The Silent Killers: Osteoporosis

What is osteoporosis?

It is thinning of the bone to the point that you are at significant risk of increased fracture.

Is it the same as osteopenia?

Osteopenia is thinning of the bones, but not to the point of osteoporosis. It is “pre-osteoporosis”.

Why do you consider this a “silent killer”?

Osteoporosis leaves its victims at significantly increased risk of fractures.

Hip fractures in the elderly population have an alarming rate of morbidity (health complications) and mortality (death) within 12 months. For any age, the risk of death after a hip fracture in men is 30% within one year and for women it is 17% within one year. Most victims of hip fracture will require skilled nursing care away from home, at least for a period of time, and many will have some degree of permanent disability.

What are the risk factors?

The person who is most likely to have osteoporosis is a petite, thin Caucasian or Asian woman over the age of 50 who has been through menopause and whose mother also had osteoporosis. Heavy alcohol use, smoking, and certain diseases (rheumatoid arthritis) and medications (steroids- either frequent shots or pills) can also raise your risk of osteoporosis.

Hyperthyroidism (over active thyroid) or over-corrected hypothyroidism (under active thyroid) can cause osteoporosis. Hyperparathyroidism (overactive parathyroids, which  can cause it as well.

How do I know that I have it?

We recommend screening for osteoporosis at age 65, or at age 60 if you are at increased risk.

How do I prevent osteoporosis?

Weight bearing exercise and making sure you get plenty of vitamin D and dietary calcium can help maintain strong bones. Quitting smoking if you are a smoker will also help prevent it. Prolonged or repeated use of oral steroids (prednisone) or frequent steroid injections (ex: decadron or cortizone) can cause thinning of the bones.

What are the treatments for osteoporosis?

There are many treatments. Some are pills, some are injections. Some are dosed daily, some are dosed monthly, and some are dosed twice a year. The right medication for you can be determined by a discussion with your physician and based on severity, availability, and other medical conditions. Many times patients are limited on options due to restrictions by their insurance companies.

What are the dangers of untreated osteoporosis?

I have seen so many people refuse treatment for osteoporosis and regret it later. Osteoporosis, as mentioned above, leaves you at an increased risk of fractures. Spontaneous or minimally provoked vertebral fractures are what I see the most. Ladies who stepped off a curb and jarred their back causing a fracture. Vertebral fractures caused by a 15 pound dog tugging on the leash at the wrong time or sitting down in the floor to play with the grand kids. These vertebral fractures cause debilitating back pain.

Who should I see if I do have osteoporosis?

Most primary care physicians are able manage osteoporosis. Sometimes there are insurance barriers that prevent us from getting you the medications you need, so a specialist, such as a rheumatologist, is required.

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