? Is there anything I can do to prevent osteoporosis?
ANSWER: Low peak bone mass in your 20s does not necessarily mean you will develop osteoporosis, but it does make it more likely. For most people, bone loss doesn’t begin until the mid-50s. Between now and then, there are steps you can take to decrease your risk of osteoporosis. They include lifestyle choices that improve bone health — such as making sure you get enough calcium and vitamin D — and treating any underlying conditions you may have that could lead to bone loss.
Your bones are living, growing tissues that are constantly changing. Throughout your life, your body gets rid of old, worn-out bone and forms new bone to replace it. Through this process, your skeleton refurbishes and maintains itself.
When you’re young, your body makes new bone faster than it breaks down old bone, and your skeleton grows in size and density. Bone density refers to how much calcium and other minerals your bones contain. Bone mass is the total amount of bone tissue in your skeleton. The higher your peak bone mass, the more bone your body has to sustain bone health throughout the rest of your life.
Bone mass increases rapidly during childhood and adolescence. For girls, maximum bone growth happens in the years between puberty and age 18. Most people reach peak bone mass by their early to mid-30s. After that, you begin to gradually lose bone as part of the normal aging process. If you start out with low peak bone mass, you are more likely to lose enough bone over time that you could end up developing osteoporosis.
Osteoporosis occurs when the body’s creation of new bone can no longer keep up with the breakdown of old bone. Bones then become weak, brittle and easily broken. Women are at higher risk for osteoporosis than men, particularly once they are past menopause. That’s because women tend to lose bone density quickly in the years after menopause.
Some aspects of bone mass aren’t within your control. Genetic factors have an effect on how strong and large your bones will be. And, in general, women have a lower peak bone mass than men. But there are things you can do that will help strengthen your bones over time. For example, regularly engaging in weight-bearing physical activity; eating a healthy, balanced diet with the right amounts of calcium and vitamin D; not smoking; and limiting alcohol all can help fight bone loss.
Other health conditions can affect your risk of developing osteoporosis. Many diseases and conditions have been identified as contributing to bone loss, including diabetes, thyroid disorders and disorders that affect the body’s hormone production. If you have any of these conditions, it’s crucial you receive timely, comprehensive treatment for it to help decrease the potential for accelerated bone loss.
If over time you do develop osteoporosis, there are ways to combat it at that point. Medications are available to treat osteoporosis that increase bone density, slow bone break down and reduce the risk of bone fractures. The most common medications prescribed for osteoporosis are bisphosphonates. Examples include alendronate (Fosamax), risedronate (Actonel) and ibandronate (Boniva).
At this point, however, your best defense against developing osteoporosis in the future is to focus on doing what you can now to strengthen your bones. If you’d like more guidance, make an appointment with your primary health care provider to talk about your risk for osteoporosis and discuss specific steps you can take to ensure your long-term bone health. — Dr. Bart Clarke, Endocrinology, Mayo Clinic, Rochester, Minnesota
- Las personas con osteoporosis deben evitar ciertas poses de yoga para la columna, dice un estudio de Mayo Clinic (People with osteoporosis should avoid certain yoga poses for the spine, says a Mayo Clinic study) published 2/26/19
- People with osteoporosis should avoid certain spinal poses in yoga, Mayo Clinic study says published 2/20/19
- El minuto de Mayo Clinic: La osteoporosis también afecta a los hombres (The Mayo Clinic minute: Osteoporosis also affects men) published 2/12/19
- Mayo Clinic Minute: Osteoporosis affects men, too published 10/3/18
- Mayo Clinic Minute: Osteoporosis is soft bones published 9/10/18
- Osteoporosis: Mayo Clinic Radio Health Minute published 8/17/18
- Women’s Wellness: Bone density in women published 5/18/18
- Mayo Clinic Q and A: Calcium and exercise both important for bone health published 3/9/18
- Preguntas y respuestas: Medicamentos para la osteoporosis (Questions and answers: Medicines for osteoporosis) published 1/4/18
- Mayo Clinic Q and A: Finding the right osteoporosis medication published 10/13/17
- Researchers report link between cells associated with aging and bone loss published 8/21/17