Osteoporosis: Should You Be Tested?
Common Myths, Misconceptions, and Misinformation About Osteoporosis:
- Osteoporosis is not a disease
after all, but simply a "natural" consequence of aging.
False. Osteoporosis is a disease and even though diseases are also "natural",
we can and should treat them!
- Osteoporosis isn't serious enough for me to worry about. False. Osteoporosis is potentially serious because it weakens the bones progressively to the point that any movement -- especially a fall -- can cause a painful, debilitating fracture of the hip, spine or other bones. It can also lead to lost teeth. In fact, osteoporosis causes one fracture every 20 seconds in the US. Hip fractures account for nearly as many deaths in the US as all auto fatalities.
- I'm healthy and I take good care of myself -- I can't be at risk. False. Unfortunately, osteoporosis often affects people with no particular risk factors and with no particular symptoms. The only way to diagnose osteoporosis for sure (or to rule it out) is with a bone density test. One in two women and one in eight men have a lifetime risk of developing fractures from osteoporosis.
- I'm too young to worry about osteoporosis now. False. You may be too young to worry, but you're not to young to take preventive action. Osteoporosis is a "disease of pediatrics manifested in geriatrics". Young people need to have an adequate dietary calcium intake and begin good lifetime exercise habits to build an optimal bone mass. Other preventive behaviors for osteoporosis are good health habits which prevent many other diseases as well: avoid smoking or drinking too much alcohol.
- I'll worry about osteoporosis after menopause. Primary prevention -- preventive measures started before the disease begins -- is the most effective weapon against osteoporosis. This means getting an adequate calcium intake and doing sufficient weight-bearing exercise in the premenopausal years. It may also mean taking hormone replacement therapy in early menopause or birth control pills in late perimenopause.
- I'm too old to do anything about osteoporosis now. False. Just as you're never too young to start osteoporosis prevention strategies, you're never too old to take action to prevent it from getting worse. It's never too late to start improving lifestyle habits, and it's never too late to begin treatment with one of the several medications available.
- Why bother making a diagnosis;
there is no satisfactory treatment and no hope for a cure. False. Several
medical interventions are now available both to prevent and to treat osteoporosis.
FDA approved medications include:
- Conjugated estrogens (Premarin®)-prevention and treatment.
- Other estrogen preparations approved for prevention: Estrace®, Estraderm®; Ogen ®
- Selective estrogen-receptor modulators: SERMs (Raloxifene®)
- Calcitonin-salmon (Miacalcin®).
- Biphosphonates (Fosamax®, Actonel®).
In addition, we know that menopausal women should have a total dietary intake
of calcium of 1,500 mg per day and that Vitamin D supplementation is very important
in women who don't get at least 20 minutes of exposure to the sun per day.
We have also learned a lot about the preventive and therapeutic benefits of
- Only "old ladies" get osteoporosis. Most patients with osteoporosis
are postmenopausal women, generally over age 55. In today's society, that's
hardly considered old! Interestingly, osteoporosis at any age makes its patients
appear older than those of the same age with better posture. Contrary to
this myth, osteoporosis also affects men (Apr. one in five patients with osteoporosis
is male), younger women who have had their ovaries removed, younger patients
with various diseases from respiratory illnesses to anorexia, patients who
take chronic steroids, and astronauts.
- Little old ladies are supposed to look hunched over. Nonsense!
- There's nothing you
can do about osteoporosis once you have it. False. Once osteoporosis is diagnosed,
medications can be started to halt further bone loss and further degeneration.
As with any condition, early diagnosis is the key to the most successful outcomes.
- Osteoporosis doesn't
kill anyone. False. Of those with hip fractures from osteoporosis, one in
four will die prematurely within one year.
- My mother didn't have
it; why should I worry about it? While you would be at increased risk
if your mother did have it, you can't bet that if she didn't have it, you won't.
Chances are, your mother may have had osteoporosis without being diagnosed.
The tools we have at our disposal are much more sophisticated than those available
even 10 years ago. Chances are also that you will live longer than your mother,
thus increasing the odds that you may be affected by osteoporosis. You may
also have other risks that your mother didn't. And finally, half of your genes
are from your father.
- Women of color aren't
at risk for osteoporosis. This mistaken belief comes from the common statement
that Caucasian and Asian women are at increased risk. African American
and Hispanic women are still at risk when they go through menopause, just a
little less than other groups.
- I always drank milk;
I have nothing to worry about. Four eight-ounce glasses of milk per
day in childhood and adolescence is worth more than 32 ounces of prevention,
but it's not the only factor. Keep drinking milk, but speak to your physician
about other preventive measures you should take and whether you need a bone
mass measurement test.
Whatever your choice of therapy, remember that you’re not committed to that choice for life! You and your physician will monitor your progress and your comfort level with your treatment plan. If there are factors that change—including your level of satisfaction—discuss this with your physician.