NATURAL MEDICINES & FAMILY PRACTICE
David Overton, PA-C 1315 Ruddell Rd. SE Lacey, WA
Osteoporosis Prevention and Treatments: addressed in appointments. Bring this checklist
Osteoporosis or osteopenia (early bone loss) is often first detected in the jaw with dental x rays, on x rays for back pain and then as height loss or abnormal boner scans. Some times it is detected as a fracture in an otherwise health patient or hump back posture known as kyphosis.
European and now American researchers found that height loss and osteoporosis increased premature death overall, but especially due to disability, poor lung function, diabetes, circulation disorders, heart disease, cancer and stroke. If you fall and sustain a fracture, it often hastens premature death due to disability and lung problems that lead to circulation and other preventable or treatable problems.
Risk factors include lack of regular exercise, poor nutrition, nutritional deficiencies, pre diabetes, diabetes, circulation disorders or heart disease, fracture after age 50, steroid use (inhaled, oral or injected), tobacco or marijuana use, more than 2 alcohol drinks per day, rheumatoid arthritis, family history, bone building issues, aging and menopause.
Most women want to focus on hormones which may increase risk for heart disease, stroke or gynecological cancers. Most women want to focus on taking calcium. Studies show women taking recommended doses of calcium have the highest rates of arteriosclerosis (hardening of the arteries).
___The best treatment is education, lifestyle changes and regular exercise. These are reviewed in appointments.
___Regular exercise improves balance so you don’t fall and sustain a fracture, while helping to preserve bone. Walking is excellent and more specific exercises can be done to improve balance even more to prevent falls while building bones. Taking drugs does not replace exercise.
___Research is rapidly linking osteoporosis to the same things that cause pre diabetes, hypoglycemia or diabetes, kidney dieases, heart disease, strokes and cancer. 90% of these and osteoporosis is directly caused by treatable lifestyle issues. Test insulin and glucose with us to find and treat blood sugar problems.
___ 1 in 9 people have silent chronic kidney disease and do not know it. We recommend kidney testing and have treatments to improve and support kidney functions to maintain healthy bones.
___Research is rapidly linking osteoporosis to circulation damage. Cardiovascular & stroke risk tests should be done. We do ECG, CardioRisk artery scans and other circulation tests in our office. If abnormal, see me for treatment.
___Vitamin D is very controversial and supplementation may cause side effects. See my articles on vitamin D and you should not take extra supplements unless your 25 OH vitamin D level is less than 20. Vitamin D testing is unnecessary and ordered so frequently that many insurance companies will not pay for the test in routine cases.
___ Cancer testing should be performed and followed up if abnormal. See me for skin, colon, breast, uterine or prostate cancer tests. If scheduled elsewhere, have the results sent for review. I will want to see your actual mammogram films.
___Next is prescribing fat soluble vitamins, mineral and other factors than contribute to bone loss and aggressive treatments. If tests are abnormal, see me for Nutritional Medicine Management.
___Bone scans and bone resorption tests should be done. These establish the diagnosis and bone resorption tests confirm a treatment is working.
I have not recommended some prescription osteoporosis drugs for years, due to concerns about side effects or lack of effectiveness. Safer prescription drugs are available.
___Biphosphonate oral drugs are poorly tolerated and only 1% is absorbed. Estrogen may increase cancer risk, clotting risks, heart disease risk, stroke risk, increase cholesterol, affect insulin metabolism, increase gallstone disease and contribute to weight gain. Estrogen bone preservation stops when you stop estrogen because it does not build new bone. SERMS or estrogen modifiers may carry all the risks of estrogens. Questions exist about the effectiveness of calcitonin.
____Less than 50% of patients prescribed oral osteoporosis drugs continue taking them after one year. No one knows why, but I suspect this is due to side effects, costs or no perceived benefits.
Place this and all future letters in a folder and bring it, along with any medicines or supplements you are taking and your written questions, to each appointment.
Sincerely, David Overton, PA-C