A new study has revealed that considering all osteoporotic patients as having simple osteoporosis and treating all of them alike by putting them on potent long term medication without finding out the cause of their osteoporosis may be ineffective and in many cases may be harmful.
What is it?
Secondary osteoporosis is a common but lesser known type of osteoporosis that affects men and women of any age. It is caused by certain medical conditions that result in bone loss or interfere with development of peak bone mass. Risk factors include conditions such as:
- Hypercalciuria (excessive urinary calcium excretion (often from a high salt diet)
- Hyperthyroidism where the thyroid gland makes too much thyroid hormone (overactive thyroid)
- Hyperparathyroidism where there is excessive production of parathyroid hormone (PTH) by the parathyroid gland
- Hypogonadism when the sex glands produce little or no hormones. In men, these are the testes; in women, the ovaries
- Vitamin D deficiency which leads to softening and weakening of the bones.
A team led by Dr Manju Chandran, Programme Director, Osteoporosis and Bone Metabolism Unit at Singapore General Hospital, evaluated 400 patients over two years. The study found that almost half of the patients with osteoporosis had one or more secondary contributors. Secondary osteoporosis, if not identified and treated, can lead to devastating consequences both in terms of fractures as well as from the disease that caused the osteoporosis in the first place.
They were particularly concerned over their findings in men: “In our study, the prevalence of secondary osteoporosis in men was found to be high, almost 63 per cent. Our recommendation is for all men with osteoporosis to have some basic laboratory testing to look at their levels of male hormone, urine calcium, vitamin D, thyroid function, etc.,” said Dr Chandran, who is also President, Endocrine and Metabolic Society of Singapore.
The Usual Treatment
Drugs such as Fosamax and Didronel are routinely given, though they do have serious side effects and some difficulty in their application. HRT is often suggested as a treatment/prevention for osteoporosis but this too has drawbacks and although it can prolong the life of bone by delaying the breakdown process it means you are retaining old bone for longer. Over time if bone is not renewed it becomes weaker, and what is needed is the formation of new bone. That is the role of progesterone is the hormone that does that and that it is why it is essential to have good hormone balance and sufficient progesterone levels to ensure that happens.
3 Key Factors in Preventing and Treating Osteoporosis
If you are concerned about osteoporosis because of family history or risk factors then being proactive is essential and it can be useful to ask your Doctor for a Urinary Dpd test as this will tell you whether you are breaking down bone now or whether the low bone density is a reflection of past problems. Bone is a living tissue and new bone can be built up at any age so improvement can be made.
1 Diet is important and your bones need a good supply of calcium, magnesium, boron, silica zinc, and vitamins C, D and K. There are some good bone supplements around that combine these elements but if you don’t want a supplement and need to increase your vitamin D intake – as 74.5% of the population do – then what about adding a vitamin D enriched yoghurt to your diet? Calin+ is new, but has a good pedigree and provides 100% of your daily RDA. It is just launched in major supermarkets in four flavours.
2 Exercise needs to be regular, enjoyable enough to continue with and weight bearing such as walking or dancing .
3 Hormone balance needs to be correct and it can be useful to arrange to have a Urinary Dpd test as this will tell you what your bone metabolism is doing at the present time. It will tell you whether you are breaking down bone now or whether the low bone density is a reflection of past problems. You may need some hormone supplementation with either oestrogen or progesterone, or both.
Progesterone is needed to build your bones and improve density, but if density is very low and/or you are breaking down bone faster than you are building it up you may need some oestrogen as well. Oestrogen slows bone breakdown and retains old bone but only for as long as you are taking it, as with HRT. Once you stop then the ‘protection’ that the oestrogen has provided in slowing down bone loss is immediately lost.
If you want to read more about osteoporosis then these articles will give you more information: