Pam, I like your approach to taking bisphosphonates and by extension, all medication, because of the serious problems which can result in varying percentages of consumers. Especially if Osteopenia is part of a normal aging process and goes no further for most. Though I am not anti-medication, and do take some drugs which I think are necessary, there are risks. I don't suffer Osteoporosis, just ran across your post.
I think some physicians may wish to err on the side of treating what may or may not develop later, but we as patients, in our own disorders, need to weigh and keep aware of problems which may develop from using a drug to prevent something else.
It's interesting to always find that medicine constantly changes in it's knowledge. There seems to rarely be a final word on a subject, and even when we think there has been, we are usually wrong.
Hi Paul, thanks for your post! I'm not one that is against meds or a strong advocate either, but we each have unique medical needs and it's hard to have a one size fits all in treatment, since it won't work. What may work for one, may not for another, so we just have to do our best and revisit our decisions in the future and keep a close eye on our bone status.
Since the bisphosphonates have a wide spectrum of side effects, it's best to determine when the time arrives to take them, if you need to. Those with very low t-scores (-3.0 and lower), previous or current fractures or are at a high risk for fracture, determined by a FRAX score, will have to decide what to do for treatment. If you should opt for one of the medications, but bisphosphonates in particular, we probably shouldn't take it longer than 5 years since this seems to be the stage where these atypical femur fractures occur.
Thanks so much for joining us and for your advocacy of osteopenia/osteoporosis, because it does not go unnoticed here. Thanks for caring about those in your life who may, some day, be faced with this.
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Hello Pam!
So...in essence...are you saying that osteopenia is some mild bone loss? At what age does this normally happen? And from what you are saying...is it good news that this diagnosis doesn't mean that you necessarily need to be alarmed and begin taking the osteoporosis medications? At which point does this condition become osteoporosis?
Sorry for all the questions...I am just very interested. You hear these terms and it is confusing as to what it really means as far as should you worry and which treatments are appropriate.
Thanks so much for writing such an in-depth and informative post!
Hi Merely Me thanks for joining us! The short answer is yes, some forms of osteopenia are normal age-related bone loss. Also, some of us may not reach peak bone mass in our teens, so we end up with this low bone density, as a result of inactivity, poor diet etc. The important thing is to determine the cause, even if you think it's the normal postmenopausal kind.
Secondary causes - which are many - can be treated, and once you've done that your scores should improve. Many medications, medical disorders and malabsorption syndromes can also cause bone loss, so again treating these is the first step. See the links in the article for secondary, medication and malabsorption syndrome causes.
Many doctors now feel that osteopenia should not be treated as osteoporosis is, but not all feel this way. Since osteopenia is not a disease, like osteoporosis, you can try to treat this with diet, exercise and supplements, but have regular DXA's to be sure it hasn't progressed to osteoporosis, which it may do in some.
The World Health Organizations definitions of t-scores are as follows:
Normal bone: Any score better than -1.0
Osteopenia: Any score between -1.0 and -2.5
Osteoporosis: Any score less than -2.5
To find out your t-score you need a DXA scan. Without the scan you won't know what category you're in.
Hope that covers most of your questions, and thanks again for joining us!