If you’re a woman in her fifties, like me, you’ve likely heard or have concerns about your bone health, specifically your risks of bone disease like osteoporosis and osteopenia. I was diagnosed with osteopenia. It was difficult to hear given that I eat well, take my bone-building supplements and exercise six to seven days a week. I started doing a bit of research and found that the medical community’s current definition of osteopenia, or bone loss, has grown to encompass millions of women just like me who are not actually at risk but simply experiencing a natural part of the aging process.
In diagnosing osteopenia, bone density in women 50 and older is compared to that of a healthy, 30-year-old white woman. Why are we expecting an older woman’s bones to look like those of a younger woman’s? By this definition, any woman over the age of 30 would appear to have bone disease. By contrast, when a woman’s bone density is more accurately compared to others in her age group, the diagnosis improves drastically, with many more women judged to have normal or only slightly osteopenic bones.
Unlike osteoporosis, wherein the bones become more brittle, porous, and are much more susceptible to devastating breaks, osteopenia is a natural thinning of the bones that is not linked to increased risk of fracture. And until the early 1990s, osteopenia wasn’t even on anyone’s radar. However, there is evidence that drug companies have played a major role in expanding the definition of osteopenia to include millions of women who aren’t experiencing abnormal bone health for their age, and “treatment” may be doing more harm than good.
Bone Drugs: More Harm Than Help?
Osteoporosis drugs are now being prescribed to women who are experiencing minimal, natural bone loss. Bisphosphonates, such as Fosamax and Boniva, are increasingly linked to moderate to serious side effects, with only modest benefits to osteoporosis patients, and no clear evidence of effectiveness in those deemed to have osteopenia. Common side effects include GI problems with reports of injuries to the stomach and esophagus. Less common but more serious problems include atrial fibrillation; incapacitating bone, joint, and muscle pain; bone loss in the jaw (osteonecrosis); and even the potential to increase the risk of femoral fracture.
Other kinds of drugs prescribed to osteopenic patients include calcitonin and hormone replacement therapy (HRT), both of which carry their own risks. Both increase the risk of cancer with HRT also upping the risk of stroke, heart attack, and blood clots, particularly in menopausal women, among other concerns. The high-dosage calcium supplements (1,200-plus milligrams a day) recommended to women over 50 by the National Osteoporosis Foundation may also be problematic. Analyses published in the medical journals The Lancet and Heart have suggested that too much of a good thing may increase the risk of heart attack, though more research is needed.
Are Denser Bones Necessarily Stronger Bones?
A recent article also suggests that the technology used to determine osteopenia may be problematic. Author Sayer Ji explains how bone density is often confused with bone strength, though the two are not entirely one and the same. Dual-energy X-ray absorptiometry (DEXA) is only capable of showing the mineral density of bone, not its quality. Density is an excellent indicator of compressive strength (the bone’s ability to resist crushing), but not an accurate indicator of tensile strength (the bone’s ability to resist breakage when pulled or stretched).
In fact, Ji explains how higher-density bone may actually be weaker. For example, glass is a high-density material with considerable compressive strength but lacks the tensile strength to prevent its shattering when dropped. Conversely, a lower-density material like wood is still very strong and capable of bending and stretching to withstand the impact of a fall.
Healthy Bones are Active Bones
Many active women who receive an unsettling osteopenia diagnosis are frightened and may limit their favorite activities out of fear of falling. But in truth, a healthy exercise regimen and a diet rich in whole foods and the right supplements are the two most crucial factors in preserving bone health. Strength training and any weight-bearing aerobic activity increases bone strength, while yoga and Pilates help improve balance—essential to preventing falls. Other ways you can decrease your risk of injury include quitting smoking (which speeds up bone loss), limiting or eliminating alcohol (which increases instability), and eating a diet naturally rich in calcium, including almonds, wild-caught salmon, and lots of leafy greens.
Contact me to schedule an appointment to discuss YOUR very specific plan of action to help keep your bones healthy and strong. There are safe options available!
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