Osteopenia

[Cataboo]

Just read this article in NPR and it's pretty outrageous:

http://www.npr.org/templates/story/s...15&sc=fb&cc=fp

How A Bone Disease Grew To Fit The Prescription
www.npr.org
In 1990 the bone condition osteopenia - a slight thinning of the bones - didn't exist. Today women are diagnosed with osteopenia and given medication. This is the story of how Merck's marketing efforts changed the definition of a disease, creating a whole new category of people who saw themselves as...

[KnottedYet]

Great article, thanks for the link!

I love the docs who tell their osteopenia patients to get to work changing lifestyle: they go to the nutritionist to learn about dietary changes, and they get sent to me to learn about weightbearing exercise.

Lifetime habit changes vs. lifetime drug use. It's good to have the options and it's good to have a doctor who can help you figure out which is the better path to try first.

[Cataboo]

Great article, thanks for the link!

I love the docs who tell their osteopenia patients to get to work changing lifestyle: they go to the nutritionist to learn about dietary changes, and they get sent to me to learn about weightbearing exercise.

Lifetime habit changes vs. lifetime drug use. It's good to have the options and it's good to have a doctor who can help you figure out which is the better path to try first.

Lifetime drug use that may long term make your bones more brittle.

Sounds like a great thing to be encouraging lots of people to do.

[KnottedYet]

Lifetime drug use that may long term make your bones more brittle.

Sounds like a great thing to be encouraging lots of people to do.

Yup. "If it ain't broke yet, don't Fosamax it."
(send 'em to me instead... evil laughter from the physical therapy department... mooo-heh-heh...)

ETA: the osteopenia/disease/drug thing reminds me of when docs used to freak at healthy women who were "anemic" during pregnancy and throw iron pills and dire warnings at them. Until someone finally realized low blood iron was normal (and desirable) as the body sequestered iron. I was anemic earlier this year and it was horrible, I was miserable. Nothing like the "anemia" I <didn't> have while preggers. Thank goodness my OB had the same stance as these bone docs; if the patient is healthy and has no symptoms, don't treat a test result. "Treat patients, not test results" is something I hear a lot.

Osteoporosis, now... that s*cks. I've worked some desperately debilitated elderly ladies, and darn tootin' I want them to be taking Fosamax. Fragile bones are bad news.

[cylegoddess]

Yes Big pharma sucks, but since many more people now days drink soda, eat acidic foods, dont exercise( sedentary) - oesteo is rising and yes! I am a fitness instructor, so I work to change it without drugs.

[Grits]

Good article. A few years ago I had one of the bone density tests with a perepheral device, it measured the heel in my case, and was diagnosed with osteopenia. I followed it up with a full diagnostic scan of the spine and hips which confirmed it and was put on Fosomax.

I then read a book, The Myth of Osteoporosis by Gillian Sanson, (poor title, the author acknowledges that osteoporosis is not a myth, but is much, much rarer a disease than you would think given all the publicity). It, as does the article, puts into question the validity of calling osteopenia a disease needing treatment and comes to the same conclusions, but coming at it from a slightly different angle. That convinced me to go off the fosomax and up my calcium intake. I've always done weight bearing exercise and really had no risk factors other than the ones you can't help - race, sex, body build.

I've heard similar things about cholesterol and blood pressure meds. The cut off for what is "normal" is changed, and a doctor goes from having healthy patients one day to lots of patients who need prescriptions just based on a number that someone, somewhere came up with. This definitely makes you think. We tend to do what our doctors recommend without questioning, but really need to do our own research.

[sarahspins]

Yes Big pharma sucks, but since many more people now days drink soda, eat acidic foods, dont exercise( sedentary)

I agree with this so much.. because the same can be said for diabetes, high blood pressure, heart disease, etc. I've heard a lot of arguments that they're on the rise simply because doctors are more aggressive at looking for them.. and on one hand I can kind of see that (as diagnositc criteria change), but it doesn't address the underlying issue that Americans just plain sit around much more than we used to... the human body was designed to be used, not sit in a recliner watching TV. No one really puts much effort into taking care of themselves until there IS a problem.

Now, I say that, I don't mean to sound crass.. I am diabetic (type 1) and I also take an ACE inhibitor to protect my kidneys as a preventive measure (I do not have high BP, or rather, I did not before taking ACE inhibitors). I'm also hypothyroid and take synthroid for that, so I'm basically on 3 medications for the rest of my life. I'm only in my 20's.. so that sucks. I worry about long-term effects, but I also know that the immediate short term results of not taking them is so much worse

[Biciclista]

Thanks for the article. To add to the above information provided by Knott, I encourage you to work on balance exercises. (which includes cycling ) because most fractures are caused by falls and most falls are caused by poor balance.

[tctrek]

So when they say do weight bearing exercise, is any exercise using weights ok? Like circuit training, squats, lunges? I have osteopenia in my hips -- what sort of exercise is good for that? I do drink milk, eat yogurt and take Calcium/Vit D supplements and I do a somewhat standard strength routine a few times a week. Is that enough?

[Crankin]

Well, I have a somewhat skeptical attitude that osteopeinia is not real. I found out I had it over ten years ago. I've been taking calcium for 25 years, been exercising for longer, mostly impact for the majority of the time. I couldn't take Fosomax and was on Evista on and off for 3 years. I stopped taking it because of the side effects. I've lost 10% of my bone density in my spine in the last 3 years; no amount of calcium has helped. Both my mom and grandmother had this. I am thin and Caucasian, both apparently risk factors.
Right now I am waiting to discuss the results of some tests to make sure I am an OK candidate for Reclast. I am praying I can take this treatment without problems, because I don't want to be on my way to becoming my grandmother, who lost 3-4 inches in height and never was the same after she fractured her hip. I'm extremely conscious of what could happen when I am riding, x country skiing, or even just walking on the icy snow. It's not going to stop me from doing this stuff, but it's making me even more cautious than usual.

[KnottedYet]

Crankin, you would be a prime example of where the doctor should be talking about drugs for the first option: as a patient you have risk factors and a family history, so your test results would just add to the data. (treating the patient)

As opposed to quite a few women who have no history and low/nil risk factors, and the only data is the test result. (treating the test) These are the women I want to see get set up with exercise programs and nutritional guidance. I really like working with these women, often they've not been very active and have poor kinesthetic awareness. We have fun, I love opening up the world of activity to someone.

Good luck with the Reclast, and stay active!

[Trek420]

Knott and all, aren't cyclists more at risk (unless we cross train) because of a lack of weight bearing?

[Cataboo]

Crankin, in addition to what Knot said - it sounds like they've actually tested your spine for bone loss, as opposed to testing your wrist or heel and inferring your spine must have issues like the article was talking about. I'm assuming your test is more accurate.

[Bike Chick]

Knott and all, aren't cyclists more at risk (unless we cross train) because of a lack of weight bearing?

That's what I was told by my doctor. She said it does nothing for bone density and that I needed to start walking and/or weight lifting in addition to cycling.

[Crankin]

I had the regular Dexa scan for bone density. I've had one every 2-3 years since about 1998. Any other test would be a "rip off" in my opinion.
I agree that for most people, getting them off of their *sses and moving, along with dietary changes is the best thing. Knott, if you can get anyone to do this, you are a saint. I am in the process of planning a beginning fitness class for my psychiatric clients; the level of unhealthy behaviors is astounding...