Treating Those at Risk for Being At-Risk for Pre-Osteoporosis

WomenIt sounds like classic disease  mongering.  Some experts believe that it is.  That’s the case with the diagnosis and treatment for Osteopenia or pre-Osteoporosis.

Osteoporosis is a condition in bone tissue where the Bone Mineral Density (BMD – the amount of bone tissue per cubic centimeter) is significantly reduced.   It is the result of a major imbalance in the amount of bone that is naturally re-absorbed in the body and the bone that is naturally produced.  In other words, more bone is being re-absorbed than the body is producing to replace it.   Osteoporosis is an abnormal condition and is classified as a disease.  In 1994, the World Health Organization (WHO) with the support of the major drug manufacturers defined the disease as being present in women who have a bone mineral density of 2.5 standard deviations below the peak bone mass of a healthy 20-year old.  Previously, the Osteoporosis diagnosis had only been used in elderly patients who had broken a bone.

At the same time, the group also created the definition for Osteopenia.  They decided that Osteopenia would be the condition for women who had bone mineral density of 1.0 standard deviations below a healthy 30-year old.  However unlike Osteoporosis, the conditions defined as Osteopenia are a sign of normal aging and not every woman who displays signs of Osteopenia will develop Osteoporosis, yet doctors are prescribing Osteoporosis drugs to also treat Osteopenia.  Since 2003, the sale of Osteoporosis drugs have doubled to $8.3 billion per year.   This is cause for alarm, according to some experts.

Researchers at the Iberoamerican Cochrane Center in Barcelona, Spain, published a critique of these practices in the January 2009 British Medical Journal.   In the article, the researchers argue that proponents of the treatment of women with slightly lowered bone mineral density with Osteoporosis drugs are exaggerating the benefits and understating the risks.  They found that the treatments for Osteopenia were largely ineffective yet carried with it risks for stroke and other cardiovascular complications, neurological abnormalities, gastrointestinal complications and even Osteonecrosis of the Jaw which is a severe disease of the jaw bone.  The critique highlighted conflicts of interest in the drug trials, showing that the analysts and authors of the studies were employees or consultants of the manufacturers of the Osteoporosis drugs.

Not only are drug manufacturers making  more drugs available to treat thinning bones, they are also funding the manufacturing and installation of more bone-density measuring devices and tests in doctor’s offices, clinics and even health clubs.  It’s estimated that based on the definition of Osteopenia, about half of the world’s population of post-menopausal women would be candidates for drug treatment.  At a cost of up to $1800 per year per patient for the drugs, that’s big money for the big pharmaceutical companies.  It’s no wonder that they want more and more women to have a bone density test.

Yet, even with a slightly reduced bone mineral density and the associated label of Osteopenia, experts recommend that women educate themselves on the risks before agreeing to treatment.  After all, it is your body and you have the final say as to what you do to it or have done to it.

Sources:

The British Medical Journal

Wikipedia

WHO Fracture Risk Assessment Tool

The New York Times

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About Paul Kulpinski, LMT

Paul Kulpinski is a licensed massage therapist, holistic wellness coach and co-founder of Mountain Waves Healing Arts in Flagstaff, Arizona with over 15 years experience in helping people achieve their optimum state of well being. Information contained in this blog should not be taken as medical advice. Readers are advised to validate the information presented here with other sources including your personal physician for information specific to you.
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