There was a time when osteoporosis was a disease which was largely suffered by postmenopausal women. However recent studies have shown its incidence is spreading among younger men and women. Researchers are calling this new type of the disease: secondary osteoporosis.
This disease has always been on the radar of doctors at Texas Back Institute because it can be responsible for causing fractures in vertebrae. They have seen just how serious a minor trauma can become in someone suffering from osteoporosis.
“If you have osteoporosis, it generally affects every bone in your body, notes orthopedic surgeon Dr. Theodore Belanger of Texas Back Institute. “It leads to an increased risk of fracture from minor trauma, such as a fall from a standing height. When severe, an osteoporotic person can sustain a vertebral fracture from something as trivial as sneezing or bending over at the waist.”
An Overview of Osteoporosis
A quick explanation of this condition will clarify the challenges it poses for back health. Osteoporosis means a loss of bone strength as a result of decreased bone mass.
According to Dr. Belanger, “We all lose some bone mass as we age, but some people lose more than others for a variety of reasons. While it’s more common in older persons, especially women who are postmenopausal and Caucasian, it can affect men or younger people of virtually any ethnicity.”
“There are many other things that cause a person to accelerate the loss of bone mass, such as exposure to corticosteroids,” noted Dr. Belanger. This high-powered medicine, used to treat other serious diseases, is one of the factors researchers feel causes secondary osteoporosis. More on this later.
Can this condition be treated with vitamin or mineral supplements? Or, are there any medicines which help bone strength? Dr. Belanger offers a cautious “yes.”
“According to some, most Americans are probably somewhat deficient in Vitamin D,” he said. “If you have true osteoporosis, as diagnosed by your physician or by a bone density test, then taking Calcium and/or Vitamin D supplements alone may not be adequate to reduce your risk of future fractures.
It may surprise some that there are different levels of Osteoporosis. The precursor and milder version to the full onset of osteoporosis is “osteopenia.”
“The World Health Organization recommendation is to take daily supplemental Calcium and Vitamin D,” Dr. Belanger notes. “If you have more severe bone loss, true osteoporosis, then medications should be considered by your doctor.
“There are several medications available, which have varying modes of action, effectiveness, risk and benefits, and cost associated. A more in depth discussion with your doctor is necessary to determine which medication treatment is best for your situation.”
Checking for Secondary Osteoporosis
According to a March 2014 article in the Wall Street Journal about the increase in osteoporosis among younger patients “Secondary osteoporosis is increasingly being diagnosed in younger patients with cancer, celiac disease, rheumatoid arthritis and inflammatory bowel disease, as well as in people taking reflux medications, blood thinners and some depression drugs, researchers say. Patients are at risk of secondary osteoporosis after bariatric surgery for weight loss, as are those receiving hormonal treatments to prevent the recurrence of breast or prostate cancer.”
Other factors noted in the article include adverse effects of diabetes on bone health, smoking, excessive alcohol use, eating disorders like anorexia nervosa and inactivity. Each has been linked to declining bone mass.
“Certain thyroid and parathyroid conditions, exposure to steroids such as prednisone, certain forms of cancer and chemotherapy can cause premature bone loss,” said Dr. Belanger.
(Logo of American College of Rheumatology)
According to The American College of Rheumatology anyone taking corticosteroids, which are drugs prescribed to suppress inflammation in a wide range of illnesses and to prevent organ rejection after transplants, have a direct negative effect on bone cells and can interfere with the body’s handling of calcium.
What are the most reliable ways physicians can check for secondary osteoporosis? Dr. Belanger has some suggestions.
“Osteoporosis is generally diagnosed by having a thorough history and physical exam, looking for risk factors such as other illnesses, dietary peculiarities, steroid exposure,” he said. “If indicated, your doctor may recommend a bone density test. This is a noninvasive imaging test. It’s important to note that osteoporosis cannot be reliably diagnosed by looking at a regular x-ray.
Since osteoporosis is typically noticed after it has had time to weaken bones, is there anything a person can look for to suggest they might an examination to determine if this condition exists? Dr. Belanger suggests watching for suspicious fractures.
“Osteoporosis is generally discovered as a result of presentation for healthcare after a fracture has occurred,” he notes. “Suspicion should be high if a significant fracture results from what would otherwise be considered a trivial event (a minor fall or lifting a heavy object) Screening is recommended in postmenopausal women, or in those with history of “fragility fractures”, or if a strong family history or other risk factors (steroids) are present.”
Incidence of Osteoporosis is Increasing
According to the National Osteoporosis Foundation, nine million adults in the U.S. have osteoporosis and an additional 43 million have low bone mass (osteopenia) which increases their risk of osteoporosis and broken bones. The foundation projects that by 2030, the number of adults over age 50 with osteoporosis and low bone mass will grow by more than 30% to 68 million. Many of these will be the younger patients.
The back specialists at Texas Back Institute see a wide range of patients with back injuries and diseases and osteoporosis is becoming more and more pervasive. We asked Dr. Belanger if he had examined any younger patients with this disease and, if so, what procedure or regimen he prescribed.
“I have seen younger patients undergoing screening for osteoporosis as part of our preoperative workup for elective spine surgery come back with surprising bone density test results,” he noted. “When diagnosed, treatment involves a combination of testing, screening for related conditions (thyroid, parathyroid), education about calcium and vitamin D and consideration of medication to treat osteoporosis.”
Regardless of your age, if you suspect you might have osteoporosis, see your family physician or a back specialist at Texas Back Institute and undergo the bone density tests. For more information or to schedule an exam, email firstname.lastname@example.org.