Undiagnosed osteoporosis widespread

July 26, 2004
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Undiagnosed osteoporosis widespread



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Undiagnosed osteoporosis widespread
A report authored by researchers from Stanford University School of Medicine published in the July 26 2004 issue of the American Medical Association journal Archives of Internal Medicine (, estimates that millions of Americans have osteoporosis and don’t know it. Osteoporosis is a disease that occurs mainly in older women in which the bones become fragile and fracture more easily than healthy bone. Three and a half million patients visited their physicians during the past year for the disease, but at least this many more individuals may be undiagnosed. Many people only discover they have osteoporosis after a bone fracture occurs.

The authors used data from an ongoing national physician survey to arrive at their conclusions. They remark that although many cases of osteoporosis go undetected, recognition and treatment have improved over the past decade. Although newer and more effective prescription drugs are being increasingly used, a disturbing trend observed is a decline in the use of calcium supplements by osteoporosis patients, down from 46 percent of osteoporosis patients in 1994 to just 24 percent in 2003. Because the newer drugs were found to be effective when tested on people who were taking calcium supplements, they may not work as well without this critical bone-building nutrient. Lead researcher and assistant professor of medicine at the Stanford Prevention Research Center, Randall Stafford, MD, PhD, commented, "Physicians and patients may be so enamored of the new drugs that they are neglecting this important component of osteoporosis treatment.”

It has been recommended by U.S. Preventive Services Task Force that all women over the age of 65 undergo bone density screening to determine if they have osteoporosis. Dr Stafford noted, “If a person's doctor hasn't diagnosed osteoporosis, there's no way they could be on optimal treatment for their bone condition . . . The gravity of fractures is often underappreciated when in fact patients with hip fractures go on to have deterioration in their health linked directly to their fractures, with a high probability of death or nursing home placement.”

The authors conclude that “As estrogens are no longer recommended for long-term use in postmenopausal women, greater attention to osteoporosis prevention is critical. This includes calcium use and physical activity as well as potential advancements in pharmacotherapy for osteoporosis prevention.” (Stafford RS et al, “National trends in osteoporosis visits and osteoporosis treatment, 1988-2003,” Arch Intern Med, 164, July 26:2004, 1525-1530.)


Osteoporosis is a debilitating, costly, and difficult-to-treat decline in bone density that occurs primarily in postmenopausal females. It causes a progressive marked reduction in bone mineral density that often results in fractures of a serious nature. Most commonly these are spinal and hip fractures. Osteoporosis is a major public health issue for more than 28 million Americans, 80% of whom are women. It is estimated that in the United States today, 10 million individuals already have osteoporosis, and 18 million more probably have a low bone density, placing them at increased risk for osteoporosis in later years. Half of the women over the age of 50 will have an osteoporosis-related fracture in their lifetime. Although osteoporosis is often thought of as an old person's disease, it can affect younger people who have hormonal difficulties, particularly women with anorexia, bleeding, or menstrual abnormalities in their 20s. Osteoporosis also occurs in men.

Known risk factors for osteoporosis are:

  • Being female
  • Thin or small frame
  • Family history of osteoporosis
  • Postmenopausal, including surgical menopause (i.e., hysterectomy including ovariectomy)
  • History of anorexia or bulimia
  • Prolonged amenorrhea (absence of menstrual periods)
  • Low calcium diet
  • Lack of exercise
  • Cigarette smoking
  • Excessive alcohol use
  • Excessive caffeine use

Calcium is the mineral that automatically comes to mind when considering osteoporosis treatment. However, although bone contains large amounts of calcium, other minerals need to be considered as important in the treatment and prevention of osteoporosis. For example, other trace minerals (minerals needed in small amounts for specific tasks--usually enzyme activation) would include zinc, magnesium, boron, and silicon.

Many people in North America who consume an average diet have magnesium deficiency, and magnesium is important in bone structure. Magnesium deficiency comes about because most magnesium in our diet comes from the magnesium contained in the chlorophyll molecule found mainly in dark green leafy vegetables--not something that most people eat on a daily basis. Magnesium intake should be about half that of calcium, approximately 300-500 mg perday. If not provided in the diet, then magnesium should be supplemented. Some researchers are now also reporting that magnesium deficiency plays a significant role in the development of osteoporosis (Dreosti 1995). Studies have shown that women with osteoporosis tend to have a lower magnesium intake than normal and lower levels of magnesium in their bones. Recommendations for postmenopausal women to increase calcium intake can lead to an unfavorable Ca to Mg ratio unless the magnesium intake is increased accordingly; the optimum ratio of Ca to Mg is believed to be 2:1. A magnesium deficiency can also affect the production of the biologically active form of vitamin D, thereby further promoting osteoporosis. Some research shows that magnesium supplementation is effective in treating osteoporosis. Magnesium supplementation (over and above the current recommended daily allowance) may suppress bone turnover in young adults and some researchers speculate that it may also help prevent age-related osteoporosis (Dimai et al. 1998).

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For longer life,

Dayna Dye
Editor, Life Extension Update
1100 West Commercial Boulevard
Fort Lauderdale FL 33309
954 766 8433 extension 7716

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