|We all want to avoid elder years of frailty, infirmity, and fractures. But did you know that it is in your power to avoid these common outcomes of old age? Bone health gets little attention in the media, much less than heart health or cancer prevention. But fractures from thin bones are so often the catalyst of infirmity and physical decline. And they are PREVENTABLE!|
We at Carolina Total Wellness take a comprehensive view of bone health, with the goal of not only stopping bone loss, but actually increasing bone density and quality. This takes a very individual understanding of the many factors that can set us up for bone thinning (osteopenia) or severe bone thinning (osteoporosis). The one we all know is Vitamin D deficiency. But there are so many other impactful nutrients for bones including Vitamin K2, Magnesium, Phosphorus, Boron, and Calcium. And only certain forms of calcium are optimal, as many OTC calcium forms go where we do not want them: our arterial walls, contributing to heart disease and stroke. Milk is NOT a good source of calcium. The increased acidity in the body due to dairy actually sucks out bone mass. Did you know the “Got Milk?” campaign was actually pushed on us by the marketing folks from the cigarette industry after they lost their jobs there? We also know that aging is a factor due to hormonal loss, earlier in women at menopause, but also in men with frequently undiagnosed low testosterone due to many reasons including statin medications, head trauma, or sleep disorders. Optimizing hormones in both men and women Other less recognized factors leading to bone loss that we see often in our practice include chronic inflammation, acidic diets, alcohol use, smoking, and high stress related cortisol levels. Addressing root cause is essential as is careful monitoring of interventions over time.
Here is where we would like to introduce you to Dr Andy Bush. He is a board certified Orthopedic Surgeon who says “I used to operate on fractures. Now I want to prevent them.”
Please read on for an education in the most cutting edge imaging techniques to monitor bones over time.
Osteoporosis – a silent epidemic
Andy Bush, MD, Central Carolina Orthopedics, Sanford, NC
Rates of osteoporosis and fractures associated with poor bone quality, which are known as fragility fractures, are at epidemic levels. It is estimated that osteoporosis affects approximately 200 million people world-wide. Currently, it is also estimated that 10 million individuals over age 50 in the United States have osteoporosis. Each year an approximately 2 million individuals suffer a fracture due to osteoporosis. The risk of a fracture increases with age and is greatest in women. Approximately 1 in 2 women and 1 and 5 men age 50or older will experience a hip, spine, or wrist fracture sometime during their lives. Approximately 40% of individuals are unable to return to their homes following a fragility fracture and require relocation to a nursing facility. As many as 20% of individuals will die within 6-12 months of a fragility fracture. Also, an additional 33.6 million individuals over age 50 have low bone density or “osteopenia” and thus are at risk of osteoporosis and fragility fracture.
Osteoporosis and osteopenia are not painful conditions. Most people are unaware that they have any problems with their bones – that is until that one day when our foot gets caught on the edge of the carpet, or we forgot to wipe up the spilled water on the kitchen floor or our little dog or cat gets in between our feet making us fall and we hear that loud and dreaded “CRACK!!”. Often, after that fateful event, life changes dramatically and then the importance of bone healthcare and not having a healthy skeleton becomes a very painful and life-altering reality.
Monitoring of the bone health is the foundation of fracture prevention in the way monitoring blood pressure is to stroke prevention and mammograms are to breast cancer prevention. The early detection of any of these conditions, allows for early treatment to be instituted to prevent the long-term consequences of the disease. Bone health assessment is looking for osteopenia or osteoporosis and determining fracture risk. Although, some may still consider developing osteoporosis an unfortunate part of growing older, it is now understood that fractures due to bone loss are not an inevitable part of aging but a potentially preventable disease process. Nutrition and exercise fight against osteoporosis – monitoring makes sure that they are working.
The term for bone monitoring is known as bone densitometry – the measurement of bone density. Determining bone mineral density (BMD) by using Dual Energy X-ray Absorptiometry (DXA) has been the traditional method of diagnosing osteoporosis and predicting fracture risk. It is a method of measuring BMD by using low-energy x-ray and has been considered reasonably reliable for measuring BMD and diagnosing and treating osteoporosis.
There is another method of bone densitometry that not only determines BMD but also give a measure of the Bone Quality. Radiofrequency Echographic Multi Spectrometry (REMS) is a newer method of performing monitoring bone health that has been used in Europe for almost a decade and has replaced DXA as the official method of bone densitometry in Italy. REMS uses ultrasound to measure BMD. However, the ultrasound is also capable of measuring Bone Quality and therefore when REMS is used to assess bone, more information is obtained. It is a more reliable method to predict fracture risk. REMS is still very new in the United States but its popularity is growing as more people are learning about it.
In conclusion, it is important to remember that your bones need to be monitored and cared for like any other part of you. Bone healthcare is an issue for everyone and something that we all need to be aware of because everyone has a skeleton. And we need to pay attention to and take care of our skeletons because…………
If you ignore your bones, they will go away!
Your Partner In Health,
Frances T Meredith, MD