{"id":117191,"date":"2024-10-22T21:18:54","date_gmt":"2024-10-22T14:18:54","guid":{"rendered":"https:\/\/hotvideos24.online\/?p=117191"},"modified":"2024-10-22T21:18:54","modified_gmt":"2024-10-22T14:18:54","slug":"at-58-i-have-the-spine-of-an-80-year-old-navigating-osteoporosis-has-been-difficult-and-expensive-well-actually","status":"publish","type":"post","link":"https:\/\/hotvideos24.online\/?p=117191","title":{"rendered":"At 58, I have the spine of an 80-year-old. Navigating osteoporosis has been difficult and expensive | Well actually"},"content":{"rendered":"<p> <script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-3711241968723425\"\r\n     crossorigin=\"anonymous\"><\/script>\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-format=\"fluid\"\r\n     data-ad-layout-key=\"-fb+5w+4e-db+86\"\r\n     data-ad-client=\"ca-pub-3711241968723425\"\r\n     data-ad-slot=\"7910942971\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script><br \/>\n<\/p>\n<div>\n<p class=\"dcr-11uwh1i\">On 16 June 2023, I got my first DEXA scan. I was 57. Three hours later, a rogue driver plowed his car into mine and shattered my wrist in three places.<\/p>\n<p class=\"dcr-11uwh1i\">Fifty-seven is relatively young for a DEXA \u2013 or dual-energy x-ray absorptiometry \u2013 scan, which measures bone density, or the amount of calcium and minerals in your bones. The CDC <a href=\"https:\/\/www.cdc.gov\/radiation-health\/data-research\/facts-stats\/dexa-scan.html#:~:text=Your%20healthcare%20provider%20may%20recommend,who%20has%20broken%20a%20hip.\" data-link-name=\"in body link\">recommends<\/a> them for women 65 and over, but while interviewing <a href=\"https:\/\/deborahcopaken.substack.com\/p\/the-menopause-disruptor\" data-link-name=\"in body link\">Joanna Strober<\/a>, CEO of <a href=\"https:\/\/www.joinmidi.com\/\" data-link-name=\"in body link\">Midi Health<\/a>, a virtual care clinic for those in perimenopause and menopause, she had urged me to get one sooner. Strober had become alarmed by how many of their fiftysomething patients were finding that they had the bones of an octogenarian.<\/p>\n<p class=\"dcr-11uwh1i\">The results of my DEXA scan arrived in my inbox a week after my car crash: I had full-blown osteoporosis.<\/p>\n<p class=\"dcr-11uwh1i\">I was still recovering from multiple injuries, so the diagnosis took a back seat. I was also under the impression \u2013 because of my age, ignorance and the invisible, pain-free pathogenesis of osteoporosis \u2013 that loss of bone mass was less of an immediate threat to my health and wellbeing than my visible injuries. But, in fact, my osteoporosis had made me more susceptible to that broken wrist. Without intervention, osteoporotic bones simply deteriorate and grow increasingly more brittle with age. They also take longer to heal from fractures.<\/p>\n<p class=\"dcr-11uwh1i\">I can attest to that: fifteen months later, it still hurts to hold a pitcher of water.<\/p>\n<figure id=\"07fe093a-7bbe-4b8f-80cc-3dae627726ce\" data-spacefinder-role=\"richLink\" data-spacefinder-type=\"model.dotcomrendering.pageElements.RichLinkBlockElement\" class=\" dcr-1your1i\"><gu-island name=\"RichLinkComponent\" priority=\"feature\" deferuntil=\"idle\" props=\"{&quot;richLinkIndex&quot;:5,&quot;element&quot;:{&quot;_type&quot;:&quot;model.dotcomrendering.pageElements.RichLinkBlockElement&quot;,&quot;prefix&quot;:&quot;Related: &quot;,&quot;text&quot;:&quot;Why do I feel a wave of sadness before breastfeeding?&quot;,&quot;elementId&quot;:&quot;07fe093a-7bbe-4b8f-80cc-3dae627726ce&quot;,&quot;role&quot;:&quot;richLink&quot;,&quot;url&quot;:&quot;https:\/\/www.theguardian.com\/wellness\/2024\/oct\/18\/what-is-dmer-breastfeeding&quot;},&quot;ajaxUrl&quot;:&quot;https:\/\/api.nextgen.guardianapps.co.uk&quot;,&quot;format&quot;:{&quot;design&quot;:10,&quot;display&quot;:2,&quot;theme&quot;:4}}\"\/><\/figure>\n<p class=\"dcr-11uwh1i\">Osteoporosis comes from <em>osteo<\/em> (from <em>ost\u00e9on<\/em>, Greek for bone) and <em>poros<\/em> (Greek for pore or passage). It describes just that: a hollowing out and reduction of bone mass such that the tiny holes that naturally occur in our bones widen into a gaping, irregular lattice. Osteoporosis occurs predominantly in <a href=\"https:\/\/www.hopkinsarthritis.org\/arthritis-info\/osteoporosis-info\/#:~:text=Using%20the%20WHO%20definition%20of,or%20greater(ref%203).\" data-link-name=\"in body link\">postmenopausal women<\/a>. A woman in her 50s has a <a href=\"https:\/\/www.hopkinsarthritis.org\/arthritis-info\/osteoporosis-info\/\" data-link-name=\"in body link\">14% chance<\/a> of having it. By age 80, she has a 70% chance.<\/p>\n<p class=\"dcr-11uwh1i\">It begins when the creation of new bone can no longer keep up with the loss of old bone. These hollowed-out bones are far more prone to breakage, particularly in the hip, spine, and, yes, wrist. The survival rate for women, following a hip fracture, is <a href=\"https:\/\/academic.oup.com\/jbmrplus\/article\/8\/5\/ziae022\/7612067\" data-link-name=\"in body link\">worse than most cancers<\/a>: half will be dead in five years. Yes, men get osteoporosis, too, but the percentages are much lower. A <a href=\"https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db405.htm#:~:text=Crude%20estimates%20are%2012.0%25%20for,%2C%20and%20both%20is%202.0%25.\" data-link-name=\"in body link\">crude estimate<\/a> for men over 50 is 4.2%, and authorities <a href=\"https:\/\/www.uspreventiveservicestaskforce.org\/uspstf\/recommendation\/osteoporosis-screening\" data-link-name=\"in body link\">don\u2019t recommend<\/a> routine bone density testing, either for men or for women my age.<\/p>\n<p class=\"dcr-11uwh1i\">But if I\u2019ve learned anything over the course of my work reporting on women\u2019s health, it\u2019s that most of what we\u2019ve been told often turns out to be wrong, and none of it has been sufficiently studied, if at all. Unsurprisingly, trying to figure out how to treat my osteoporosis has only confirmed this.<\/p>\n<hr class=\"dcr-z9ge1j\"\/>\n<p class=\"dcr-11uwh1i\"><span style=\"color:var(--drop-cap);font-weight:700;\" class=\"dcr-15rw6c2\">I<\/span> had several risk factors for osteoporosis: small body frame (5ft 2in, thin), family history (including a great aunt who died from a broken hip), ethnicity (white; Asians are also more prone) and a prior history of fractures. So my primary care provider had agreed it couldn\u2019t hurt to get a DEXA scan at 57 as a baseline. At my annual physical, my vitamin D levels were below normal \u2013 another red flag. My gynecologist also thought it a good idea and ordered the scan, which took three months to schedule.<\/p>\n<p class=\"dcr-11uwh1i\">The resulting diagnosis of full-blown osteoporosis shocked me. I\u2019m an active woman in good shape for my age. I don\u2019t smoke or drink. I eat a balanced diet. I do yoga twice weekly, ride my bike and walk 10,000 steps every day. Yet my DEXA results were similar to those of an 80-year-old woman.<\/p>\n<figure id=\"01828203-1dc5-419e-b411-ad3348f4d0da\" data-spacefinder-role=\"inline\" data-spacefinder-type=\"model.dotcomrendering.pageElements.ImageBlockElement\" class=\" dcr-173mewl\"><figcaption data-spacefinder-role=\"inline\" class=\"dcr-1fujct4\"><span class=\"dcr-1inf02i\"><svg width=\"18\" height=\"13\" viewbox=\"0 0 18 13\"><path d=\"M18 3.5v8l-1.5 1.5h-15l-1.5-1.5v-8l1.5-1.5h3.5l2-2h4l2 2h3.5l1.5 1.5zm-9 7.5c1.9 0 3.5-1.6 3.5-3.5s-1.6-3.5-3.5-3.5-3.5 1.6-3.5 3.5 1.6 3.5 3.5 3.5z\"\/><\/svg><\/span><span class=\"dcr-1qvd3m6\">The author a few weeks after the car accident that broke her wrist.<\/span> Photograph: Townsend Davis Caption<\/figcaption><\/figure>\n<p class=\"dcr-11uwh1i\">DEXA scan results include T-score numbers, which indicate how many standard deviation units below the mean the subject\u2019s bones have deteriorated in three key places for breakage: lumbar spine, femoral neck and hip. The mean is 0, for a healthy young person with strong bones. Any score between -1 and 0 is considered healthy. Scores from -1 to -2.5 point to osteopenia, which is less a clinical diagnosis and more an indication that bone mass loss has begun. Any score below -2.5 indicates osteoporosis.<\/p>\n<p class=\"dcr-11uwh1i\">My hip T-score was -2, but my lumbar spine T-score was -3.2; my left femoral neck was -2.7. \u201cThe patient has Osteoporosis lumbar spine, left femoral neck,\u201d the radiologist wrote in my report. \u201cPatient fracture risk is elevated.\u201d<\/p>\n<p class=\"dcr-11uwh1i\">After recovering from the crash, I set out in search of answers. But even I, a woman who writes about women\u2019s health, had no idea which specialist to contact. An orthopedist? A rheumatologist? An endocrinologist? A gerontologist? Some combination of all four?<\/p>\n<p class=\"dcr-11uwh1i\">The consensus among friends, family and Google was to seek out an endocrinologist. Endocrinologists treat diseases of hormonal imbalance. Osteoporosis, I was surprised to learn, is a hormone-related disease \u2013 a drop in estrogen or an overactive thyroid, parathyroid or adrenal gland can all weaken bones.<\/p>\n<p><gu-island name=\"InteractiveBlockComponent\" priority=\"critical\" deferuntil=\"idle\" props=\"{&quot;url&quot;:&quot;https:\/\/interactive.guim.co.uk\/uploader\/embed\/2023\/10\/archive-zip\/giv-13425WMrLo2pc9VIk\/&quot;,&quot;scriptUrl&quot;:&quot;https:\/\/interactive.guim.co.uk\/embed\/iframe-wrapper\/0.1\/boot.js&quot;,&quot;alt&quot;:&quot;Graphic with three lines of text that say, in bold, \u2018Well Actually\u2019, then \u2018Read more on living a good life in a complex world,\u2019 then a pinkish-lavender pill-shaped button with white letters that say \u2018More from this section\u2019\u00a0&quot;,&quot;format&quot;:{&quot;design&quot;:10,&quot;display&quot;:2,&quot;theme&quot;:4},&quot;elementId&quot;:&quot;ad8f0dfb-077f-48e9-86b9-18737165d9ec&quot;,&quot;isMainMedia&quot;:false}\"><\/p>\n<figure id=\"ad8f0dfb-077f-48e9-86b9-18737165d9ec\" data-alt=\"Graphic with three lines of text that say, in bold, \u2018Well Actually\u2019, then \u2018Read more on living a good life in a complex world,\u2019 then a pinkish-lavender pill-shaped button with white letters that say \u2018More from this section\u2019\u00a0\" data-testid=\"interactive-element-Graphic%20with%20three%20lines%20of%20text%20that%20say,%20in%20bold,%20%E2%80%98Well%20Actually%E2%80%99,%20then%20%E2%80%98Read%20more%20on%20living%20a%20good%20life%20in%20a%20complex%20world,%E2%80%99%20then%20a%20pinkish-lavender%20pill-shaped%20button%20with%20white%20letters%20that%20say%20%E2%80%98More%20from%20this%20section%E2%80%99%C2%A0\" data-spacefinder-role=\"inline\" class=\"element element-interactive element--inline element-inline dcr-1edkzp\"><a data-name=\"placeholder\" href=\"https:\/\/interactive.guim.co.uk\/uploader\/embed\/2023\/10\/archive-zip\/giv-13425WMrLo2pc9VIk\/\" class=\"dcr-1eupayo\">Graphic with three lines of text that say, in bold, \u2018Well Actually\u2019, then \u2018Read more on living a good life in a complex world,\u2019 then a pinkish-lavender pill-shaped button with white letters that say \u2018More from this section\u2019\u00a0<\/a><\/figure>\n<p><\/gu-island><\/p>\n<p class=\"dcr-11uwh1i\">But the sole endocrinologist in network for my insurance who was taking new patients did not have an appointment for another six months.<\/p>\n<p class=\"dcr-11uwh1i\">While I waited, I scheduled a Zoom with <a href=\"https:\/\/deborahcopaken.substack.com\/p\/osteoporosis-is-the-silent-killer?utm_source=publication-search\" data-link-name=\"in body link\">Dr Mary O\u2019Connor<\/a>, an orthopedic surgeon I\u2019d previously interviewed for the launch of her book, <a href=\"https:\/\/amzn.to\/3zoFNi4\" data-link-name=\"in body link\">Taking Care of You: The Empowered Woman\u2019s Guide to Better Health<\/a>. At her urging, I added a daily 2000 IU Vitamin D3 supplement and upped my intake of calcium-rich foods. \u201cIf you don\u2019t have adequate vitamin D3,\u201d she explained, \u201cyou cannot absorb the calcium that you eat.\u201d She also suggested lifting weights, so I bought some dumbbells and found a 30-minute online workout I <a href=\"https:\/\/youtu.be\/-vGcK_1glIk?si=qsw2F7ZP8AK-ovEA\" data-link-name=\"in body link\">actually liked<\/a>.<\/p>\n<p class=\"dcr-11uwh1i\">While researching specialists, I noticed that many rheumatologists included osteoporosis as an area of expertise. They mostly treat connective tissue disorders, but I figured they could at least do the bloodwork I needed.<\/p>\n<p class=\"dcr-11uwh1i\">Dr Lauren Wong, a rheumatologist from NYU Langone, one of those rare physicians who treats you as an equal, ordered a ton of that bloodwork. At my follow-up, she had some answers. \u201cYou have hyperparathyroidism,\u201d she told me: my PTH, or parathyroid hormone, levels had come back unnaturally high. Parathyroid hormone, she explained, regulates our calcium levels, and too much parathyroid hormone can contribute to osteoporosis by triggering the <a href=\"https:\/\/theros.org.uk\/information-and-support\/osteoporosis\/causes\/hyperparathyroidism\/#:~:text=If%20the%20parathyroid%20glands%20are,breakdown%20and%20renewal%20of%20bone).\" data-link-name=\"in body link\">release of calcium<\/a> from bone stores. Wong agreed I needed to see an endocrinologist and possibly a parathyroid surgeon after that.<\/p>\n<p class=\"dcr-11uwh1i\">\u201cHyperpara \u2026 what?\u201d I\u2019d never heard of this hard-to-pronounce disease.<\/p>\n<p class=\"dcr-11uwh1i\">My endocrinology appointment was still several months away \u2013 god bless America \u2013 so I sought the advice of <a href=\"https:\/\/deborahcopaken.substack.com\/p\/an-ounce-of-prevention-part-i\" data-link-name=\"in body link\">Dr Babak Larian<\/a>, a parathyroid surgeon in LA with an excellent <a href=\"https:\/\/www.youtube.com\/@LarianMD\" data-link-name=\"in body link\">YouTube channel<\/a> about hyperparathyroidism. Over Zoom, Larian told me he thinks it\u2019s absolutely ridiculous that women in this country are advised to get DEXA scans at 65, given that menopause begins in our late 40s or early 50s. \u201cI think 50 should be the standard,\u201d he said.<\/p>\n<figure id=\"b598b629-4498-4a5b-92de-6f49e13062e9\" data-spacefinder-role=\"richLink\" data-spacefinder-type=\"model.dotcomrendering.pageElements.RichLinkBlockElement\" class=\" dcr-1your1i\"><gu-island name=\"RichLinkComponent\" priority=\"feature\" deferuntil=\"idle\" props=\"{&quot;richLinkIndex&quot;:24,&quot;element&quot;:{&quot;_type&quot;:&quot;model.dotcomrendering.pageElements.RichLinkBlockElement&quot;,&quot;prefix&quot;:&quot;Related: &quot;,&quot;text&quot;:&quot;First my left knee, then my right: my middle-aged body\u2019s betrayal&quot;,&quot;elementId&quot;:&quot;b598b629-4498-4a5b-92de-6f49e13062e9&quot;,&quot;role&quot;:&quot;richLink&quot;,&quot;url&quot;:&quot;https:\/\/www.theguardian.com\/wellness\/article\/2024\/jul\/08\/middle-age-knees-injury&quot;},&quot;ajaxUrl&quot;:&quot;https:\/\/api.nextgen.guardianapps.co.uk&quot;,&quot;format&quot;:{&quot;design&quot;:10,&quot;display&quot;:2,&quot;theme&quot;:4}}\"\/><\/figure>\n<p class=\"dcr-11uwh1i\">Larian also explained that we have extremely poor statistics on the prevalence of hyperparathyroidism in the US. \u201cWe\u2019re so far off the mark,\u201d he said, \u201cthat I don\u2019t even know where to start the conversation.\u201d Furthermore, \u201cbecause this is a disease mainly of women, they are [often] not diagnosed\u201d.<\/p>\n<p class=\"dcr-11uwh1i\">The <a href=\"https:\/\/www.endocrine.org\/patient-engagement\/endocrine-library\/primary-hyperparathyroidism\" data-link-name=\"in body link\">Endocrine Society<\/a> states that the incidence of primary hyperparathyroidism in the US is somewhere between 0.1% and 0.7%; women and African Americans are more prone to it. However, a recent <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/25059283\/\" data-link-name=\"in body link\">retroactive survey in Canada<\/a> found that 5% of Canada\u2019s population have some form of hyperparathyroidism. Larian believes hyperparathyroidism can be triggered by menopause, and thus that more than 5% of menopausal women have it. But they are completely unaware of this because its symptoms \u2013 such as fatigue, muscle weakness, depression, memory problems \u2013 mimic those of menopause, and primary care doctors don\u2019t routinely check women\u2019s blood for high levels of PTH.<\/p>\n<p class=\"dcr-11uwh1i\">I redoubled my efforts to find an endocrinologist who could see me sooner and once again failed. But then I came down with another UTI \u2013 an annoyingly common event, thanks to genitourinary syndrome of <a href=\"https:\/\/www.theguardian.com\/society\/2023\/dec\/17\/millions-of-women-are-suffering-who-dont-have-to-why-its-time-to-end-the-misery-of-utis\" data-link-name=\"in body link\">menopause<\/a>, though I have far fewer now thanks to <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8058921\/\" data-link-name=\"in body link\">vaginal estrogen<\/a> \u2013 and my urologist just happened to know a young endocrinologist who was taking on new patients. A breakthrough!<\/p>\n<p class=\"dcr-11uwh1i\">The endocrinologist confirmed my hyperparathyroidism diagnosis. So she ordered more scans and tests and asked me to seek out a parathyroid surgeon or two to see if I had an adenoma \u2013 a non-cancerous growth on the parathyroid gland and the hallmark of primary hyperparathyroidism \u2013 which would then need to be removed.<\/p>\n<p class=\"dcr-11uwh1i\">I consulted with two surgeons, neither of whom found an adenoma on a scan, so I didn\u2019t need surgery. Instead, they concluded that I had secondary hyperparathyroidism, brought on by a lack of vitamin D.<\/p>\n<p class=\"dcr-11uwh1i\">Getting to the bottom of my osteoporosis was quickly becoming a full-time job. Never mind all the visits themselves \u2013 even finding the right doctors, who were in-network, could take hours upon hours of research. At this point, I\u2019d either seen in person or interviewed 10 doctors in total.<\/p>\n<figure data-spacefinder-role=\"inline\" data-spacefinder-type=\"model.dotcomrendering.pageElements.NewsletterSignupBlockElement\" class=\" dcr-173mewl\"><a data-ignore=\"global-link-styling\" href=\"#EmailSignup-skip-link-31\" class=\"dcr-jzxpee\">skip past newsletter promotion<\/a><\/p>\n<aside aria-label=\"newsletter promotion\" class=\"dcr-av5vqf\">\n<p class=\"dcr-1xjndtj\">Practical advice, expert insights and answers to your questions about how to live a good life<\/p>\n<p><gu-island name=\"SecureSignup\" priority=\"feature\" deferuntil=\"visible\" props=\"{&quot;newsletterId&quot;:&quot;well-actually&quot;,&quot;successDescription&quot;:&quot;Practical advice, expert insights and answers to your questions about how to live a good life&quot;}\"\/><span class=\"dcr-1eusqlu\"><strong>Privacy Notice: <\/strong>Newsletters may contain info about charities, online ads, and content funded by outside parties. For more information see our <a data-ignore=\"global-link-styling\" href=\"https:\/\/www.theguardian.com\/help\/privacy-policy\" rel=\"noreferrer\" class=\"dcr-1rjy2q9\">Privacy Policy<\/a>. We use Google reCaptcha to protect our website and the Google <a data-ignore=\"global-link-styling\" href=\"https:\/\/policies.google.com\/privacy\" rel=\"noreferrer\" class=\"dcr-1rjy2q9\">Privacy Policy<\/a> and <a data-ignore=\"global-link-styling\" href=\"https:\/\/policies.google.com\/terms\" rel=\"noreferrer\" class=\"dcr-1rjy2q9\">Terms of Service<\/a> apply.<\/span><\/aside>\n<p id=\"EmailSignup-skip-link-31\" tabindex=\"0\" aria-label=\"after newsletter promotion\" role=\"note\" class=\"dcr-jzxpee\">after newsletter promotion<\/p>\n<\/figure>\n<hr class=\"dcr-z9ge1j\"\/>\n<p class=\"dcr-11uwh1i\">OK, great, I thought. I know <em>why<\/em> I have osteoporosis at 57. Now what do I do about it?<\/p>\n<p class=\"dcr-11uwh1i\">Luckily, I was already on track. In 2022, I\u2019d started taking estrogen, which the <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC10009319\/\" data-link-name=\"in body link\">British Menopause Society<\/a> calls \u201cthe treatment of choice for osteoporosis prevention\u201d. The North American Menopause Society\u2019s recent <a href=\"https:\/\/menopause.org\/wp-content\/uploads\/professional\/nams-2022-hormone-therapy-position-statement.pdf\" data-link-name=\"in body link\">2022 position paper<\/a> on hormone therapy also states that estrogen prevents bone loss and reduces fracture risk.<\/p>\n<p class=\"dcr-11uwh1i\">In an ideal world, I\u2019d have been prescribed estrogen the minute I had my uterus removed in 2012 for another medical issue. But back then, HRT was not the standard of care for any woman, with or without a uterus, as it was still being <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37847875\/\" data-link-name=\"in body link\">falsely demonized<\/a> as causing breast cancer. Could the 10-year gap between my hysterectomy and commencement of hormone therapy have contributed to my osteoporosis? According to a number of doctors I consulted, quite possibly, yes.<\/p>\n<p class=\"dcr-11uwh1i\">Meanwhile, the pharmaceutical industry offers no shortage of drugs for people with osteoporosis \u2013 as doctors, friends and relatives readily reminded me \u2013 but the deeper I dug into each one, the less I was sure I wanted any of them. Bisphosphonates like Fosomax, often the <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2667901\/\" data-link-name=\"in body link\">first drug of choice<\/a> following an osteoporosis diagnosis, inhibit bone resorption and increase bone mass density. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC10009319\/pdf\/10.1177_20533691221139902.pdf\" data-link-name=\"in body link\">But there isn\u2019t much data<\/a> on <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC10009319\/pdf\/10.1177_20533691221139902.pdf\" data-link-name=\"in body link\">long-term use in younger patients like me<\/a>. Plus, in rare instances, they have been shown to <a href=\"https:\/\/my.clevelandclinic.org\/health\/treatments\/24753-bisphosphonates\" data-link-name=\"in body link\">cause<\/a> osteonecrosis of the jaw (ONJ) and atypical femur fractures \u2013 exactly the injury I was trying to avoid.<\/p>\n<p class=\"dcr-11uwh1i\">Prolia injections target a specific molecule that bone-removing cells need in order to work, but they also make one more susceptible to infections. With my recurring UTIs and concomitant antibiotic resistance, this, too, was a no go. Also, once you start with Prolia, you have to keep taking it twice a year, and the <a href=\"https:\/\/www.medicalnewstoday.com\/articles\/drugs-prolia-cost#next-steps\" data-link-name=\"in body link\">cost<\/a>, depending on one\u2019s insurance and eligibility for <a href=\"https:\/\/www.evenityproliahcp.com\/access-and-support\/prolia-copay-program\" data-link-name=\"in body link\">coupons<\/a>, can be prohibitive. Forteo, an anabolic that is a synthetic form of parathyroid hormone, stimulates the formation of new bone and also boosts bone mineral density, but is contraindicated for people with hypercalcemic disorders such as hyperparathyroidism. Moreover, one of its side effects is dizziness, and I\u2019m a lifelong fainter with low blood pressure and <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/orthostatic-hypotension\/symptoms-causes\/syc-20352548\" data-link-name=\"in body link\">orthostatic hypotension<\/a> \u2013 so probably not a great idea if I wanted to avoid falling and breaking more bones.<\/p>\n<p class=\"dcr-11uwh1i\">I told my endocrinologist I needed to think about all of this. In the meantime, I asked her to check my PTH levels again. Lo and behold, Dr O\u2019Connor\u2019s vitamin D3 regimen had worked! My PTH levels are now in the normal range, and my hyperparathyroidism is gone.<\/p>\n<figure id=\"4d859ae5-bec5-4a35-8746-46eec2e0391f\" data-spacefinder-role=\"richLink\" data-spacefinder-type=\"model.dotcomrendering.pageElements.RichLinkBlockElement\" class=\" dcr-1your1i\"><gu-island name=\"RichLinkComponent\" priority=\"feature\" deferuntil=\"idle\" props=\"{&quot;richLinkIndex&quot;:39,&quot;element&quot;:{&quot;_type&quot;:&quot;model.dotcomrendering.pageElements.RichLinkBlockElement&quot;,&quot;prefix&quot;:&quot;Related: &quot;,&quot;text&quot;:&quot;Three things to know about your brain in menopause \u2013 and how to navigate the changes&quot;,&quot;elementId&quot;:&quot;4d859ae5-bec5-4a35-8746-46eec2e0391f&quot;,&quot;role&quot;:&quot;richLink&quot;,&quot;url&quot;:&quot;https:\/\/www.theguardian.com\/wellness\/2024\/mar\/01\/how-menopause-changes-brain-body&quot;},&quot;ajaxUrl&quot;:&quot;https:\/\/api.nextgen.guardianapps.co.uk&quot;,&quot;format&quot;:{&quot;design&quot;:10,&quot;display&quot;:2,&quot;theme&quot;:4}}\"\/><\/figure>\n<p class=\"dcr-11uwh1i\">What effect did this have on my skeleton? My endocrinologist thought it would be worthwhile to repeat the DEXA scan at the same office where I got the first one. Alas, their next appointment isn\u2019t until four months from now \u2013 a full 18 months after my first scan. In New York City, getting the healthcare I need should be easy. It is not.<\/p>\n<p class=\"dcr-11uwh1i\">\u201cWhat if I don\u2019t take anything?\u201d I said to my endocrinologist. \u201cWhat are my risks if I continue lifting weights to build strength and muscle, taking vitamin D and estrogen, eating calcium rich foods and exercising daily?\u201d<\/p>\n<p class=\"dcr-11uwh1i\">Whether to take drugs, she said, was ultimately my choice, but my osteoporosis was serious. \u201cEven a sneeze,\u201d she said, \u201ccan break your spine.\u201d<\/p>\n<p class=\"dcr-11uwh1i\">Great, I thought. I\u2019ll try to avoid sneezing.<\/p>\n<p class=\"dcr-11uwh1i\">Utterly confused, I spoke with oncologist Dr Avrum Bluming, co-author of <a href=\"https:\/\/amzn.to\/4et7sNA\" data-link-name=\"in body link\">Estrogen Matters<\/a>. He calls osteoporosis a disease of decreased bone resilience: the ability of bone to stretch without breaking. Drugs like Fosomax and Prolia treat bone density, he said, but not bone resilience.<\/p>\n<p class=\"dcr-11uwh1i\">Here, again, estrogen was key. \u201cBone mineral density is not a great test for osteoporosis, which is a lack of bone <em>elasticity<\/em>,\u201d he said. Bone mineral density \u201cdoes not correlate very well with risk of fracture. What we do know is estrogen does prolong the ability of bone collagen fibers to remain flexible or elastic, and it decreases the risk of serious fracture, especially hip fracture, by up to 50%.\u201d<\/p>\n<p class=\"dcr-11uwh1i\">I still wasn\u2019t sure what to do about treatment or where to turn to find out. Should I try to find a different endocrinologist? I called my daughter, who\u2019s in her fourth year of med school, but she had no new insights from her studies.<\/p>\n<p class=\"dcr-11uwh1i\">Then, this summer, I read a revelatory <a href=\"https:\/\/www.nature.com\/articles\/s41586-024-07634-3\" data-link-name=\"in body link\">new study in Nature<\/a> co-authored by Dr Muriel Babey, an endocrinologist and researcher at UCSF. Its headline immediately caught my eye: \u201cA maternal brain hormone that builds bone.\u201d In the study, Babey and her colleagues finally answer the question that has been puzzling endocrinologists for over a century: how do the bones of breastfeeding women stay strong and resilient when they are losing so much calcium to milk production? In theory, a lactating mother should have severely osteoporotic bones. (In rare instances, called <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC10404404\/\" data-link-name=\"in body link\">pregnancy and lactation-associated osteoporosis<\/a> (PLO), they do.)<\/p>\n<p class=\"dcr-11uwh1i\">The answer lies in a newly discovered hormone: CCN3, the so-called Maternal Brain Hormone, which the researchers found almost by accident by studying the hormones of female mice, a rare occurrence as male mice are the norm for most animal studies.<\/p>\n<p class=\"dcr-11uwh1i\">When Babey\u2019s team gave CCN3 to female mice who were very old or lacking in estrogen, it doubled the mice\u2019s bone mass and, critically, their bones were more resilient and broke less easily. CCN3 has not yet been tested in humans, but if it works on women the way it works in female mice, Maternal Brain Hormone could be <em>the<\/em> missing magic bullet in terms of osteoporosis treatment.<\/p>\n<p class=\"dcr-11uwh1i\">I contacted Babey to ask if and when the hormone might come to market. \u201cFor pharmaceutical application,\u201d she said, \u201cthe timeline is usually around five to 10 years\u201d. Too late for me, alas, but it does give me hope that my daughter might have better options if she is diagnosed.<\/p>\n<p class=\"dcr-11uwh1i\">I gave Babey a brief history of my osteoporosis journey and the various treatments I\u2019d considered. \u201cWhat if I do nothing?\u201d I said.<\/p>\n<p class=\"dcr-11uwh1i\">\u201cI would definitely get another baseline first before even deciding if anabolic treatment will be necessary,\u201d she said. She also suggested I get a mini-trampoline to build balance and strength, and to try <a href=\"https:\/\/www.theliftedmethod.com\/bootcamp\" data-link-name=\"in body link\">exercise programs<\/a> designed for <a href=\"https:\/\/www.youtube.com\/@margaretmartinpt\" data-link-name=\"in body link\">people with osteoporosis<\/a>. There is extremely limited data, she stressed, on the benefits of so-called rebound exercise, but one <a href=\"https:\/\/link.springer.com\/article\/10.1007\/s40279-014-0220-8\" data-link-name=\"in body link\">study<\/a> did show an increase in bone mass in premenopausal women.<\/p>\n<p class=\"dcr-11uwh1i\">Reader, I bought a mini-trampoline. It can\u2019t hurt.<\/p>\n<p class=\"dcr-11uwh1i\">Meanwhile, I\u2019m still taking estrogen and incessantly calling my radiologist\u2019s office to get an earlier appointment. Until then, I will hold off on drugs, and I will try not to sneeze or get in any more car accidents.<\/p>\n<p class=\"dcr-11uwh1i\">\u201cJust don\u2019t fall!\u201d an older friend recently advised me with a shrug and a smile, when I asked how she manages her osteoporosis. As I made my way through the large stack of medical bills on my desk from this 15-month odyssey, wondering which to pay now and which to try to push off until later, this seemed as good as advice as any.<\/p>\n<ul class=\"dcr-11uwh1i\">\n<li class=\"dcr-11uwh1i\">\n<p class=\"dcr-11uwh1i\">Deborah Copaken, founder and editor of <a href=\"https:\/\/deborahcopaken.substack.com\/\" data-link-name=\"in body link\">Ladyparts<\/a>, is an <a href=\"https:\/\/www.deadlineclub.org\/2024-awards-winners\/\" data-link-name=\"in body link\">award-winning<\/a> <a href=\"https:\/\/www.deborahcopaken.com\/#\/essaysjournalism\/\" data-link-name=\"in body link\">journalist<\/a>, <a href=\"https:\/\/www.deborahcopaken.com\/#\/photojournalism\/\" data-link-name=\"in body link\">photographer<\/a>, <a href=\"https:\/\/www.imdb.com\/name\/nm0178528\/?ref_=fn_al_nm_1\" data-link-name=\"in body link\">screenwriter<\/a>, and the New York Times bestselling <a href=\"https:\/\/www.deborahcopaken.com\/#\/books\/\" data-link-name=\"in body link\">author<\/a> of seven books, including Shutterbabe, The Red Book, and Ladyparts.<\/p>\n<\/li>\n<li class=\"dcr-11uwh1i\">\n<p class=\"dcr-11uwh1i\">The headline of this article was amended on 22 October 2024 to reflect that the writer is now 58.<\/p>\n<\/li>\n<\/ul>\n<\/div>\n<p><script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-3711241968723425\"\r\n     crossorigin=\"anonymous\"><\/script>\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-format=\"fluid\"\r\n     data-ad-layout-key=\"-fb+5w+4e-db+86\"\r\n     data-ad-client=\"ca-pub-3711241968723425\"\r\n     data-ad-slot=\"7910942971\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script><br \/>\n<br \/><div data-type=\"_mgwidget\" data-widget-id=\"1660802\">\r\n<\/div>\r\n<script>(function(w,q){w[q]=w[q]||[];w[q].push([\"_mgc.load\"])})(window,\"_mgq\");\r\n<\/script>\r\n<br \/>\n<br \/><a href=\"https:\/\/www.theguardian.com\/wellness\/2024\/oct\/22\/osteoporosis-menopause-bone-density-diagnosis-treatment\">Source link <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>On 16 June 2023, I got my first DEXA scan. I was 57. Three hours later, a rogue driver plowed his car into mine and shattered my wrist in three &hellip; <a href=\"https:\/\/hotvideos24.online\/?p=117191\" class=\"more-link\">Read More<\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"class_list":["post-117191","post","type-post","status-publish","format-standard","hentry","category-health","entry"],"_links":{"self":[{"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/posts\/117191","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=117191"}],"version-history":[{"count":0,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/posts\/117191\/revisions"}],"wp:attachment":[{"href":"https:\/\/hotvideos24.online\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=117191"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=117191"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=117191"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}