Medication and lifestyle changes can keep bones strong
Four fractured bones in just a few years. Multiple emergency room visits. And, strong medications to help with pain.
This was what one 75-year-old patient endured until she sought treatment from Dr. Kelly Krohn, MD, bone specialist and medical director of bone health at The CORE Institute, Arizona’s largest orthopedic practice, specializing in advanced orthopedic and neurological care.
The cause of her misery? Osteoporosis. It’s a common diagnosis, but it can often be missed.
“That story is told over and over again in my clinic all day long,” Dr. Krohn says. “We eventually addressed the underlying problem and put her on treatment, and she hasn’t had any more fractures for the last year and a half.”
Osteoporosis – when the body loses too much bone – affects one in three women and one in five men over the age of 50, according to the International Osteoporosis Foundation. The disease causes more than 8.9 million fractures a year across the world.
“When you hit menopause as a woman and get older as a man, you remove more bone than you replace every day,” Dr. Krohn explains. “If you live long enough, your bones get fragile. If your bones get fragile and you break something, we call it osteoporosis.”
He says it’s a fallacy that people can completely overcome osteoporosis through exercise alone. While exercise is important, patients with osteoporosis can’t grow new bones without medication. The most important thing exercise does is to help reduce the likelihood of falls.
“You can help yourself with weight-bearing exercises and good nutrition, calcium and Vitamin D,” Dr. Krohn says.
In the past two decades, medical advances and new drugs have greatly improved treatment options for osteoporosis patients.
“We have many medications that predominately work by reducing the loss of bones,” Dr. Krohn says. “We’ve also gotten smarter about who should take the medicines and who should not.”
There is a range of drugs available for treating osteoporosis. For women in menopause, estrogen can strengthen bones, but comes with an increased risk of breast cancer. Other medications increase bone mineral density – how much calcium and other types of minerals are in your bones – and reduce future fractures.
There have even been advancements in medications that can grow new bone. “These drugs are used for the toughest patients,” Dr. Krohn says. “We don’t use them routinely if there are other choices, but they are dramatically beneficial.”
People who have suffered a fracture related to osteoporosis often are not identified or treated for osteoporosis. Doctors, like Krohn, are increasingly focused on identifying patients with a high risk of fractures and recommend they seek out a specialist with an interest in osteoporosis.
Dr. Krohn says many primary care physicians are comfortable with simple osteoporosis but are often not comfortable doing a complete bone medical workup or prescribing complex bone medications.
The National Osteoporosis Foundation recommends asking your doctor about osteoporosis, and if you need to see a specialist, your health care provider may be able to suggest one. Many doctors can treat osteoporosis, including endocrinologists, rheumatologists and orthopedists, among others, but it’s important the doctor has an interest in the disease and stays educated about it, Dr. Krohn says.
“People can die as a result of the complications of broken bones,” Dr. Krohn says. “It’s serious business, but if we address them correctly earlier in their life, we can reduce the rate of fractures somewhere between 50 and 85 percent.”
Risk factors and screening for osteoporosis
Dr. Kelly Krohn says generally all women should be screened by 65, or earlier if they have risk factors or fractures. Most men should be screened at 70, or earlier if they have risk factors or take steroids. Medicare covers routine screening for osteoporosis using a painless bone mineral density test, similar to an X-ray. If you’ve never been tested or haven’t been tested recently and have any of the age or other risk factors, please discuss the matter with your physician.
- A history of previous fractures.
- Physical inactivity or a sedentary lifestyle.
- Smoking can lower bone density.
- Low body weight or weight loss is associated with greater bone loss.
- Use of some sedatives, antidepressants, steroids and high consumption of alcohol can increase the risk of hip fractures.
Above: Dr. Kelly Krohn speaks to an audience about bone health.
Learn more from Dr. Krohn at “What Can I Do to Reduce the Chance of Life-Changing Broken Bones?”