Osteoporosis: A Silent, Subtle, but Dangerous Disease

Bitterroot Orthopedics and Sports Medicine
A service of Marcus Daly Memorial Hospital
Timothy Woods, MD
1200 Westwood Drive
Hamilton, MT 59840
(406) 375-4868

Many readers would take exception to the description of osteoporosis as a "disease", since after all, it is often treatable with calcium and vitamin D. May is National Osteoporosis Prevention Month, so I thought it appropriate to discuss briefly some of the issues, including a recent report from the Hospital for Special Surgery (Scott Rodeo, M.D.), who determined that even exceptionally fit, NFL athletes, can have some of these problems.

Osteoporosis is a widespread metabolic bone disease characterized by decreased bone mass and poor bone quality. It leads to an increased frequency of fractures of the hip, spine, and wrist-where you and I might meet in our Emergency Room! It affects an estimated 10 million Americans, with 18 million more who are at risk, and another 34 million Americans at risk of osteopenia-its' precursor.

80 percent of people who suffer osteoporosis are female. It is however, underdiagnosed, and underreported in males. This leads to an estimated 350,000 hip fractures each year. But perhaps the greatest cost is the loss of function. 70 percent of those who suffer osteoporosis fractures do not return to their pre-injury level of function. As a result, the acute and long-term expense of these fragility fractures was estimated at $17 BILLION, back in 2005.

Primary Osteoporosis (more common in females) is the most common type. Secondary Osteoporosis (more common in males) is a disease in which an identifiable agent or disease process causes loss of bone e.g. inflammatory disorders, endocrine disorders, medication-induced osteoporosis.

Lack of Vitamin D contributes to osteoporosis. In the United States, over 40 % of elderly adults still living in their homes, are deficient in Vitamin D. More than 50 % of post-menopausal women who were being treated for osteoporosis, had low levels of Vitamin D. This is important because without adequate Vitamin D, all the calcium supplements will provide little benefit to osteoporosis patients. Vitamin D is sometimes called the "sunshine vitamin." It is produced when the skin is exposed to sunlight. Sun avoidance and the use of sunscreen may account for the low Vitamin D levels in some. Anyone living in a northern climate like Montana, where long sleeves and skin covering for 6 months or more of cold weather will also have limited sun exposure required to activate Vitamin D. It is this activation that sunlight causes which enables Vitamin D to facilitate our absorption of calcium we ingest. No doubt, dermatologists will take exception, but this isn't the level of ultra-violet exposure that causes skin cancer. Some studies have shown that 30-60 minutes is sufficient. So, get outside, exercise outdoors, get some sunshine and soak up some Vitamin D. Your bones will thank you.

This need was discovered in even highly fit athletes who performed at the NFL Combine in 2015. Dr. Rodeo wrote that more than half of the football athletes participating, had inadequate levels of Vitamin D. They were in their 20's, and 59 % were found to have inadequate levels of Vitamin D. This is shocking and suggests that Vitamin D deficiency is more wide-spread than expected, affecting young healthy athletes and not just senior citizens.

If you or someone you know has had a fragility fracture (hip, spine, and even wrist), they are likely osteoporotic. They are certainly at increased risk for another fracture. They may well have a Vitamin D deficiency that is exacerbating their osteoporosis-despite regular calcium supplements. Check with your physician, or call for an appointment at the Osteoporosis Clinic at MDMH-375- 4868.

Questions and or comments regarding this week's health column please contact, Timothy Woods, MD at Bitterroot Orthopedics and Sports Medicine - Osteoporosis Clinic, a service of Marcus Daly Memorial Hospital, 1200 Westwood Drive, Hamilton, MT 59840. Working together to build a healthier community!