(Sorry, I know that I have posted on this endlessly – there are still millions out there who aren’t getting the message. . . . Comments follow. Jan)
AGING: OSTEOPENIA DEBATE
Bone-density diagnoses are complicated
By Rita Price THE COLUMBUS DISPATCH
As she stood in the shower, Joyce Morison propped one leg on the side of the tub and balanced on the other — the classic leg-shaving stance familiar to women everywhere. But then Morison heard a sound that was not part of the routine. “A pop, almost as if you snapped your fingers,” she said. “All at once, I was sitting down.”
Morison’s left femur had snapped. The injury she suffered in 2008 was excruciating and also mysterious: Morison did not have osteoporosis and in fact had been taking Fosamax, a bone-strengthening bisphosphonate, for 12 years. “I was told that I was a good candidate for osteoporosis,” said Morison, now 65. A doctor had prescribed medication because bone-mineral-density tests put the Bexley resident in the osteopenia range, a term for low bone density.
But osteopenia isn’t really a diagnosis, and some doctors say too many people are being treated for something that is often wrongly viewed as a precursor to full-blown osteoporosis. Some researchers also suspect that long-term use of the popular drug Fosamax could actually lead to more fractures by rendering bones brittle. The link has not been proved in clinical trials, but reports of femur fractures such as Morison’s are being tracked.
Dr. Seth Kantor, an Ohio-Health rheumatologist, said diagnostic problems arise when clinicians and patients focus too much on the result — known as the T-score — read by a scanning machine that measures bone-mineral density. World Health Organization guidelines say T-scores from minus-1.0 to minus-2.5 mean a patient has low bone density; a T-score of minus-2.5 or below signals osteoporosis. But that’s only part of the picture. Determining a patient’s actual risk of fracture, and thus the potential need for treatment, depends on a variety of factors such as age, weight, race, family history of osteoporosis, and overall health and fitness. (*1)
“If you ask, ‘At what T-score should I start treatment?’ the answer is: ‘There is no answer,’” said Kantor, who sees patients at the Grant Arthritis and Osteoporosis Center. “What has happened is that a lot of doctors and patients focus on the bone mass and not bone quality.”
Dr. Velimir Matkovic, director of the Osteoporosis Prevention and Treatment Center at Wexner Medical Center at Ohio State University, has studied bone-mineral density for more than 40 years. Like Kantor, he laments the over use of the word osteopenia. “Since the mass screening with DXA (dual-energy X-ray absorptiometry) machines has taken place, this term has been used as an intermediary level of mineralization,” Matkovic said. “It’s a reading on a machine.” He said he regularly sees women, especially younger ones, who are taking medicines they probably don’t need. “In my clinic, I eliminated more of those prescriptions than I was prescribing,” Matkovic said.
Still, osteoporosis is both common and devastating, and doctors must stress prevention. (*2) Although some bone loss is a normal part of the aging process, disease is not. Getting enough calcium and vitamin D — either through foods or in supplements — can help keep bones strong. (*3) “I check the vitamin D level on everyone who comes to my office,” Kantor said. “More than 90 percent are deficient.” (*4) Exercise also is important, and it doesn’t have to be strenuous. Weight-bearing is key, so swimming doesn’t count. “It just means bearing your own weight, and simple walking is an excellent weight-bearing exercise,” Kantor said. “Don’t park the car in the closest spot at Kroger. Park in the farthest one.”
Osteoporosis is far more likely to occur in women, but men are not without risk, Kantor said. “Many people think it’s just women, but 25 percent of hip fractures are in men,” he said. Morison also suffered a fracture — less severe — in her right leg. The music teacher has surgically inserted rods in both legs now, and although they have healed well, they often ache. She switched to a different medication for a while but now just focuses on diet and exercise. (*5) “I’m just taking my calcium and vitamin D,” Morison said, “and hoping for the best.” rprice@dispatch.com
Osteoporosis
Although osteoporosis affects all bones in the body, breaks are most common in the hips, wrists and spine. More than 40 million people already have osteoporosis or are at risk because of low bone mass. Osteoporosis can strike at any age, although the risk of developing the disease increases with age. In the future, more people will be at risk of developing osteoporosis because people are living longer and the number of elderly people in the population is increasing.
SIGNS • Sloping shoulders • Curve in the back • Height loss • Back pain • Hunched posture • Protruding abdomen
RISK FACTORS • Being female • Getting older • Menopause • Not getting enough exercise • Having a small, thin body (less than 127 pounds) • Having a family history of osteoporosis • Smoking • Drinking more than one drink a day for women • A diet low in dairy products (*6) or other sources of calcium and vitamin D
Sources: National Institutes of Health, U.S. Department of Health and Human Services
#1. All good, but better would be a thorough blood analysis from a complete Blood Count Panel and comprehensive Chemistry Panel; want the Lipid Panel, Inflammation Marker Panel and Thyroid Panel. Then one can see what the body really has to reveal, for this is where the truth lies, no guessing needed. Strive toward middle of the r0ad to optimum level on every single reference point. One does this thru these markers, then we adjust the dietary regimen until its as good as it gets. Where the numbers are off, fix with food. So many of us are too acidic. This promotes disease and tons of pain – don’t need it. You are what you eat. Adjust it. Need more plant-based (especially green-leafy)fruits and vegetables. That is where the minerals are and the delicious alkalinity to make you feel good and be well and have your ” acid-base” (pH) in balance. With a diet having high levels of acid, more calcium is lost in urine. When eating more alkaline foods, more calcium is retained in the bones
The net acid loads to the body come from ingesting cereals, dairy products, legumes, meat, fish and eggs – – with the worst offenders being the hard cheeses which are rich sources of calcium. Eating any and all of these without getting enough fruits and vegetables will promote bone loss and osteoporosis.
Just like having your pH in balance, its good to remember that the calcium thing must be in balance as well. It is more than how much calcium you take in; this is balanced by the outgo of calcium from your bones via urine. Can think of no one who speaks more plainly on this than Dr Loren Cordain in Paleo on Bones (go to the Paleo section up in FIND IT), or buy the book – everyone should have his Paleo Diet book.
#2. Prevention should not equate to pharmaceuticals, but on dietary needs as found and determined via blood workup analysis.
#3. Most important is the calcium balance (calcium intake/calcium loss thru urine), already described in 1) and 2). Essential fatty acids (Fish oil) are so important to every part of body from brain on down; pH balance, and of course – Vitamin D-3.
#4. Be certain you are getting Vit- D3 and not D2
#5. One could hope that Ms Morrison has given up dairy and stopped taking any kind of calcium supplement whatsoever as it can only lead to calcification in parts of the body and circulating blood; opting to eat more fruits and vegetables which will naturally and dramatically increase the mineral nutriment for her body.
People who aren’t accustomed to eating the larger quantities of plant food often find it agreeable to take it in the form of juicing. It is efficient, easy and (for me) so delicious. I use a lot of carrots. For my day’s juice I gather a pound or two of carrots, 5 – 6 stalks of celery, a big cucumber, a couple of apples, a couple hands full of greens on hand like Kale, Bok Choy, etc. I love Garlic and use it in almost everything but my coffee, so in goes a toe or two of garlic and a piece of fresh ginger 1 1/2 or 2″. This is just delicious and I love it. Will drink 2 or 3 glasses a day and miss it when I don’t have it ready to go. Got these particular ingredients from reading Charlotte Gerson’s book on the Gerson Therapy. Still haven’t done the coffee enemas (tho I bought the bag to do it with and the organic coffee). . .but I will – truly. I want to see just how healthy an old gray mare like me can actually get. Though honestly, don’t know how much better it can get. My newest blood report in this week says I’m all but perfect. Everything possible is in normal range, even those things which they say go down as one ages, are right up there “in range”. . . go figure! I am blessed. Be well….good nite Jan