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Did you know that In women over 45 years of age, osteoporosis accounts for more days spent in hospital than many other diseases, including diabetes, myocardial infarction and breast cancer? That’s just one of the sobering osteoporosis statistics and facts on the International Osteoporosis Foundation’s (IOF) website.
You may think you are ok, but unfortunately, many internists don’t seem to be as concerned about bone density as other major health issues. The IOF notes that many women who sustain a fragility fracture are not appropriately diagnosed and treated for probable osteoporosis. Another sobering statistic from the IOF – the great majority of individuals at high risk (possibly 80%), who have already had at least one osteoporotic fracture, are neither identified nor treated. So What Do You Do?
Have Your Bone Density Checked
There are several types of bone density tests. The IOF describes the different kinds of Bone Density tests. They are all simple and painless. If you have any of the risk factors below, you should get a Bone Mineral Density (BMD) scan to determine your bone density.
- being female
- being thin and having a small frame
- a family history of osteoporosis
- estrogen deficiency as a result of menopause
- low testosterone levels in men
- over 65
- under 65 postmenopausal women who have one or more additional risk factors for fracture
- being Caucasian or Asian (although other ethnic groups can also be at risk)
- lifestyle factors such as smoking, infrequent exercise, having several alcohol drinks or caffeinated beverages a day or amenorrhea (absence of menstrual cycles caused by low body fat or medications)
- a "highly athletic lifestyle." Bill Rogers, four time winner of both the Boston Marathon and the New York City Marathon, was diagnosed with osteoporosis. (Running Times)
How Often to Have a BMD
Medicine.net says that monitoring bone density at one- to two year intervals may not be useful. repeat DEXA scans cannot distinguish between a "real" change in bone density or a variation in measurement from the machine itself. Changes of less than 2%-4% in the vertebrae and 3%-6% at the hip from test to test can be due to the precision error of the method.
Medications Can Cause Osteoporosis
You should also be aware of things that might make matters worse. Certain medical conditions and medications, completely unrelated to osteoporosis, can have the effect of causing osteoporosis. This is called secondary osteoporosis. Prior to treating the osteoporosis, it is essential to manage the underlying cause. Doctors can give other forms of treatment based on the contributing factors. See the Osteoporosis Research Center (ORC) Newsletter for more details on the Secondary Causes of Osteoporosis listed below:
Heartburn Medications. Recently studies were released that show an increased risk of spine or hip factors from use of proton pump inhibitor (PPI) heartburn medications as Prilosec®, Prevacid® and Nexium®. Drugs known as H2-receptor antagonists or H2 blockers, which includes brand names such as Zantac® and Pepcid®, were not significantly linked to fracture risk. (Health Day News, May 9)
Steroids. Steroids (corticosteroids or glucocorticoids) taken for conditions such as multiple sclerosis, lupus, emphysema, asthma, and rheumatoid arthritis, psoriasis, etc., can cause secondary osteoporosis. Physicians are well aware of this risk and try to prescribe the lowest dose possible of steroids while still maintaining symptom control.
Heparin/Coumadin® are brand-name blood thinners that affect the bone if taken for a long time.
Anticonvulsant medications taken for seizure disorders affect the bone by interfering with vitamin D metabolism.
It’s important you understand your potential risks and factors that contribute to osteoporosis and to have a BMD if you have the risk factors mentioned above. The websites listed below have a wealth of information on osteoporosis risk factors and treatments.
Resources
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