Something to ponder: Which came first? The drug or the disease? Drug companies led the development of Dexa machines, paid to have them put in doctors’ offices, often fund clinical trials, and are creating guidelines for using their drugs. Doctors are readily prescribing drugs with little or no knowledge of the drug, side effects, what to prescribe and for how long. And more disheartening, doctors do not take the time to get to know their patient’s health history. You must advocate for your own health. Do your homework! Know your sources! Make an informed decision! Below are some interesting articles, podcasts and videos on drugs and the disease.
Seattle Times
“Disease expands through marriage of marketing and machines”
NPR.com
How a Bone Disease Grew to Fit the Prescription
Dr Osborne
The Hidden Truth About Bone Density - The Myth
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Before DEXA scanners, osteoporosis was diagnosed on the basis of a fragility fracture. Now it's diagnosed on the basis of estimated bone density (done by a DEXA machine that is very open to errors), even though bone density and bone strength can be very different things. If it were just down to bone density, you wouldn't have fragility fractures if you have normal bone density or osteopenia! If DEXA scans were reliable, you'd be able to compare results from different machines: if two different machines give different results, how can they possibly both be correct?!
I had a cat scan with contrast in December of last year and the doctor documented that I have osteopenia instead of severe osteoporosis that the dexa scan which diagnosed severe osteoporosis. I know I walk and feel my bones are strong. The doctor kept insisting on giving be meds but I keep refusing. I hate taking the chance of side effects and taking my chances to do stay healthy without drugs.
"Osteopenia" on a normal x-ray (including a CAT scan) is radiology speak for low bone density severe enough to show up on a machine not intended for this. It does not mean you don't have osteoporosis. It means you probably do. In this context, there is no separate code for osteoporosis.
While a CT scan , XRays, Ultrasound may detect that you have OP, however it should be followed up with a DEXA & labs. The CT scan, XRay, ultrasound is interpreted by a Radiologist and only provides what he/she suspects regarding Osteoporosis.
In 2015, I had bilateral foot paint & my XRays revealed my I might have Osteoporosis. That was followed up with a DEXA that confirmed my OP. It turns out I had stress fractures.
Apparently, if we OP, our bones look very white on a CT scan, XRay, Ultrasound this the reason for the comment on the Radiologist report.
AND osteopenia was a disease invented to sell Fosomax to more women! It simply means you don't have the bone density of a 30 year old. But the diagnosis terrifies women, who then start on the drugs and special supplements. Great marketing!
You'd be right to be terrified if it means greater likelihood of spinal fractures. Just because bones naturally thin with age, doesn't mean it's risk free.
I had read about the NPR article earlier this year. It made me think about what women did before the the advent of Fosamax (introduced in 1995) and the subsequent development of the DEXA scan. I come from a family of thin, small-boned women who lived well into their 80s, 90s, and one reached 100. They didn't "exercise" but instead entertained, cooked, baked to their heart's content. And always with a joyful attitude and a smile on their face. So in the years before 1995, these women didn't suffer from osteoporosis? Who knew if they did? Did any of them have compressed vertebras? It was never discussed among my older female relatives although they talked about their hot flashes ad nauseam. They didn't watch their diets (as if whole foods/plant -based or alkaline/acid was a thing back then). They did have "coffee and cake" every afternoon (they all were phenomenal bakers - so think lots of sugar and white flour). None, thankfully, broke a bone except my mother who broke her wrist in her 60s after a fall in which she landed on her wrist that occurred sometime in the 1980s. Osteoporosis was never mentioned even though my mother was a tiny, wisp of a woman. She lived until 88, and never broke another bone.
Please read the NPR article How A Bone Disease Grew To Fit The Prescription and pay special attention to the second to the last paragraph. Big Pharma is alive and well and getting richer due to overprescribed drugs which may not even be needed, as in mild osteopenia. My own rheumatologist actually told me that he sees rarely any side effects from these drugs. Do I believe him? Absolutely not. It's best to do your research and make your own informed decision.
I am not sold on taking those drugs. I know people on them that had thigh fractures just from walking. I am still going to eat healthy and I do take a calcium supplement with vitamin K.
A lot of older women in my family were small-boned. Some of them did get spinal fractures and kyphosis. They became very stooped, it was painful and limited their breathing and activity in many ways. I wouldn't make light of having frail bones.
I agree 100% that we should not make light of frail bones! I am, for certain, worried about sustaining a fracture, but I am more worried about being married to a drug for the rest of my life—so many drugs to choose from, so many unknowns. My beef with the medical community is that doctors are prescribing drugs to very young women, many in their 50s, the minute they cross the line from osteopenia to osteoporosis, and often before that. And from women I have talked with, they have no idea what they have signed up for. I am not suggesting that women should not take drugs; it’s a very individual and sometimes emotional decision. But please make an informed decision! I am confident I have made the right decision for me, which is to work on better bone health through nutrition and exercise. I have added electrolytes, collagen peptides, protein powder, D3, and K2 to my regimen. I am 77 years old; still hike, bike, downhill ski, play Pickleball, lift weights, jump on my trampoline, and wear a weighted vest while walking my dog six times daily. I’m not going to let fear of breaking a bone control my life.
I take your point. There seems to be a 'one size fits all' approach. For example, when my husband broke his hip he was prescribed calcium even though his blood test showed his level was good. I think the GP did it as a precaution. However, calcium supplements have not yet been shown to reduce the frequency of bone fractures so you wonder what the point is. You are wisely taking the kind of precautions which suit you instead of blindly accepting what you are told. On the other hand you read of so many examples of people with crippling spinal fractures, your anecdotal evidence of your own elderly relatives may be of little significance in the bigger picture.
Love your handle, btw. Very clever. Just a quick comment about calcium; nearly everything I read—and it seems most doctors agree on this—that calcium is best absorbed through food and can be dangerous when taking supplements if they are not absorbed readily. Calcium from supplements can build up in your arteries and cause blockage. I enjoyed the stories about healthy relatives living vibrant lives, but that family history came from Kitchenbuddy, not me. However, my mother lived w untreated osteoporosis until 97 and her older sister is still alive at age 100. They both had broken hips while in their 90’s and recovered well. I’ve lived with osteopenia/osteoporosis now for nearly 20 years and hope for 20 more good years. Fingers crossed.
I have read that about calcium too and try to get mine via my diet, although it takes a bit of effort to get the recommended amount every day. I've lived (knowingly) with the ops for 6 years now without a problem. In fact, I take ibandronate because I had breast cancer. A whole other can of worms! Anyway, I hope you remain in good health for the next 20 years, what you're doing seems to be working.
An active person is far more likely to have strong bones, than those who sit in front of a TV or computer all day. The water quality of the place you grew up in also has a bearing on your bone density. Calcium rich, Limestone water or water which flows through Chalk outcrops will be hard water. Water which come from Basalt or granite rich soil will be soft (deficient) in Calcium. it is easy to tell the difference; if your kettle or water boiler furs up with a chalky substance it is hard water. I was brought up on limestone; I have strong bones and I have always been an active person. I'm 76, and I only had to surrender my first two teeth to a dentist last year. OK, I'm slowing down now, balance is off, use a walker now and am awaiting a Mobility scooter. I was very active, Walking, Climbing, Dancing, and my job was nursing. Very little sitting down.
For instance, a paralysed person will develop bone weakness , because the person cannot exercise. Probably wouldn't show up in a blood test, but the body will be repurposing the calcium from that person's bones to other systems. Even more so without sunlight.
This is why it could help your bones when you reach menopause to take a cod liver oil capsule and a vitamin K supplement. Also get outside during daylight, as sunlight, even through clouds will convert the vitamin A in your diet to vitamin D. Exercise is vital to keep bones strong and healthy.
Great article! I’ve had so much pressure from GPs re taking medication. When the score reached osteoporosis I had 1 prolia shot resulting in fear and side effects so stopped. Went the algae cal, vit D K2 journey with exercise and weights program. Most recent deca showed back in osteopenia and normal range. Now in late 70’s my dexa scores have bounced around in similiar range - no major decline.
However GP put the pressure on me again and I started taking Actonel. I’m torn as know I’ll upset GP if a stop! He’s I nice GP re other issues!! Wish a major side effect would show up. I do agree the pharma companies are controlling the medical profession.
My mother was born long before the invention of DEXA machines and she developed and lived with osteoporosis. By the time she died in her late 80's she had shrunk in height and had a curved spine and had problems with digestion/ She died after a fall caused her to break her hip, setting off a chain of events which led to her death.
It is quite possible that DEXA scans diagnosing osteopenia lend themselves to overprescribing. In the UK within the NHS patients are not usually given DEXA scans unless they have broken a bone or there are other reasons to suspect osteoporosis. Personally I am glad that we have such useful tools. The DEXA scan was developed by a radiologist.
We appreciate the thoughtful discussion around osteoporosis and bone health.
While we encourage open dialogue, as we note in our community guidelines “if statements are set out as proven facts where they are not, this can be confusing and misleading for those reading posts”. The pharmaceutical industry does play a role in osteoporosis treatment development, but osteoporosis is a well-documented condition supported by extensive research which has been recognised for decades.
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