If you were told you have osteoporosis or osteopenia, here is a non-pharmacological approach to care that may be safer.

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Since the invention of the Dexxa scanner, many women have been told their calcium numbers were low in their bones increasing the risk of fractures from falls and compression fractures as you age.

According to the Hospital for Special Surgery (HSS), For post-menopausal women and men age 50 and over, the result of DXA is based on T-scores: A T-score equal to or above -1.0 is considered normal bone density. A T-score between -1.0 and -2.5 is considered low bone density, sometimes referred to as osteopenia. A T-score -2.5 or below is considered osteoporosis.

While doctors will manage risk using medication, often these medications may result in side effects affecting the jaw and strange fractures years later. Many of the drugs are poorly tolerated as well. With any approach to treatment, the benefits must outweigh the risks and you should research this approach fully before using medications.

What is often not discussed in detail is there are safe regimens supported by the latest research that can help you stay healthy, and avoid the side effects associated with medications. For the best information, consult your pharmacist as well as your doctor.

While women are most likely to have these risks due to hormonal changes as we age, a small portion of men have those risks too.

A Nonpharmacological Approach to Bone Fracture Prevention

Significant bone loss and decreased bone strength are signals of osteoporosis, which can increase the risk of fracture. Osteoporosis affects people of all races and ethnicities and both sexes. In the United States, an estimated 10 million people age 50 and older have osteoporosis. Most of these people are women, but about 2 million are men.26

What Is the Relationship Between Osteoporosis and Bone Fractures?

It has been known for decades that low bone mineral density (BMD) is an important indicator of fracture risk.4,7,13 However, it has become apparent that a majority of fractures occur in non-osteoporotic people.10-11,14,18,21,25 The National Osteoporosis Risk Assessment observed that more than two-thirds of patients with fractures did not have osteoporosis.20

Overall, most fractures occur in those with BMD above the “osteoporotic” cutoff point. The majority of fractures are a result of previous fractures, falls, and advancing age (such as loss of muscle with advancing age and balance issues). Thus, the issue is not just low BMD, but also falls and advancing age.

Enhancing Skeletal Health and Improving Advancing-Age Issues

A major goal is to prevent falls and, by extension, fractures. The following recommendations are aimed at enhancing skeletal health and improving advancing age issues:

  • Exercise: High-quality evidence from two scientific reviews shows that cardio, resistance and weight training, and supervised balance training in adults can reduce the number of falls and fall-related fractures.15,19
  • Nutrition: A research team examined the relationship between the Mediterranean diet and the risk of falling in older adults.2 Participants with the highest adherence to the Mediterranean diet showed a 28% lower frequency of falling compared with those with the lowest adherence. Multiple systematic reviews have reported that higher adherence to the Mediterranean diet is associated with an 18% decreased risk of fracture.5,8,12
  • Smoking: Numerous peer-reviewed studies have found a link between smoking, reduced BMD values, and an increased incidence of fractures.1 The Surgeon General’s report causally linked tobacco smoking with several skeletal system disorders.23
  • Alcohol: Excess alcohol consumption is known to be detrimental to human health. Compared to non-drinkers, a 33% higher risk of fractures was found in those who consume three drinks of alcohol per day and a 41% higher risk with four alcoholic drinks per day.Interestingly, having one or two drinks a day was associated with a lower risk of osteoporosis.
  • Vitamin & Mineral Supplements: A review of six quality clinical trials using vitamin D and calcium supplements demonstrated a 16% reduced risk of fracture.27 In another high-quality study, the rate of injurious falls and injured fallers more than halved with strength and supervised balance training and vitamin D.24
  • Research teams have shown that inappropriate dosages (low and high) of vitamin D and calcium do not reduce fracture or fall rates.9,16,22,28 It also has been discovered that osteoporosis is linked to reduced magnesium levels.17 In a long-term study of over 48,000 participants, supplemental calcium and magnesium were associated with about a 40% reduction in fracture risk.3

The most effective and digestible form of vitamin D, calcium, and magnesium is cholecalciferol (vitamin D3), calcium citrate, and magnesium oxide, respectively. Recommended dietary allowances for adults are 800-1,200 units/day of vitamin D, 1,000-1,200 mg/day of calcium, and 400 mg/day of magnesium.

Before starting any of the above recommendations, consult with your doctor. References supporting the above information are available upon request from the clinic director.


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