Bone Health /Osteoporosis/ Osteopenia

If you are concerned about your bone health, bone density, or the increased risk of fracture that accompanies osteoporosis, We provide a unique and comprehensive program for achieving and maintaining maximum bone health.

ABOUT OSTEOPOROSIS
Osteoporosis is the most common bone disease in humans and poses a serious health threat to women and men.  It is characterized by low bone mass and deterioration of the microarchitecture of bone tissue, leading to fragility of the bone and an increased risk of fracture.  Osteoporosis currently affects approximately 30% of postmenopausal Caucasian women in the United States.  It is estimated that 50% of the population by the year 2020 will be at risk for osteoporotic fractures.  Women account for 71% of the 1.5 million osteoporotic fractures per year.  The estimated treatment cost for this health concern is over 18 billion dollars per year.

RISK FACTORS

There are several risk factors associated with the development of osteoporosis. 

• Genetics - may be the most important factor in determining the risk of osteoporosis. 

• Lifestyle choices - play a significant role.

• Hormonal factors - influences bone mass and the rate of bone resorption.

• Smoking and alcohol have an adverse effect on bone density. 

• Certain health conditions affect the body’s ability to make and maintain adequate bone quality.

• Nutrition - including foods rich in vitamin D, calcium and protein are very important. 

• Physical activity with an emphasis on weight-bearing exercises reduces the risk of osteoporosis.

BONE REMOLDING 

The process of bone resorption (breakdown) and bone formation is called bone remolding.  Osteoclasts stimulate the production of enzymes that dissolve minerals and protein in bone and thus promote bone resorption.  Osteoblasts create a protein matrix primarily of collagen, resulting in remineralization of the bone, thereby promoting bone formation.  Bone remolding is normally a balance of bone resorption and bone formation. 

An imbalance between bone removal and bone replacement results in bone loss and an increased risk of bone fracture.

PATIENT EVALUATION

The diagnosis of osteoporosis can be made with a comprehensive history and physical.  A thorough review of potential risk factors will point the clinician to obtain the best diagnostic tests for you.  A thorough evaluation would include a test of bone mineral density such as a DEXA bone density test.  MRI and CT scans may be considered to assist in the diagnosis.  A blood measurement of vitamin D is critical to help in choosing the correct amount of replacement.  Markers of bone breakdown and bone formation such as urinary N-telopeptide, estradiol, osteocalcin, n-terminal propeptide Pro-Collagen may also help in the assessment.

DIAGNOSIS AND TREATMENT

Our approach to the diagnosis and treatment of osteopenia (early bone loss that precedes osteoporosis) and osteoporosis is as follows:

• A detailed history with emphasis on modifiable risk factors
• A complete physical
• Obtain the appropriate diagnostic testing
• An appropriate treatment program including: Supplements/ Bio identical hormone therapy/ diet/ exercise