June 27, 2007

Good Bones: Prevention and Treatment for All Ages

Our Bodies Ourselves Executive Director Judy Norsigian and Managing Editor Heather Stephenson recently wrote about the potential side effects associated with some medications for post-menopausal osteoporosis, and they offered smart tips to help navigate the pharmaceutical hype.

Writing in the Washington Post, Nancy J. Nelson personalizes the challenge of determining one’s risk for bone fractures and making informed decisions about treatment options:

I share an anxiety with several women friends in their 50s and 60s. We’ve all been told that because our bone mineral density is low — though not low enough to meet the definition of the brittle-bone disease osteoporosis — we need to take medication to reduce our chance of fractures. This means primarily hormones or Fosamax, the top-selling osteoporosis drug, for which doctors wrote more than 20 million prescriptions last year, nearly $2 billion worth. Knowing the associated risks — heart disease, stroke and breast cancer for hormones; ulcers of the esophagus and stomach, and jaw decay for Fosamax — none of us is eager to follow our doctors’ orders. [...]

I also suspect my friends and I are a lot less at risk than someone in my parents’ generation. My mom and three of her pals have all fallen and had fractures; no one I know in my generation has done either.

My search of the scientific literature suggests we are right to be wary of over-medication.

Low bone density is only one of several well-established risk factors for bone fractures. Age and fracture history are just as important, according to Michael R. McClung, director of the Oregon Osteoporosis Center and a member of the council of scientific advisers for the International Osteoporosis Foundation. None of these factors alone is very good at predicting fracture risk. But some doctors don’t appear to have gotten the message.

“Many younger women whose bone density is borderline low are getting treated, although their risk of fracture in the next five to 10 years is fairly low,” said Nelson B. Watts, director of the University of Cincinnati Bone Health and Osteoporosis Center and chairman of the Food and Drug Administration’s Advisory Committee for Endocrine and Metabolic Drugs. “And many patients who have had fractures are not being evaluated or treated, even though their risk of a second fracture in the next five to 10 years is fairly high.”

Nelson reports on a new fracture-risk tool that may be published later this year by the World Health Organization. The tool, which will combine bone density with other risk factors, could end up altering osteoporosis treatment guidelines.

And it’s still important to remember the basics when it comes to good bone health: quitting smoking, limiting alcohol consumption to two drinks per day, exercising (particularly weight-bearing exercises like running or tennis) and making sure you get enough calcium and vitamin D.

Plus: It’s never too early to start educating girls about good bone health, note Newsweek columnists Barbara Kantrowitz and Pat Wingert:

Getting that message across is the focus of a new public service educational campaign sponsored by the American Academy of Orthopedic Surgeons (AAOS) and the National Institute for Child Health and Human Development (NICHD). The campaign ads feature a young girl with the headline “Almost Past Her Prime.” “This is a prevention campaign,” says Dr. James H. Beaty, AAOS president and a pediatric orthopedic surgeon at the Campbell Clinic in Memphis. “We’re trying to prevent future problems rather than treat them when the kids become adults.”


One Response to “Good Bones: Prevention and Treatment for All Ages”

  1. Maggie Says:

    I am SO sick of the ads on TV for osteoporosis drugs. Why exactly should anyone take health advice from Sally Field?

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