Posts Tagged ‘BMD’
Fractures are NOT FUN. Not something you want to repeat. Any fracture is a Bone Attack. It is a warning that you probably have Bone Health issues that can be improved. Get a Complete Bone Health Evaluation and work to prevent a second fracture. Most people can succeed in preventing that second fracture.
I see many individuals who have had a first fracture. Often the DXA, BMD, and T-score are not that bad. I even see many who have good DXA test scores. But they still fractured with relatively minor trauma. They proved that they have increased Fracture Risk. Why?
Forteo is a daily shot. That is a nuicence, but a small price to pay for the only Anabolic, the only osteoporosis medication which will increase bone mass in spongy (cancellous) bone. Diabetics give themselves a daily shot for the rest of their lives. Forteo is for only 2 years and uses a tiny insulin needle.
People worry about the warning that lab rats got Osteosarcoma after being given very high doses of Teriparatide for the equivalent of 70 human years. We have not seen this in humans, or chimps, or monkeys, or dogs. Rats have bones that grow all their lives. We do not give Forteo to growing humans, pregnant women, nursing women, persons with Paget’s Disease or unexplained elevated Alkaline Phosphatase, or persons who have had radiation to their bones.
Remember that you must take adequate Calcium, with food, spread out over 3 meals. You must take enough Vitamin D3 to be able to absorb Calcium. You must eat enough Protein for your OsteoBlasts to make new bone matrix.
A patient had no idea why her doc sent her to me for a Complete Bone Health Evaluation. As a “baby-boomer”, she lives by the motto: “You are only as old as you choose to be.” And she chooses to remain young. If only it were possible…..
“I can’t have Osteoporosis. I used to drink milk. I am active and I plan to stay active!!! So I just can’t have Osteoporosis!” Unfortunately, she does have Osteoporosis by BMD on her DXA, by the multiple Vertebral Fractures on VFA, and by FRAX. Still, there are simple steps to rescue her Bone Health before she Fractures.
Patients who have already fractured may need osteoporosis medications. Adding fractures to a low BMD or T-score on DXA makes the Clinical Osteoporosis more severe and increases Fracture Risk. This is true of vertebral fractures detected on VFA, as well as clinically obvious fractures, like hip or wrist or shoulder.
Fracture Risk is the big deal. Fractures are what we want to avoid. Having suffered one fracture makes a Second Fracture 3 to 5 times as likely as the first. Bummer. Calcium, Vitamin D, Protein, Multivits and Exercise alone often cannot overcome those odds. Real bummer. Adding a medication often can avoid the Second Fracture.