Low Density History

My grandmother probably never heard of osteoporosis. For most of her life the disease was rare and largely unknown.  But in 1982, right around her 90th birthday (and by then she was too old to care) the word osteoporosis was suddenly thrust into the common vocabulary. A massive public information campaign began, warning post-menopausal women by every means possible of imminent danger and disfigurement from weakened bones. The pharmaceutical companies, pushing their lucrative hormone replacement therapy (HRT), sponsored the campaign that sent a generation of fearful women scurrying to their doctors for prescriptions. No one seemed concerned about the absence of studies that proved HRT could prevent or reverse osteoporosis. Soon, though, a problem did emerge: there was no easy way to test the strength of bones in living people. So the Dual Energy X-ray Absorptiometry (DEXA) machine was developed in 1988, and finally our bones could all be compared on the basis of density.

Subsequently, the World Health Organization established a large database of DEXA readings, and in 1994 they announced international standards for osteoporosis. They also changed its definition. It went from being a disease characterized by fragility fractures to a condition marked by low bone mineral density, no fracture needed. Suddenly half of all post-menopausal women – and quite a few other people – were painted with the ominous diagnosis.

But the 1994 definition has some obvious shortcomings. It doesn’t take into account the fact that bone mineral density alone can not adequately predict the quality of our bones or their tensile strength which are most significant predictors of fractures. Also, the standards compare my bones with those of young women on a normal curve, not considering what might be normal and healthy and perfectly suitable for me. Furthermore, the DEXA machine that set the standards has some serious limitations, typically rating larger bones higher than smaller bones of the identical density. (There are more details here.) In other words, being diagnosed based solely on a DEXA score should not be nearly as scary as our doctors tell us.
Of course, fragility fractures truly are a serious problem, and I don’t want any. So I’m taking charge of all the factors that are within my control. I’m optimizing my nutrition and exercise, and minimizing the risk of falling. To reduce stress I’m turning back the clock on history, and living like my grandmother did, letting my bones do their work.
Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s