What You Don't Know about Osteoporosis Can Hurt You

Many individuals who suffer from osteoporosis have had adverse issues with prescribed medications, and have stopped seeking treatment.
According to the National Osteoporosis Foundation, osteoporosis is a disease of the bone that makes a person’s bones weak and more likely to break. The month of May has been designated as National Osteoporosis Month to bring more awareness to preventing osteoporosis and falls. 
Approximately 10 million Americans have osteoporosis and another 44 million have low bone density, placing them at increased risk. Further, one in two women and up to one in four men will break a bone in their lifetime due to osteoporosis. Diet, exercise and a healthy lifestyle are keys to preventing and managing the disease. 
A Crisis in Treatment
What you may not know is what Orinda, California, internist Dr. Elliott Schwartz calls “a current treatment gap or crisis in treatment or lack of treatment” for individuals who have the disease. As medical director of the Northern California Institute for Bone Health, Dr. Schwartz also works with the UCSF Skeletal Health Service.
According to Dr. Schwartz, the treatment crisis has come about due to the aging of our population and the fact that many individuals who suffer from osteoporosis have had adverse issues with prescribed medications, and have stopped seeking treatment. The decrease in the rate of treatment over the last several years has spawned a large increase in the number of hip fractures in the aging population.
“Practitioners need to help their patients understand what the issues are,” he says. “People don’t trust the treatment they have received, so have become afraid of these medications and their negative side effects. Yet, most of the time, in my opinion, things can be done to ameliorate the situation and reduce the potential for these adverse reactions. For example, I recommend reducing the dose by half (e.g., from 70 mg to 35 mg a week) of alendronate, a class of medications called bisphosphonates that is used in osteoporosis treatment.
“In addition, we have new medicines, called anabolic medicines, or bone builders, that can be used before taking a bisphesphemate drug for a better result or outcome. These include teriparatide (Forteo) and abaloparatide (Tymlos™). Neither is associated with the rate of side effects that many osteoporosis patients have experienced.”
Dr. Schwartz points to studies that show that 25% of patients who have had a fracture are likely to have another fracture in the next year, and 50% will experience a new fracture in five years. “These statistics offer a good reason to get into treatment and not to become afraid and do nothing,” he says. 
Vitamin D and Exercise
He also stresses the importance of getting an adequate amount of Vitamin D each day and the value of physical exercise. "Patients should be referred to physical therapy for strengthening exercises, he notes. “In a new area of research in sarcopenia, the degenerative loss of skeletal muscle mass, we have learned that people lose about 40% of their muscle mass from age 40 to age 70 or 80. To prevent this loss or reduce its progression, people need to exercise in their old age. While exercise does not build your bones, it helps you keep your muscle strength intact, so you can maintain agility and coordination. This means you will fall less often, thereby reducing fractures.”
In addition to the Northern California Institute for Bone Health, more information about osteoporosis and its treatment is available at the National Osteoporosis Foundation and the Mayo Clinic. (If you find other great sources of information, please share them with us.)
Note: Referrals to the Northern California Institute for Bone Health (NCIBH) for a comprehensive bone density test (DXA), which includes an analysis of bone quality, can be made at 510-625-9100 (www.betterbones.org). Dr. Schwartz can be reached for consultations at his medical practice office at 510-451-3800.