Osteoporosis: Is your therapy helping?


It is estimated 44 million Americans have reduced bone density. In 2005, 10 million Americans were affected by osteoporosis, increasing to about 17 million in 2010. Approximately 80 percent of those affected are women. Data on vitamin D deficiency is at epidemic proportions, hitting 60 to 70 percent of most persons in the U.S., and hitting up to 90-plus percent in high-skin pigmented populations, such as Hispanics and African-Americans.

Therapies may include exercise, nutrition and medications, both chemical and hormonal.Often, dual energy Xray absorptiometrybone scans are used for screening. However, they are not sensitive to small changes and often not repeated for a year. How do you or your doctor know if you are being successful in your selected treatment? I will not discuss therapy, but a way to see if your chosen therapy is working.

Let’s discuss how your bones break down and then rebuild themselves. Have you ever seen the machines used by road repair crews that move along, crunching up old asphalt? That machine is followed by another that deposits new asphalt, rolls it out and bingo –you have a new smooth surface. Your bones operate the same way. Osteoclasts break down old bone and are followed by osteoblasts that fill in the holes left behind.

This combo is called a basic multicellular unit. This construction team typically works in tandem for four to eight months. One million BMUs are working to replace 8 to 10 percent of your bones every year. Like any construction project, debris or bone markers are left behind. These bone markers may be measured in the blood or urine. Ratios then indicate if your acceleration of bone loss persists, or it has reversed into bone building. You don’t have to wait for a year to find out.  You can check every month or so until your ratios turn positive. This is called a Pyridinium Crosslinks test, which is available through most labs.

If you are putting the time, effort and finances into osteoporosis therapy, make sure you are getting a benefit. Perhaps you are doing great. But if you are not, then you need to change your therapy to one that works for you.