Americans tend to embrace medical procedures and drugs. But ABIM Foundation suggests that some of these tests – such as having a bone density tests and then getting medications for a diagnosis of osteopenia – can have unintended consequences.
First of all, let's back up a bit and look at these screenings. Bone density tests are the way health professionals can diagnosis osteoporosis, which is a disease of the bones that causes them to weaken and break easily. This condition affects all bones in the body; however, WomensHealth.gov reports that the breaks tend to happen in the hip, wrist and spine.
Just being a woman raises your risk of developing osteoporosis as does getting older and going through menopause. Also have a small thin body that weighs less than 127 pounds is a risk factor, as is having a family history of osteoporosis. Lack of exercise can play a role in getting this condition. Additionally, disorders such as rheumatoid arthritis, type 1 diabetes, premature menopause and anorexia nervosa increase your risk of osteoporosis. Long-term use of certain medication also may increase your risk. These medications include glucocorticoids (which are used to treat arthritis, asthma and lupus), some anti-seizure medications, gonadotropin-releasing hormone (which is used to treat endometriosis), antacids with aluminum, some cancer treatments, and too much replacement thyroid hormone.
So you’d think that as you age, you should get tested often for bone density. In fact, according to Choosing Wisely, an initiative of the ABIM Foundation in partnership with Consumer Reports Health and the American Academy of Family Physicians, reports that many women are routinely screened for weak bones through the use of an imaging test called a dual-energy X-ray absorptiometry (DEXA) scan. This scan can show if a person has osteoporosis, which then can be treated.
However, the initiative noted that many people find out they have osteopenia, which involves mild bone loss. These people have a low risk of bone fracture. “But a diagnosis of osteopenia can lead to treatment with such drugs as alendronate (Fosamax and generic), ibandronate (Boniva and generic), and risendronate (Actonel, Atelvia, and generic), which pose numerous risks,” the initiative warned. These risks can include fractures of the thigh bone, pain in the throat or chest, difficulty swallowing and heartburn. Other rarer side effects can include bone pain, joint pain, eye pain, muscle pain, bone loss in the jaw or an abnormal heart rhythm. Other medications that can be prescribed for osteoporosis have risks such as blood clots, heart attacks, strokes and infection.
When should a screening for bone density be done? Choosing Wisely states most women should have their bone density measured when they reach the age of 65. However, women who are younger than 65 should talk to their physicians about having this test if they have risk factors for weak bones, such as a fracture from a minor trauma, rheumatoid arthritis, a parent who had a hip fracture, or a history of smoking, heavy drinking, or long-term use of corticosteroid drugs.