|Angus B. Worthing, MD, FACR, FACP
Arthritis and Rheumatism Associates, P.C.
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|What is osteoporosis?
Does someone in your family have osteoporosis (thinning of the bones) or a history of hip fracture? According to the National Osteoporosis Foundation, one in two women and one in four men over age 50 will have an osteoporosis-related fracture in their life. Osteoporosis can develop when the natural microscopic remodeling process inside bones, which normally consists of constant extraction and replacement of calcium, is disrupted. It is crucial to perform a careful interview and physical exam, followed by a state-of-the-art screening test much like an x-ray (“DEXA” test), which Arthritis & Rheumatism Associates, P.C. (ARA) has on-site for your convenience. This will clarify if your bones are healthy, or if you have osteopenia (a milder form of bone thinning) or osteoporosis. Also, simple blood tests can make sure your calcium and vitamin D levels are healthy.
Individualized treatment plan
In the recent past, most women and many men with low bone density were all treated with the same kind of medicines. Now, we can treat each person individually. First step would be to determine your risk of breaking a bone by comparing your results with established national statistics. If you have a higher risk, you should understand all three families of medicines that are now available and decision of which is best for you should be determined – along with other adjunctive treatments such as supplements, diet and exercise.
|Three families of medication
The oldest class of medications called “bisphosphonates” includes Fosamax, Actonel, Boniva, and Reclast. This family of drugs slows down the natural extraction of calcium from bone by osteoclasts (“bone eating” cells). Reclast and Boniva can be given conveniently through a small IV once a year (Reclast) or quarter (Boniva), so that you can avoid taking pills. The most recent type of medicine for osteoporosis, Prolia, also blocks the “bone eating” cells and is given just twice a year through simple injection under the skin by our nurses. The strongest treatment, called Forteo, supplements one’s natural parathyroid hormone and is taken as a daily injection at home, like insulin.
If you have ever wondered if you have osteoporosis, then I and my