Patients who have already fractured may need osteoporosis medications. Adding fractures to a low BMD or T-score on DXA makes the Clinical Osteoporosis more severe and increases Fracture Risk. This is true of vertebral fractures detected on VFA, as well as clinically obvious fractures, like hip or wrist or shoulder.
Fracture Risk is the big deal. Fractures are what we want to avoid. Having suffered one fracture makes a Second Fracture 3 to 5 times as likely as the first. Bummer. Calcium, Vitamin D, Protein, Multivits and Exercise alone often cannot overcome those odds. Real bummer. Adding a medication often can avoid the Second Fracture.
We discussed other risk factors in a recent blog. Some of those also tip the balance too far for nutrition alone. Some of those, such as smoking, you can control. Others, like needing to use Corticosteroid pills or inhalers, you simply have to deal with.
My next series of blogs will address medications. We have Bisphosphonates, a Synthetic Estrogen Receptor Modifier (SERM), an OPG Analog/RANK-Ligand Antibody, and an Anabolic. What is important is how each class of medications works. Minimize your Fracture Risk with whatever it takes.
Jay Ginther, MD