Have you arrived at the age when your doctor tells you it’s time to get a bone density test?

If so, chances are that you old as the hills. Kidding!! Chances are your test results have likely come back not normal. And by “not normal” I mean that you were told you have osteopenia (mild bone loss) or osteoporosis (moderate to severe bone loss).

What’s a bone density anyway?

A bone density test measures the amount of bone mineral present at different sites on the body. The idea here is that the lower the bone density, the weaker the bone, and the greater your chances of having a hip fracture.

And hip fractures for those of you that don’t already know are “no bueno” to use the technical terminology. As we age hip fractures can lead to prolonged immobilization and possibly life-threatening pneumonia.

What Your Doctor Will Advise

If you are diagnosed with less than ideal bone density, chances are your doctor may tell you to take calcium and vitamin D in the the osteopenia case, or to go on heavy duty bone-building medications for the osteoporosis case.

Let’s look at these recommendations a bit more closely

The Institute of Medicine advises a calcium intake of 1000-1200mg a day. However, over the last five years, we’ve learned that calcium — at least, in the form of supplements — isn’t risk-free.

An intake of 1,000 mg from supplements has been associated with an increased risk of heart attack, stroke, kidney stones, and gastrointestinal symptoms.

Now an analysis of the research suggests that consuming calcium at that level doesn’t even reduce fractures in people over 50. Say what??? Yup. As a matter of fact, in countries with the highest rates of dairy consumption, you find the highest rates of osteoporosis. How now brown cow? Well surely, Vitamin D is beneficial. Actually, it may not be and stop calling me Shirley.

More about Vitamin D

Taking vitamin D supplements apparently does not improve bone density says a study involving more than 4,000 healthy adults published in the esteemed Lancet journal.

Professor Ian Reid from the University of Auckland in New Zealand, the veritable epicenter of cutting edge research about bones and penguins, both equally important and fascinating subject matter, explains:

“Most healthy adults do not need vitamin D supplements.

Riveting analysis no?

Looking at the data from 23 studies involving 4,082 healthy adults his team did not identify any benefits for people who took vitamin D for an average period of 2 years. The authors concluded:

“This review provides little evidence of an overall benefit of vitamin D supplementation on bone density. Continuing widespread use of vitamin D for osteoporosis prevention in …. adults without specific risk factors for vitamin D deficiency seems to be inappropriate.”

Well, what about the osteoporosis medications?

Surely these powerful drugs with a ton of horrible side effects must help reduce hip fractures. Guess again. And stop calling me Shirley.

Most of the studies looking at the benefits of medication on osteoporosis are looking at changes in bone DENSITY and not necessarily fracture risk. And the problem is that bone density screening tests are actually not able to identify patients who will actually sustain a fracture.

One review suggests that bone density testing may NOT be an accurate marker of bone strength or risk of fracture.

Increases in bone density may not correlate with a reduced fracture risk in clinical trials of osteoporosis therapy in postmenopausal women. Why? Because the appearance of bone on X-ray is not a predictor of bone strength.

And as an example, one study that was touted as showing a benefit of Actonel, a popular osteoporosis medication said that  “the incidence of hip fracture was 4.2 percent among those assigned to risedronate and 5.1 percent among those assigned to placebo.” So, not even a 1% improvement. Wow……a billion dollars in revenue later……

Falling and Not Low Bone Density is the Main Cause of Fractures

Seeing a reduction in bone density is a normal part of aging. Bone density testing may be a case of finding a test to sell a drug. I mean, we are taking completely asymptomatic women (the target group for bone density testing), and telling them that they have a “disease” that puts them at risk for hip fracture, starting them on powerful medications with tons of side effects, when we don’t even have strong evidence that these interventions are of any value whatsoever.

Most fracture patients do NOT have osteoporosis. Patients at high risk of falling related to physical decline or lack of balance are the ones that make break some bones.

So What Should I Do If I Have Been Diagnosed With Osteoporosis?

Obviously talk to your doctor about your results, but then do your own research.

  • What are the actual benefits of the medication?
  • What is your personal risk of fracture
  • What is the benefit of taking the medication relative to your personal risk of fracture?
  • What are the short and long term side effects of medications?

Next I would look to optimize your health to try to hang on to as much healthy bone as possible.

  • If your vitamin D levels are low, correct them. Supplementing for low vitamin D levels does reduce hip fracture
  • Reduce inflammation in your body. Studies show that patients with high inflammatory markers are more likely to have weaker bone
  • Minimize processed foods that create inflammation and have no nutritional value. Yes, I’m talking to you!! Sugary, carby, comes in a box and never expires food.
  • Alcohol is no friend to bone
  • Neither is smoking
  • Neither is having fun — stop having any fun.

Finally, work on your physical fitness and balance.

  • Nothing works better to protect you from fracturing a bone than NOT FALLING.
  • Weight training, balance work, yoga, tai-chi and not doing stupid crap like trying to walk a mile to your car on a sheet of ice will go very far in reducing your hip fracture risk.

That’s all for now!!!