Louise H Connolly MD
A different kind of medical practice
310 372-4706
Osteoporosis/Dem Bones
So they just did a bone density scan on you and the results weren’t good.
Your doctor wants you to “try” Fosamax but you aren’t so sure. You’ve heard some people take it for years without any improvement.
And the internet is full of troublesome warnings about bad side effects. Shouldn’t you take a closer look first? Aren’t there other alternatives?
Here’s where I can help. And yes, here is where I really would take a closer careful look. And here’s why.
First, bones are the slowest part of your body to change. And yes, they do change. Every molecule in your bones will be replaced, but this takes ten years! In contrast, the cells lining your intestine will replace themselves every four days, and your blood sugar will change second by second. Thus bones improve their density very slowly. In addition bone density scans lack sufficient accuracy to correctly interpret change. Years can be lost without benefit. Let me give you an example. Many 60 y/o women are only losing 1% of their bone density yearly. But if I put that woman in a bone density scanner 25 times in one day, the variation in density can be up to 4%! So what’s real and what’s Memorex? IMHO, it takes 5 years of scanning to get meaningful results.
Second, you can’t FEEL the improvement. You never felt bad to begin with. So you really don’t have a clue what’s going on unless you measure something more than just DEXA scans.
Third, bone density is only one factor determining bone strength and fracture risk. Bone architecture is also very important. Those spicules of bone should be lined up at all the right angles to carry the heavy load of the body. But they do NOT have to be solid. They just have to have the right tensile strength. Let me give you another example. The ancient Romans invented the arch. Before this invention, roads were made of solid stone. Now the Roman arch was just as strong but it was much less dense. That’s the principle of bone architecture.
Height, weight, and age are also very important variables. The taller and heavier you are the harder you fall and the higher your chance of a fracture. So height and weight matter. If a 50 y/o and an 80 y/o woman with the same bone density fall, the 50 y/o is bruised, the 80 y/o breaks her hip. So age matters. Thus your bone density should be individualized to YOU. And there are more variables. You could think of them if you try.
Lastly, and perhaps most importantly, a DEXA scan is only a static picture of density. It tells you nothing of bone dynamics. Bone is constantly being broken down and it is also constantly being built. Fosamax is very good at stopping bone breakdown. (It also inhibits bone formation a bit.) So isn’t it important to know how much bone you are actually losing to begin with? If you aren’t losing bone, is Fosamax really the best treatment? I think not. I’d concentrate on bone formation instead.
So let’s look at bone dynamics. How do we make bone? Well first we need the “raw materials” for this construction project. These raw materials include some vitamins and a whole lot of minerals. No, it’s not just calcium and vitamin D. The raw materials usually come from our diet and increasingly, as our soil gets depleted, our supplements. It’s hard to get them into the body from our intestinal tract. And that little purple pill certainly makes it harder. Vitamin D helps some of them in, vitamin B6 helps others. Once they get in, we need to direct them to the bones. It’s no good if they calcify our arteries or our breasts. Vitamin K2 helps here. On the way to the bones, we have to make sure that they aren’t lost in our sweat or our urine. Phosphates and diuretics are our enemies here. Boron is our friend and blocks the exodus. There’s more, but these are the basics. With the basics, we can begin to help ourselves correctly, and then we can begin to build.
Here’s an analogy. You just took a snapshot of the water level in a bath tub and found it to be low. You don’t know whether the drain is open or closed, whether the faucet is turned on or off, whether the water supply even exists or if the shower head is pointed over the bathtub or over the bathroom floor. So, do you now know how to proceed? Well, you don’t. You need to know all of these things and more to fill up the bathtub. OK now, the snapshot is your DEXA scan, and your low water level is your bone density. I hope that helps.
Whether it does or not, I know what to do here. I can help you start off this journey on the right track. You are welcome to come in, bring your bone density scan and your latest complete blood work.
It may take a few visits but we’ll get all the information we need. Then you’ll have a much greater chance of improvement and cure.
Otherwise too many people see their bone densities going sideways for too many years.
