If diet and exercise alone were enough to prevent or even reverse the changes wrought by osteoporosis, management would be fairly straight forward. Unfortunately, that is not the case. So what are the medical implications for those diagnosed as osteoporotic? The main dangers come with falling, but even lesser forces can result in low trauma fractures which are both debilitating for the patient and costly for the health system. There are several different families of medications that can help with osteoporosis. Some work by slowing the destructive reabsorbption of bone; some help promote new bone development, some produce an additional strengthening scaffolding around the existing bone. The sometimes difficult question for the physician in charge is who should get what medications. The medications are relatively expensive and are reckoned about 50% effective in preventing fractures. If you have osteoporosis (T score of -2.5 or lower) -read here for more details- http://www.west4thphysio.com/osteoporosis/osteoporosis/ and if you have already had an osteoporotic fracture then according to the experts you should be treated as the benefits easily outweigh the risks.
If however you come in with a T score between -1 and -2.5 then you are classified as osteopenic. Your bones might not have the strength they had at age 25 but they may not ever deteriorate to full osteoporosis. Should you be treated with medication? To help physicians make the decision the World Health Organisation (WHO) has come up with a formula (the FRAX calculator) to measure and grade variables like age, gender, medical history, lifestyle and others, to calculate the likelihood of an osteoporotic fracture occuring within the next 10 years. This FRAX calculator does capture many of the major variables and, when used properly, can help the physician with wise decision making but it has been criticized for leaving out some important factors such as how much weight bearing exercise a person does and how friendly their diet is towards building bone – http://www.west4thphysio.com/osteoporosis/oteoporosis-diet/ Regular weight bearing exercise such as resistance training, hiking, dancing or walking can help protect the hips and spine http://www.west4thphysio.com/osteoporosis/osteoporosis-and-exercise/. And for once, being a little heavier is considered a good thing. Extra body weight will put more stress on the bones, stimulating them to become stronger. In addition, body fat will produce estrogen which also helps develop bone strength. Indeed, estrogen therapy is sometimes considered as part of overall osteoporosis management. The decision to use medication is not always an easy one and will be made in careful consultation with your family physician, but exercise and diet will always matter.