Osteoporosis (Bone Loss)

Osteoporosis is a progressive disease that causes the bones to deteriorate and eventually leads to fractures. It decreases bone mass and interrupts the bone remodeling process, causing them to become thin, porous, and brittle.

In the United States, 10 million people have osteoporosis and 34 million more have low bone mass (weak or thin bones); these people are at increased risk for fractures and osteoporosis. Half of women and a quarter of men older than 50 years will have an osteoporosis-related bone fracture in their lifetime.

The actual breaking down and rebuilding of bone tissue is performed by two groups of cells: osteoclasts and osteoblasts. Bone remodeling occurs when osteoclasts break down small amounts of bone. After the bone has been broken down and reabsorbed in the body, then osteoblasts move into the area and start building new bone. Osteoporosis occurs when there is an imbalance between new bone formation and old bone resorption. The body may fail to form enough new bone, or too much old bone may be reabsorbed, or both. Bone loss in women occurs fastest in the first few years after menopause, but continues in the following years.

Until recently, osteoporosis was thought to be a natural part of aging. Now we know that this is not the case. Due to a loss of bone mass and tissue, bones that were once strong may be unable to endure the stress of normal activities. Each year, osteoporosis is responsible for more than 1.5 million fractures. These fractures usually occur in the spine, hip, or wrist, but they may occur in other bones as well. Osteoporosis fractures can be painful and debilitating; sometimes, they can even result in death.

Dr. Roberts uses a multi-pronged approach to osteoporosis. One of her main treatments involves testing hormone levels. Treating hormone imbalance is important because declining estrogen and progesterone levels cause bone density to decrease and fracture risk to rise. Estrogen, especially, is important for bone growth and strength: it works with osteoblasts responsible for bone formation. If levels are low, raising them can slow bone loss and even regenerate density. Dr. Roberts also attacks osteoporosis with exercise regimens, supplements such as calcium and vitamin D, and lifestyle changes, such as smoking cessation and reduction of alcohol consumption. Working with these strategies first is important because prescription drugs such as bisphosphonates, calcitonins, and parathyroid hormone derivatives can come with serious side effects.