Osteoporosis

Over the course of my career, there have been tremendous changes in both the diagnosis and the treatment of osteoporosis. Today I would like to focus on the latest things you should know about osteoporosis. When I first started in the area of osteoporosis, the diagnosis was made using an extremely primitive method of bone biopsy. This was a painful, time consuming and very impractical procedure. There was very little reason to do this diagnostic procedure because other than calcium and sodium fluoride, the treatment was extremely limited with very few benefits. Today, we can diagnose osteoporosis with minimal time, effort and cost.

Osteoporosis is by definition characterized by low bone mass and structural deterioration of bone tissue, which leads to an increased susceptibility of fractures of all the bones, in particular the hips, spine, and wrist. The diagnostic procedure of choice is bone densitometry, which is performed in about twenty minutes and is readily available. Every female who has reached menopause should have a bone density in the same fashion that they would have a mammogram or PAP smear. A bone densitometry should also be done on women prior to menopause if they have a history of thyroid or other hormonal imbalances, if they have had an eating disorder, if they have a strong family history of osteoporosis or fractures, or if they are on long term medications that affect the bones. 

Males may also benefit from a bone density because osteoporosis is not a disease limited to women alone. If a male has similar problems to the ones I just mentioned, including hormonal issues such as thyroid disease, chronic illness and use of chronic medications for other conditions, for example, corticosteroids, they may also be at a high osteoporosis fracture risk. I strongly recommend that everybody that has a bone densitometry should have both the hip and spine measured. The use of bone density models that simply analyze a finger or a heel is a very primitive screening process. 

At the moment, probably close to 28 million Americans are affected by osteoporosis. This is almost one out of every two women over the age of 50. By the age of 75, 1/3 of all men will be affected by osteoporosis. Osteoporosis causes nearly 1.6 million fractures annually resulting in costs directly and indirectly of nearly $10 billion dollars. The truth is that individuals suffering hip fractures have a 5 to 20% greater risk of dying within their first year following an injury than other individuals in their age group. A woman’s risk of hip fractures is equal to her combined risk of breast, uterine and ovarian cancer. The point is that, this can be totally prevented and ultimately osteoporosis is a disease that can be eradicated if we make an early diagnosis and aggressively treat people who have bone loss. We now have a number of different prescription drug treatments. All these drugs help to stop bone loss, reverse bone loss and/or aid in the making of new bone. These treatments are tailored individually to the patients’ needs and have reduced the incidence of bone fractures dramatically. Additionally, there is an exciting new non-pharmaceutical treatment option, the BioDensity machine, now available in our office.

Author: Norman B. Gaylis, M.D., F.A.C.P., M.A.C.R.