Patient Articles

Osteoporosis

What Is Osteoporosis?

Osteoporosis is the most common bone disease in the US. About ten million Americans have osteoporosis. Almost eight million of these are women and two million are men. Having osteoporosis weakens your bones. This makes your bones more prone to breaking (fracture).  Patients with osteoporosis usually do not have enough calcium in their bones, and their bones cannot do the job of supporting the body.

What Causes Osteoporosis?

You develop osteoporosis when there is an imbalance between old bone being broken down and new bone being built. This process of bone breakdown and new bone formation is a normal part of bone metabolism. It is how our skeleton adapts to the stresses we place on it. Osteoporosis does not have any symptoms. People often do not know that they have osteoporosis, until they have a fracture of the hip or spine. Therefore, it is important to know your risk of developing osteoporosis. People who are especially prone to osteoporosis include:

  • Caucasian and Asian women with small frames
  • People with a family history of fracture
  • Postmenopausal women or women who have had a hysterectomy
  • People who take certain medications (eg, thyroid medications,corticosteroids, some breast cancer and diabetes medications)
  • Cigarette smokers or people who drink too much alcohol
  • People who have vitamin D deficiency
  • Those with digestive problems

How Is Osteoporosis Diagnosed?

Osteoporosis is determined by bone mass density (BMD) measurements. The results are given as T scores. T scores close to zero show that your bones are healthy. T scores below -1 indicate weak bones. If they fall below -2.5, you have osteoporosis.

New Developments

This year, there have been many new developments in the assessment of patients with Osteoporosis, low bone mass. The following are some of the more important highlights.

Your physician may be using a FRAX measurement to determine the health of your bone as a replacement of a T score .The FRAX is composed of not only the patient’s Bone Density but takes into account clinical risk factors like age, family hx. and use of corticosteroids A value of greater than 18 at the spine or 3 at the hip is significant for a higher risk of fracture. This information provides you and your doctor a better way to determine your need for medical therapy.

In March, the FDA published some new recommendations on how long post-menopausal women should take Bisphosphonates; Fosamax, Reclast .Other drugs for osteoporosis were not included because of a lack of data.

The consensus was that for women at high risk, ie have a T-score of less than -2.5 or who have had a fracture a period of 5 years or more may be necessary. For those who may be at moderate risk ; T score -2.0 a duration of 3 years may be sufficient. Since age is significant risk factor for a fracture , patients should actively discuss the need for a change in treatment with their physician.

See the following for more information on the FDA recommendations:

http://www.nejm.org/doi/pdf/10.1056/NEJMp1202623

David Mandel , MD