Osteoporosis (Bone Loss)

Osteoporosis is a progressive disease that causes the bones to deteriorate and eventually leads to fractures. It decreases bone mass and interrupts the bone remodeling process, causing them to become thin, porous and brittle. It affects 44 million Americans, 68% of whom are women.

In the United States today, 10 million people already have osteoporosis and 34 million more have low bone mass (weak or thin bones); these people are at increased risk for fractures and osteoporosis. Half of women and a quarter of men older than 50 years will have an osteoporosis-related bone fracture in their lifetime.

The actual breaking down and rebuilding of bone tissue is performed by two groups of cells called osteoclasts and osteoblasts. Bone remodeling occurs when small amounts of bone are broken down by cells known as osteoclasts. After the bone has been broken down and reabsorbed in the body, cells known as osteoblasts move into the area and start building new bone. Osteoporosis occurs when there is an imbalance between new bone formation and old bone resorption. The body may fail to form enough new bone, or too much old bone may be reabsorbed, or both. Bone loss in women occurs fastest in the first few years after menopause, but bone loss continues into old age.

Until recently osteoporosis was thought to be  a natural part of aging. Now we know that this is not the case. Due to a loss of bone mass and tissue, bones that were once strong may be unable to endure the stress of normal activities. Each year osteoporosis is responsible for more than 1.5 million fractures. These fractures usually occur in the spine, hip or wrist, but they may occur in other bones as well. Osteoporosis fractures can be debilitating, painful and sometimes can result in death. For example, only one-third of the people who break a hip ever return to being as active as they were before the fracture.

Dr. Roberts uses a multi-pronged approach to osteoporosis. One of her main treatments would involve testing their hormone levels through saliva, urine, or serum panels. Treating hormone imbalance is important because declining estrogen and progesterone levels cause bone density to decrease and fracture risk to rise. Estrogen especially is important for bone growth and strength because it works with osteoblast cells responsible for forming bone. If levels are low, raising them can slow bone loss and even regenerate density. Dr. Roberts also uses exercise regimens and supplements like calcium and vitamin D to address osteoporosis, or lifestyle changes like quitting smoking or limiting alchol. Working with these strategies first is important because prescription drugs like bisphosphonates, calcitonins, and parathyroid hormone derivatives come with serious side effects.