It is estimated that approximately 55% of American people, aged 50 and older are threatened with Osteoporosis, according to the National Osteoporosis Foundation. Over 10 million Americans have been diagnosed with this potentially disabling disease and 34 million have signs of decreased bone mass/ Osteopenia which may be a precursor to Osteoporosis if left untreated. This silent disease progresses painlessly in which the bones in the body become fragile, brittle and porous increasing the incidence of a fracture or break exponentially. Any bone can be affected, but of special concern are fractures of the hip and spine. A hip fracture almost always requires hospitalization and major surgery. It may not only impair a person's ability to walk unassisted and cause prolonged or permanent disability but also increases the risk of death by 25%. Spinal or vertebral fractures also have serious consequences, including loss of height, severe back pain, and deformity.
Risk Factors that increase the likelihood of developing Osteoporosis:
Being female (80% increased risk than men) Older age Family history of osteoporosis or personal history of broken bones Being small and thin framed Hormonal Imbalance
Low estrogen levels in women, including peri-menopause, surgical menopause, menopause
Missing periods (amenorrhea)
Low levels of testosterone in men Diet
Low calcium Low vitamin D Excessive intake of protein, sodium and caffeine
Certain medications such as steroid medications, some anticonvulsants and others
Certain diseases and conditions such as anorexia nervosa, rheumatoid arthritis, gastrointestinal diseases and others that impair nutritional absorption of vitamins and minerals
Diagnosis: The standard of care for testing bone density is a DEXA scan which stands for dual
energy x-ray absorptiometry. DEXA is a form of X-ray that can detect as little as 2% of bone loss per year. A standard X-ray is not useful in diagnosing bone loss because it is not sensitive enough to detect small amounts of bone loss or minor changes in bone density.
The DEXA scan can indicate:
Low bone density prior to a fracture occurring
If bone density is decreasing, increasing or staying the same when repeated at intervals
The probability of obtaining a fracture within 10 years Whether treatment is warranted
Treatment & Prevention:
Calcium Supplements: Latest studies question the effectiveness of calcium supplements in reducing the risk of fractures associated with osteoporosis and evidence suggests they may even increase the risk of cardiovascular events such as heart attacks.
Bisphosphonates (Fosamax, Boniva, Actonel, Reclast): Popular group of drugs prescribed to slow or stop bone loss that occurs during the body’s bone remodeling cycle. These drugs stop or slow the natural process that involves the removal and replacement of bone tissue. As a result, these drugs are prescribed for 5 years or less due to research demonstrating that if taken more than five years bones may become more brittle thus increasing the risk for atypical fractures of the femur. The problem with limiting the intake of these drugs to less than five years is that the drug’s half life (meaning the time the drug stays in the human body) is approximately 10 years or longer.
Hormones: Bio-identical hormones have effectively shown to not only decrease bone loss but also assist in bone building. Low estrogen and testosterone levels are related to decrease bone density and increased bone reabsorption. By increasing both estrogen and testosterone bone loss is not only delayed but bone density has been shown to improve. According to a study published in the American Journal of Obstetrics and Gynecology, Bio-identical Estrogen Pellet Therapy increased bone density by 8.3% per year compared to oral estrogen which increased bone density by 1-2% per year.
There has been a lot of controversy over the treatment and prevention of Osteoporosis. Diet and exercise is the core for any wellness plan but sometimes this simply is not enough. “One size does not fit all” even in the recommendation of supplementation as seen with the dangers of calcium supplementation. Individualized planning is essential for the prevention and maintenance of Osteoporosis. Prescribing medications with extremely long half life’s that have been proven to increase the risk of atypical fractures of the hip is not the answer. Bio-Identical Hormone Replacement Therapy which include Estrogen & Testosterone specifically in Pellet form has been proven to effectively slow if not stop bone loss in addition to increasing bone density. By improving bone density the risk of mortality related to a fractured hip is greatly reduced thus improving one’s quality of life.