HEALTH: Osteoporosis is a very serious condition NOV. 2008

Osteoporosis is a condition that affects more women than does heart attacks, strokes, breast, uterine and ovarian cancer combined.

Fifty percent of women over age 50 have low bone mass, 10 to 20 percent have osteoporosis. The condition is defined in a person who has a bone mineral density that is two standard deviations from what would be normal for a 20-year-old women.

The condition may also occur in men and in anyone in the presence of certain hormonal disorders and other chronic diseases.

Osteoporosis by itself does not have specific symptoms. Its main affect on an individual is to increase the risk of bone fractures.

The one-year death rate in those who suffer fractures as a result of osteoporosis is 15 to 20 percent. Only 30 percent of individuals who have a fracture return to the level they were at before the fracture. You can see that osteoporosis is a serious condition.

Furthermore, the percentage of cases makes it clear that the condition is under-diagnosed and therefore under-treated.

The decision to treat is based on the patient’s score, the risk for fracture and the patient’s age.
Treatments consist of several modalities. Exercise that is weight bearing has a moderate impact.

Studies show that fracture risk will decrease as duration of exercise increases. It appears that vitamin D and calcium are sufficient for prevention, but not for treatment.

Hormonal therapy is good. Estrogen is approved for prevention and treatment.
However, estrogen poses other problems. The bisphonates appear to be the drugs of choice. They are once monthly dosing. They decrease the risk for back as well as peripheral bone fractures.

Obviously the best approach to osteoporosis is prevention.

There some things that are not changeable that put a person at high risk.

For example, advanced age, female sex, estrogen deficiency, European or Asian ancestry, post-menopausal are all pre-disposal to osteoporosis.

However, excess in alcohol, vitamin D deficiency, smoking, physical activity are activities that we can modify and reduce the risk to osteoporosis.

Due to the mortality of breaking a hip and the morbidity that comes with a fracture in advancing age, it is probably a good idea to have a bone density test. I am sure your doctor will be happy to assist you.

-- Dr. Dwight James is a family doctor practicing in Porterville. Contact him at djmdjd@msn.com.