What is Osteoporosis ?
Its an skeletal disorder characterized by compromised bone strength that predisposes to an elevated risk of bone fracture. Bone strength reflects an integration of bone density and bone quality.
What are the symptoms of Osteoporosis or low bone mass ?
There are no symptoms of low bone mass or from bone loss. Even if fractures of the vertebral spine are present due to osteoporosis or low bone mass, symptoms can be variables or even no symptoms at all.
How is Osteoporosis or low bone mass diagnosed ?
There are multiple bone densitometry devices (DXA scan) that can measure specific skeletal sites. They are classified as A) Central devices, which are capable of measuring the bone mineral density in the spine (vertebral column) and the hip and B) Peripheral devices that are capable of measuring the wrist, heel, finger etc.
When measuring bone density and mineral content in the spine, the area of interest is the lumbar spine L1 through L4 and for the hip we look at the total hip and femoral neck ( bones in the leg and hip region). A score of negative 2.5 or less is considered Osteoporosis ( T score -<2.5 )
Low bone mass or Osteopenia is diagnosed when there is a T score higher than negative 2.5 but lower than negative 1.0.
In addition, osteoporosis can be diagnosed clinically by history of fragility fractures ( is defined as a fracture resulting from the force of a fall from a standing height or less or a bone that breaks under conditions that would not cause a normal bone to break ) and physical examination.
What are clinical risk factors for low bone density or Osteoporosis ?
Loss of height
Low Body weight
Advanced age
Menopause
Smoking
Alcohol intake
Inflammatory medical conditions
Prior fragility fractures
Family history of osteoporosis
Malabsorption conditions
Certain medications
Who should be tested or screened for osteoporosis ?
Women age 65 and older.
Postmenopausal women under 65 with risk factors.
Adults with fragility fracture.
Adults taking medications associated with low bone mass.
Perimenopausal patients with risk factors associated with low bone mass such as low body weight, prior fragility fractures or certain medications.
Anyone being treated to monitor treatment effect.
What are the pharmacologic treatment recommendations for Osteoporosis or low bone mass ?
Initiate therapy in those with hip and vertebral fractures.
Initiate therapy in those with T score < 2.5 at the hip region, total hip or vertebral column at the lumbar spine.
Initiate treatment if a 10 year probability of hip fractures is high or a 10 year major osteoporosis related fracture is elevated.
How can Texas Menopause help ?
In addition to using conventional treatment for osteoporosis and osteopenia , we use aggressive nutritional therapies including dietary supplementation to help you reverse the effects of aging on bone. We will teach you what dietary factors affects positively or negatively your skeletal system. Also learn how some environmental factors impaired bone formation that could lead to bone fractures. We will offer an individualized approach for the management of low bone mass and osteoporosis that includes nutritional evaluation, counseling, fitness and flexibility assesment and necessary radiological follow up studies.
