DEAR DR. GOTT: I have been told I have osteoporosis and have a few questions. I’m 66 years old. My bone is 3.5, whatever that means. My doctor told me about Reclast but no way do I want that in my body or in my bones.
I had breast cancer in ’04, so far so good. I’ve had chemo and six weeks of radiation treatment.
Thank you for your help in this area. When you’re told if you fall you will break a hip, that’s not good. Bad feeling.
DEAR READER: Osteoporosis is a decrease in the density of bone that occurs when the normal buildup and breakdown of minerals fall out of balance. A T density of 3.5 indicates you definitely have reduced density that can be reversed to some degree, but should be addressed now. For all of us, men and women alike, bone mass begins to decrease naturally after the age of 35 and is known to occur more rapidly in women following menopause. Mild bone loss is known as osteopenia which is a precursor to osteoporosis.
Almost 10 million individuals in the United States have osteoporosis, while another 18 million have reduced bone mass that places them at increased risk for developing osteoporosis and possible fractures. In fact, the World Health Organization (WHO) has posted figures that indicate 22% of all Caucasian women between the ages of 60 and 69 carry the diagnosis. By the time they reach the 70 to 79 age bracket, the likelihood increases to 39%. Hormonal changes play a significant role. Women lack estrogen, while men lack androgen. Also, we tend to consume less dairy as we age, mistakenly believing it is essential for children’s teeth and bones but not as important for adults as they age. There are other factors that also come in to play, such as the use of corticosteroids and other specific medications to include anticonvulsants, thyroid abnormalities, excessive consumption of alcohol, rheumatoid arthritis, and a sedentary lifestyle. There are two essential minerals that form normal bone – phosphate and calcium. Early on, the body uses these minerals to produce healthy bone. If an individual’s calcium intake is insufficient and the body cannot absorb what it requires through that person’s diet, bones can become weak, setting the stage for fracture.
Osteoporosis can be present for years without any symptoms and without the individual even knowing the condition exists. When signs occur early on, they may include pain, particularly in the neck and lower back, that can be attributed to countless other problems and essentially ignored. Later on, common issues can include pain which can occur almost anywhere in the body but is common in the spine, hips, wrists and ribs, as well as a dowager’s hump, loss of height, stooped shoulders, and more.
The Reclast your physician is recommending is in a class of drugs known as bisphosphonates. It is an oral medication designed to slow bone loss. When taken, the individual must stand or sit upright for 30 minutes after taking it to lower the risk of developing heartburn and esophageal ulcers. It is also necessary that you wait 30 minutes before ingesting any food, beverages (excluding water), vitamins, calcium, or other medications. The problem with some of the drugs in this category is that they can initially reduce the risk of fractures but long-term, have been found to cause non-traumatic femur fractures and osteonecrosis (death) of the jaw bone.
All things considered, I feel your safest bet is to exercise as much as possible and take a trial of 1500 mg of over-the-counter calcium and 800 IU vitamin D for a given period. Bring the suggestion to the attention of your physician for his or her opinion. If this doesn’t cause some improvement, adding one of the bisphosphonate medications is your best option to avoiding further loss and reducing your risk of fracture.
Readers who would like related information can order my Health Report “Osteoporosis” by sending a self-addressed, stamped number 10 envelope and $2 US check or money order to my attention at PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print out an order form from my website www.AskDrGottMD.com.
