Osteoporosis is a disease in which bones become fragile and more likely to break. If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks. These broken bones, also known as fractures, occur typically in the hip, spine, and wrist. Any bone can be affected, but of special concern are fractures of the hip and spine. A hip fracture almost always requires hospitalization and major surgery. It can impair a person’s ability to walk unassisted and may cause prolonged or permanent disability or even death. Spinal or vertebral fractures also have serious consequences, including loss of height, severe back pain, and deformity.
Osteoporosis is often called a “silent disease” because bone loss occurs without symptoms. People may not know that they have osteoporosis until their bones become so weak that a sudden strain, bump or fall causes a fracture or a vertebra to collapse. Sometimes a person’s osteoporotic hip, for example, can spontaneously break under the pressure of standing. Collapsed vertebrae may initially be felt or seen in the form of severe back pain, loss of height, or spinal deformities such as kyphosis or stooped posture.
• Being thin or having small frame
• Estrogen deficiency as a result of menopause, especially early or surgically induced
• Being Caucasion or Asian
• Being female
• Cigarette smoking
• Excessive caffeine intake
• Excessive use of alcohol
• Low testosterone in men
• An inactive lifestyle
• Low lifetime intake of calcium
• Vitamin D deficiency
• Advanced age
• Amenorrhea (unusual absence of menstrual periods
• Certain chronic medical conditions
• Chronic use of certain medications such as anticonvulsants, prednisone, chemotherapy
• Family history of osteoporosis
• Anorexia Nervosa
Screening for osteoporosis can be done using ultrasound and a type of xray called DEXA scan. If someone has obvious osteoporosis, this can be incidentally picked up on a typical xray that may have been performed for another reason, but will not be able to quantify the bone loss. Ultrasound is a good screening tool, but if the result is even slightly abnormal, the person should have a formal DEXA scan. A DEXA scan is a painless procedure that involves a person lying on a table while a low level xray beam moves across the spine and hips. The score of main importance is the Tscore. It’s best to have a T-score on the + side, although having a Tscore as low as -1.0 is considered ‘within normal limits’. Having a T-score between -1.0 and -2.5 is considered osteopenia, while a Tscore less than -2.5 is considered osteoporosis.
Treatment of Osteoporosis includes adequate calcium intake (1500mg daily), supplementation with Magnesium, Boron, and Vitamin D, as well as weight-bearing exercise to increase strength and muscle mass. In addition, hormones are very effective in increasing bone density, particularly bio-identical progesterone and testosterone. Synthetic hormones are not as effective and also have many side effects. Other supplements that are useful include zinc and L-arginine. It is also very important to eat healthfully, getting natural sources of calcium, and avoiding substances that deplete your bone, such as alcohol, caffeine, acidic foods, and cigarettes.
It’s important to realize that achieving good health, in general, requires good nutrition, regular exercise, hormonal balance, and avoidance of toxins. If you focus on these things and acquire good habits, you shouldn’t have to worry about diseases such as osteoporosis because, by default, your body will be able to take care of itself. For instance, I previously had many risk factors for osteoporosis, and a little over one year ago, I was headed towards osteopenia. My T-score was -0.6. After being on Progesterone, thyroid, cortisol, vitamins, a mostly healthy eating plan, and regular exercise regimen for a year, my T-score is now +2.0. My plan was to get healthy in general, and I didn’t focus on bone density. I still have fun, forget to take my vitamins on occasion, and drink a cup of coffee every morning, so achieving wellness doesn’t have to be a scary proposition. It’s never too early to change your life course. I’d like to mention something else. Some people are concerned that thyroid and cortisol supplementation will cause bone loss. While it is true that longstanding HYPERthyroidism and long term use of HIGH doses of steroids will contribute to bone loss, supplementation with thyroid and low doses of cortisol to balance one’s hormones is something entirely different. My Tscore is case in point!