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
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
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