Ask the Expert: Dr. Joseph Lane, Orthopedic Surgeon, Answers Your Questions on Managing & Treating Osteoporosis
Q1. Why is it that despite the amount of milk we consume in our country, osteoporosis is still a widespread issue? Is it true that one can have strong bones without drinking milk? What proactive approach should a woman in her late 20′s take to prevent osteoporosis later in life?
Osteoporosis is widespread because calcium and vitamin D alone will not stop post-menopausal bone loss. A proactive approach for a woman in her 20’s can include calcium 800 mg per day, 2000 units of vitamin D3 per day, exercise and maintenance of menstrual regularity. Avoid having BMI go below 18.5. It is important to consult with your physician.
Q2. I am 65-year-old female. I don’t take drugs of any kind except for Aleve for old age pain, about 3 times a week. I had a bone density scan 2 years ago and it showed a little bone loss. I am a 6 feet tall, a little overweight, but super healthy. I really don’t even take vitamins and supplements as I can never remember to take them when I eat a meal due to no other drugs, so I am not in that habit. Should I be taking vitamins or supplements? I love yogurt (Greek) and eat it every day for lunch and a snack. I have read lately that calcium supplements can cause heart problems later on. Any info would be helpful at this point. Most of my relatives lived to 90′s and I would like to also with healthy bones.
Post-menopausal care includes calcium citrate 800-1000 mg per day in combination with diet and calcium supplements, vitamin D3 2000 units per day, exercise, reasonable weight, and periodic testing for calcium, vitamin D and bone density. If you have only mild osteopenia and no history of fractures, then vitamin D and calcium may be all you need. Consult with your physician before starting a regimen.
Q3. Are osteopenic bones a precursor to osteoporosis? Can supplements such as calcium and vitamin D bring things back to normal? If so, what would suggested dosages be?
Osteopenia in time may progress to osteoporosis. Calcium and vitamin D would mildly slow the decline but not reverse the progression. To gain bone mass, one needs to take an anti-anabolic agent such as Fosamax, Prolia or Evista. Anabolic agents such as PTH 1-34 (Forteo) today are largely reserved for rescuing the skeleton. As always, consult with your physician.
Q4. What is recommended for women, pre- or post-menopausal, that can help keep osteoporosis at bay?
Take calcium 800-1000mg per day and vitamin D3 2000 units per day, and get a bone density test. If the risks are high, consider drug intervention. A physician can help determine what is appropriate for you.
Q5. I have osteoporosis and was told to go for hip replacement surgery but can’t afford the surgery. What are some non-surgical treatments for osteoporosis?
Non-surgical treatments for osteoporosis are calcium, vitamin D, exercise and drug interventions. Consult with your physician to determine if non-surgical care is right for you.
Dr. Joseph Lane is an orthopedic surgeon and chief of the Metabolic Bone Disease Service. He specializes in malignant and benign bone tumors; metabolic bone disease; and fractures, non-unions and delayed healing.