Risk of Osteoporosis is Preventable
Published by Contra Costa Times
Posted on Wed, Jun. 07, 2006
By Dr. Annie Cherayil
RECENTLY, I cared for an 81-year-old lady who was admitted to the hospital with back pain so severe she was no longer able to live by herself.
In the hospital, X-rays showed severe osteoporosis and compression fractures of her spine. Her vertebrae had collapsed on themselves, causing her pain.
Osteoporosis is the loss of bone structure and strength, so the bones become weak and brittle. This means they can break more easily, especially in the hip, spine and wrist.
In the United States today, nearly 10 million people already have osteoporosis, and another 80 million have low bone mass, meaning they are at increased risk for developing it. Osteoporosis affects women much more than men.
How do we treat osteoporosis?
Drug therapy for osteoporosis includes the following:
Biphosphonates can irritate the esophagus (the tube connecting the mouth and stomach), so it is important to take the pill with plenty of water so it won't get stuck. Sit or stand a full 30 minutes after taking it, avoid meals for 30 minutes before or after, and do not lie down for a few hours after. Rarely biphosphonates can cause severe bone loss in the jaw.
A few years ago, however, research showed that female hormone therapy increases the risk of blood clots, strokes, heart attacks, dementia, and some cancers. The estrogens were shown to increase the risks of stroke, dementia, and blood clots, not breast cancer and heart attacks.
Women should understand the benefits and risks of these hormones before taking them. Female hormones and biphosphonates together (but not at the same time) give added benefit for severe osteoporosis.
How do you know if therapy is working? Talk to your doctor. In some cases, further tests may be indicated.
The elderly woman I cared for hadn't been aware of her osteoporosis until it was too late. Talk to your doctor about your risks for osteoporosis, and how you can prevent or treat it.
Dr. Cherayil practices family medicine at the Concord Health Center. Healthy Outlook is written by the professional staff of Contra Costa Health Services, the county health department. Send questions to series coordinator Dr. David Pepper at firstname.lastname@example.org. For more health information, go to www.cchealth.org.