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Take 3 Important Steps After a Diagnosis of Osteoporosis or Osteopenia
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sequoiahealth posted:
Moving Away from Fear
Unfortunately the most common reaction to a diagnosis of osteoporosis or osteopenia is panic, fear and a rush to take a pill. This is partly due to the strong insistence by most physicians in wanting their patients to start medications "right away." This rush to medication is accompanied by phrases such as "your spine is so bad it will break in half" or "you have the bones of an 90 year old" which make it difficult to say no.

Lifestyle is King
It is important to know that osteoporosis or osteopenia are heavily influenced by your lifestyle habits. Your exercise program, the foods you choose to eat, the supplements that you take and your stress levels all impact the health of your bones. Instead of rushing to medication, after you have been diagnosed with osteoporosis or osteopenia, (you can take medication any time along the way) I recommend considering three important steps before doing anything else:

1. Start a Personal Health Journal
Documenting and organizing your current health and fitness habits is a valuable tool not only for you but any other health or fitness professional that reviews your case. It will first help you take stock of your current lifestyle habits and then track various lifestyle changes along the way.



Journaling is an excellent way to begin stopping and reversing your bone health problems. Your bones respond favorable to safe and effective exercises, improved eating habits, better sleep patterns and stress reduction activities. Osteoporosis medications (if you decide to take them) work best with lifestyle changes so changing your lifestyle first makes more sense.

2. Determine Your Risk for Fracture
After a diagnosis of osteoporosis or osteopenia, the most important fact to know is what is my risk of sustaining a fracture. Reducing your risk of fractures is going to be your sole mission and much more important than increasing bone density. So one of the most important pieces of information to focus on is not your bone density scores but your FRAX percentages.



The FRAX Index calculates your risk of hip fracture. Bone density or BMD are the numbers your doctor gave you after your DEXA scan. BMD is only ONE risk factor of 12 that are important in determining your fracture risk. Go to http://www.shef.ac.uk/FRAX/ for more information.

3. Create a Professional Bone Health Improvement Plan
So many times I see bone health programs that consist of an odd collection of what people have read on the web or seen on television. These programs are usually missing key components and have not been reviewed by a knowledgeable professional or customized to meet individual needs. Having good bone health program goes beyond just improving bone density. Your bones respond to many different changes in your life. The foods you eat, the water you drink, your sleep patterns and exercise activities can all benefit your bone health.

I hope these 3 steps help take some of the mystery and fear out of your osteoporosis or osteopenia diagnosis.
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bonebabe responded:
Very good information. I'm glad to see you pointing out as I frequently do, that it's not just about the T-score. The goal of testing is to reduce your risk of fracture. There are many variables in this.

As for the FRAX, we use it as a guideline in our osteoporosis center. I think we should point out before people go to that website and enter the numbers that it is formulated for people with osteopenia only who are not currently on any osteo meds. If they were on hormone therapy or Evista they need to have been off for more than one year. If they were on any of the other osteo drugs, they need to have been off for greater than 2 years.

We also advise our patients to take home the information they receive and preach to their children and grandchildren the importance of building bone mass during their youth because if you don't have much to start with and begin to lose what you do have, it doesn't take long for you to be in big trouble.
 
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schoolboardlady replied to bonebabe's response:
Also, the medical community needs to look into the effect of extended breast feeding on women in perimenopause. Educated Women of my generation jumped on the breast feeding bandwagon without regard to the effects on the bones. I had my first child at 32 (breastfed 6 mos) second child at 37 (breastfed for 18 mos) and third child at 41 and breastfed for almost 36 mos. After each child, my period did not return for two years--2.5 years with my third child. Final menopause occurred only 8 years after my last child (only 5 years of menstrual cycles after third child. What does six years of lower estrogen do besides lower my risk of breast cancer. While yes, I ate well and took prenatal vitamins--I did not exercise much and held on to 40 excess pounds of pregnancy weight. Fat women don't get into bathing suits during the short Chicago summers and so on, so very little vitamin D was produced from sunlight. My situation is not unique but the osteoporosis experts ignore the effect of breast feeding and absence of menstrual cycles during that time.
 
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schoolboardlady responded:
EXCELLENT ideas and information.
I can pinpoint when I lost the most bone density.
The two years before menopause at age 48 and the following three years--which were menopause hell for me--hot flashes constantly, insomnia, bouts of extreme aerobic work outs to lose weight when I had energy, multiple job loss and the stress that went with that-- finally moving and the loss of everything else--and more cycles of insomnia and situational depression-plus breast cancer scare (lobular carcinoma in situ). It's now been five years since last cycle, at least one of us is working, sleep 90% improved, major vitamin D and calcium regimen in addition to other dietary improvements and my ostepenia/porosis in the spine has seemed to have slowed considerably. No statistical significance since 2008 baseline. Osteopenia in the hip, no significant change. Oddly, my wrist measurement is remarkably "normal".
 
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bonebabe replied to schoolboardlady's response:
Absolutely. I think that because, historically, women of childbearing age were still in the under age 35 bone building years, not much was thought of them losing bone. But now women are having children later and we know that the peak age to maximize building your bone mass is 21, instead of the 35 a generation ago. Your point is well taken and I hope will be addressed in the not so distant future.

We also know that women can lose up to 20% of their bone mass in the 5 years going into and through menopause - when they're not even aware of it! Scary.


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