Osteoporosis Myths and Facts

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There is considerable hype and misinformation regarding osteoporosis. Some people have serious osteoporosis that does require treatment with medication. In my opinion, medications for osteoporosis have been significantly over-prescribed. Commercials featuring Sally Field (of The Flying Nun fame) seem to make the case that the most common drugs to treat osteoporosis are safe and effective. However, some troubling side effects have emerged. These include areas of necrosis in the mandible (bone death in the jaw), and gastrointestinal disturbances. Borderline osteoporosis and osteopenia (low bone loss – less severe than osteoporosis) can be successfully treated without medications with a motivated patient.

In my early forties, I was diagnosed with borderline osteoporosis. I remember that day vividly. After receiving my diagnosis at an osteoporosis center in San Francisco, I drove home across the Bay Bridge to Berkeley. Tears rolled down my face as I tried to understand how, at 40 years old I could have this condition. What did the diagnosis mean? Would I have to give up biking, tennis and roller-skating? All of the sudden I feared my body. I feared that I might twist my body in some odd way and break my hip. These were the stories I had heard about women who were osteoporotic. This situation set a fire under me to find out all that I could about low bone mass.

In 1994, I opened the East Bay Osteoporosis Center. We provided bone density screenings for patients, using state of the art Dual Energy X-Ray Absorptiometry (DEXA), testing the hip and lumbar spine. I analyzed and wrote all the reports, and learned first hand what treatments were working, and which were not. I did observe an increase in bone mass in patients using Fosamax, which is in the category of drugs called bisphosphonates, after a year of treatment. But I questioned the quality of bone that was being laid down. With the subsequent discovery that some patients developed necrosis, my concerns have heightened. Perhaps these medications are actually toxic to the bone. On the other side of the spectrum, was the use of bio-identical progesterone as a treatment that could reverse osteoporosis. It is now known that bio-identical progesterone can help a small amount, but it will not reverse significant osteoporosis. Bone is extremely complex. To make an accurate diagnosis doctors must order the right lab tests to determine whether or not a patient is actually losing bone. If someone is losing bone due to a vitamin D deficiency, gastrointestinal problem, or other undiagnosed issues, then the root cause will go undetected if proper labs are not included before prescribing treatment. The medications for osteoporosis have side effects. Always the question is, do the benefits outweigh the risks? In my case, at age 59, I am slowly gaining bone with nutritional supplementation, exercise and bio-identical hormone balancing. I no longer fear my body and while I do not recommend this for everyone, I still roller-skate.

Facts

• It is possible to build bone without medications – but it will take dedication to do so
• For some, it is possible to increase bone density with nutrition and weight bearing exercise
• Whole body vibration and weight training can increase bone mass
• Most doctors do not order proper lab tests to determine if bone is actually being lost
• Gastrointestinal problems are common. Digestive disorders such as gluten intolerance, can result in bone loss.
• A diagnosis of osteoporosis does not mean you are losing bone presently. It is possible you may have never gained it. A good example is someone who had an eating disorder as a teenager, or someone who smoked cigarettes in formative years. Both situations can result in low bone mass production.
• Some people with significant osteoporosis do need medications. There are several that I will review in future articles including, bisphosphonates, Forteo and bio-identical hormones.

Before considering your treatment options you will need to know the following information

• Is your doctor well versed in alternative and conventional treatments for bone health?
• Did you have a bone density of your lumbar spine and hip? Wrist and heel bone densities are not reliable.
• Have you been diagnosed with osteopenia or osteoporosis?
• Are you losing bone now? The only way to know this is if several bone marker tests were performed.
• Is your current nutritional program meeting your need for bone maintenance and growth?
• What are your hormone levels?
• What is your vitamin D level?
• What is your exercise, nutritional and supplement plan?