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Myth to Fact — 10 minutes

Myths and facts surrounding Osteoporosis

Osteoporosis is a normal aging process.

Fact: Gradual bone mineral loss from aging begins in the mid-twenties and is a natural, inevitable process. Osteoporosis is an exaggeration of this process that occurs in a significant portion of the population. This exaggeration can be stopped or slowed down through treatment.

Only menopausal women can have osteoporosis.

Fact: Because of the fall of estrogen production during menopause, all women are at risk of developing osteoporosis. But osteoporosis will affect some pre-menopausal women as well as one in five men.

Bone fracture is the only consequence of osteoporosis.

Fact: Bone fracture is a significant consequence of osteoporosis. But some consequences of these hip fractures are even more serious, particularly hip fractures where outcomes can include arrythmia and heart attack, infection and pneumonia, and anesthesia complications. In the year after experiencing a hip fracture, risk for death increases by 33% in men and 20% in women, with this risk continuing to persist for 10 years, according to a hospital-based registry analysis published in The Journal of Clinical Endocrinology & Metabolism.

Osteoporosis isn’t all that common.

Fact: According to Osteoporosis Canada, one third of all women and one-fifth of all men will break a hip, spine, wrist, or shoulder due to osteoporosis during their lifetime.

Osteoporosis will show on a regular x-ray.

Fact: Only advanced osteoporosis will show on a regular x-ray. Osteopenia and osteoporosis can be diagnosed only by measuring bone mineral density (BMD) and dual x-ray absorption (Dexa) examination of spine and hip is the most common test.

Osteoporosis will show on my regular blood tests.

Fact: Osteoporosis, even severe, will not show on blood tests. Calcium levels remain normal and even esoteric blood tests like C-telopeptides or P1NP are not diagnostic.

Osteoporosis can be prevented with a calcium-rich diet and exercise.

Fact: A calcium-rich diet and exercise are an essential part of osteoporosis prevention but they are not enough: smoking cessation, low alcohol use, reducing corticosteroids, controlling thyroid, parathyroid, intestinal and renal disorders are also part of prevention. Genetic factors cannot be controlled and in many cases the use of bone protecting drugs like bisphosphonates is warranted.

Correction of osteoporosis will rapidly show on a control BMD measurement.

Fact: It takes a minimum of one year and in many cases two years before significant changes in bone density can be measured. However, there are blood tests (C-telopeptide, P1NP, etc.) that can be used at 3 and 6 months following the beginning of therapy to confirm drug effectiveness and/or patient compliance.

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