LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

improve bone density

Osteoporosis and Fractures–Are You at Risk of Breaking a Hip?

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Bone density testing is another one of those tests that seem inevitable as we age, especially for women.  You should always work to improve bone density.  For myself and my office, however, I view bone density as a powerful tool giving us the ability to look into how much your lifestyle is impacting your bone health.

We have a peripheral DXA unit and run bone density testing days in office.  I strongly promote the idea that everyone over the age of 25 should have his or her bone density checked.  Much like everything else in medicine, we normally wait to test until we are more likely to be in the crisis stage.

For me personally, I’d prefer to know if there is a problem decades earlier and make some small changes now rather than drastic changes later.

Beyond this, however, there is a much deeper discussion that I frequently have to have with patients about bone density testing.  I have had patients with very low bone density who have not had a fracture, and clearly there are those who suffer fractures despite good bone density scores.

Further complicating the issue, drugs used to treat osteoporosis like Fosamax and Actonel may raise bone density but don’t always lower the risk of fractures.  But I thought bone density = fracture risk???

The relationship is not so clear.  Actually, bone density alone only accounts for about 25% of your fracture risk.  This means that if you have a bone density test that comes back in the osteoporotic range and your doctor merely writes a prescription for Fosomax or Actonel, he or she has done a great disservice and merely scratched one aspect of fracture risk.

Hopefully, this will soon be changing.  There has been a fracture risk assessment tool developed call the FRAX tool, that is gaining ground as a much better marker of your personal risk of suffering a low impact fracture.  And guess what?  Bone density is only one small factor in this risk.  This particular article delves into the changing dynamic as it relates to predicting your risk of fractures.

So what IS included?  Here’s the list:

  • country  (because some countries have higher risks–ironically, closely associated with dairy intake…)
  • bone mineral density
  • age
  • gender
  • low body mass index
  • previous fragility fracture
  • parental history of hip fracture
  • glucocorticoid treatment
  • current smoking
  • alcohol intake (3 or more units per day)
  • rheumatoid arthritis
  • other secondary causes of osteoporosis

You can see it is a much more comprehensive list than merely checking bone density.  One thing that is not on here that I would add is your overall risk of falling.  A higher risk of falling will obviously increase your risk of suffering a fracture.  Because of this, activities like whole body vibration, yoga, tai-chi and strength training of the legs will lower your risk of a fracture because you are going to lower your risk of a fall.  Pretty simple.

None of this, however, addresses the factor of bone health in general, which I have covered in a previous blog article that can be read by clicking here.

In the meantime, this is a great opportunity to see just how fast your doctors adopt current medical research.  The FRAX tool has been around for some time now, but is clearly gaining ground in its ability to predict your risk of a fracture.  At this stage, the evidence is solid enough to make this tool almost a requirement in a conscientious, up to date on the research doctor’s office.  If your doctor is willing to order a bone density test, but ONLY recommends medications if it comes back in the osteoporotic range without any additional questions being asked, maybe it’s time to move on.

If you have had a bone density test that came back in the osteopenic range (the range that medications should ABSOLUTELY NOT be used), did your doctor recommend medications?

How to Prevent Osteoporosis and Improve Bone Density

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You’re 25. Worrying on how to prevent osteoporosis is something the seniors should be concerned about. It’s not even on your to do list to improve bone density.

Bone health is something we generally don’t begin to worry about until later in life.  And even then, generally only if you’re a post-menopausal female.  That’s when it’s time to get all those screening tests done like bone density, mammography, colonoscopy and heart stress tests.  Much like everything else in medicine today, the problem is that we generally wait to identify problems when things are already in the crisis stage.

This is likely because mainstream medicine really doesn’t have many tools to handle problems until they become sick enough for drugs or surgery.  Identifying a problem with a patient’s physiology very early on and using lifestyle and targeted supplementation to fix this problem is just not understood by mainstream medicine.

In case you’re a little confused, bone density is a perfect example.

Bone health is a dynamic event that begins in childhood and continues pretty much up until the day you die.  Certainly there are some critical periods of bone development such as the years leading up to your mid twenties.  Up until your mid-20’s, you are (or were…) trying to add as much bone mass as possible so that the long, slow, inevitable slide downward of bone loss can last as long as you need it to.

But the years beyond your twenties remain just as critical, if only because of the sheer numbers of years we have to maintain bone health.  Bad choices can lead to small changes in bone density that magnify over time.  That soda habit at 30 may suck out 5% of your bone mass in your 30’s (purely a theoretical percentage!), but this certainly would not be enough to get you labeled as osteoporotic in need of medication like Fosomax.  So why bother checking, right?

Wrong.

In this theoretical example, if we waited until were 65 to check your bone mass, we would now discover that you have lost 17.5% of your bone mass due to a single bad habit.  Now things are much more serious and will require more intense intervention.

But what if, in a perfect world, you had your bone density checked at 40 and were told that your bone density is 5% less than everyone else your age and that soda is a likely culprit?  Making that lifestyle change now will pay huge dividends by the time you’re 65.

This is one of the main reasons that our office uses in-house DEXA based bone density testing and we promote it to patients in his or her 20’s and beyond.  It never ceases to amaze me how many patients we identify that are 10% under were that should be in their 20’s, 30’s or 40’s.  But luckily, simple changes (like adding vitamin D) can drastically change the future health of these patients.

And we are not just talking about bone density here.  Beginning at least 5-10 years ago, scientists began to expand their viewpoint of the role of bone in health.  No longer is bone viewed as the anchor point for muscles and ligaments.  Rather, bone is an incredibly active tissue that plays a role in many aspects of our health such as body composition and weight and our risk of diabetes.

Yes–bone plays a critical role in your risk of diabetes.  Treat your bones poorly and they will treat you poorly.  Luckily, the lifestyle choices necessary to treat your bones good just so happens to be the same as the lifestyle choices for pretty much everything else.  My recommendations can be found by clicking here.

One aspect in particular that plays an important role in bone health is acid-base balance.  Basically, our bodies use calcium from our bones to buffer the blood from too much acid in our diets.  This is all fine and dandy for a single meal or a long buffet filled weekend in Vegas.  But when this pattern is a lifestyle, calcium is continually being leached from your bone to counteract the bad effects of your diet.

In this particular study, researchers looked at how well a potassium solution could counteract the effects of a very high salt intake (salt produces an acidic situation in the blood).  While it was a small study, the researchers were able to successfully use the protective solution to protect the bones during this short term abuse with the salt.

Based on this study, I am in no way suggesting that you can do what you choose and just take a few shots of potassium during the day.  But it does begin to show just how powerful an alkaline based diet (think plant-based) could be in protecting your bones.