Osteoporosis is the weakening of the bone by demineralization which thereby increases the chance of bone fractures. It can be detected by measuring the density of the bones. At age 30, bones have reached their maximum density and strength. Read more in this patient education guide.
Calcium and Vitamin D are critical for postmenopausal women and can prevent osteoporosis from occurring. While bone density is mainly determined by genetics, lifestyle can also alter your bone density and increase your risk for osteoporosis.
Doctors Who Treat Osteoporosis - Patient Education
While there are no physicians that focus solely on the care, diagnosis and treatment of osteoporosis, there are specialists that diagnose and monitor osteoporosis.
Once an initial diagnosis has been made, endocrinologists and rheumatologists will rule out any underlying disease that may be contributing to osteoporosis.
When looking for a physician, it is helpful to consult with the local hospital that may have an osteoporosis clinic or center within the facility to ask for referrals.
- Gynecologists - Concentrate on the health of the female genital system and associated conditions. They often work in the capacity of primary care doctor for women.
- Endocrinologists -Focus on glands and hormones, which control the body's metabolism.
- Rheumatologists -Focus on diseases of the bones, joints, tendons and muscles. Often seen to rule out Rheumatoid arthritis.
- Geriatricians -Focus on health and disease of the aging process including those that occur in the elderly patient. Dementia and incontinence fall into this category.
- Orthopedists -Focus on the health of the musculoskeletal system.
- Physiatrists -Concentrate on rehabilitation therapy and physical medicine to restore the functions of the patient. They assess and treat those suffering from pain, disabilities and lack of function.
- Family Physicians -Manage the overall health of a patient and often act as a liaison between the patient, family and other specialists. They are generally familiar with the patient, having followed both patient and his/her family over a period of time and can provide additional osteoporosis patient information to other specialists not as familiar with the patient.
How to Prepare for Your Osteoporosis Doctor Visit
Having made your appointment with a healthcare provider, there are certain actions that you need to take in order to maximize the benefit of your Osteoporosis doctor visit. Please read the osteoporosis patient education guide listed below.
Bone density tests are done with dual energy X-ray absorptiometry (DEXA). Although it is painless and easy, there are a few steps to take in preparation.
- Stop taking calcium supplements two days prior to the DEXA scan as increased levels can cause inaccurate measurements.
- Meals are eaten as usual.
- Do not take osteoporosis medication the day of the test.
- Wait two weeks or more for the scan if you are also undergoing a barium enema or other radiological test using contrast material as it will interfere with the scan result.
- Inform the technician if you are right or left-handed since scanning of the hip is done on the non-dominant side.
- On the day of the scan, wear loose-fitting clothes without metal zippers.
Questions to Ask Your Doctor About Osteoporosis
From your initial diagnosis throughout your treatment and care, you will have questions about your osteoporosis. Please read our osteoporosis patient education guide below so that you can make informed decisions about your condition.
Question About My Diagnosis
- How often do I need to take a bone density test? Are they accurate?
- What does the T score mean?
- Should I have a blood test for this condition?
- Can I cure the condition? Can I keep it from getting worse?
Questions About My Treatment
- Can I treat my condition with exercise? If so, how much exercise?
- Would hormone therapy improve my condition?
- What are the side effects of medication?
- Can I take the medication with the drugs that I am currently taking? Are there any contraindications?
Questions About My Lifestyle & Family
- Is osteoporosis genetic?
- What medications put me at higher risk for osteoporosis?
- What foods should I avoid?
- What vitamins should I take?
- Are there lifestyle changes that would improve my bone health?
- How can I prevent my bones from breaking?
Common Tests or Labs to Diagnose Osteoporosis
In addition to dietary modifications, patients with gout may need medication to help with flare-ups and pain.
It is important for patients with gout NOT to take aspirin or aspirin-based products, which are high in uric acid.
Please read the following osteoporosis patient education guide to common tests and labs.
| Test |
Why Test? |
What Happens? |
Normal Result |
|
Dual X-Ray Absorptiometry (DEXA)
|
Scans and measures the density of the spine, hip and total body
*Test of Choice
|
If clothing has no snaps, buttons or zippers, no change of clothing is needed.
You will lie on a padded exam table while an instrument arm shifts above you, scanning the density of your hip and spine.
You are not enclosed in the machine and leaning on a square cushion raises your legs.
|
Normal T score is -1.0 or above.
-1 to -2.5 shows osteopenia: the start of bone loss.
|
|
Urinary N- Telopeptide Type I collagen (uNTX)
|
Tests for bone resorption (bone loss). Marker found in the urine
|
A urine sample is given from a second-morning void of at least 1 ml or a 24-hour urine collection. (volume must be recorded)
The specimen must be refrigerated during storage for the laboratory .
|
Normal is <20 nmol/mM creatinine
|
|
Bone-specific alkaline phosphatase (bone ALP or BALP)
|
Evaluates new bone formation rate
|
A tourniquet (elastic band) is placed around the upper arm and the site for puncture is wiped with an alcohol swab.
A needle with syringe is inserted into a vein (usually opposite side of elbow or back of hand) and blood is withdrawn for analysis.
|
Normal is 20 to 140 IU/L
|
|
Level of Vitamin D
|
Pinpoints any deficiency, which prevents calcium absorption despite amount of calcium consumed.
|
A tourniquet (elastic band) is placed around the upper arm and the site for puncture is wiped with an alcohol swab.
A needle with syringe is inserted into a vein (usually opposite side of elbow or back of hand) and blood is withdrawn for analysis.
|
50-80 ng/ml
|
Common Medications and Treatments for Osteoporosis
There are several different classes of drugs that treat osteoporosis. Treatment is specific to each individual. Side effects and warnings must be taken into consideration. Please read the following osteoporosis patient education guide regarding common meds and treatments prescribed by doctors.
| Drug Type |
How it is taken? |
How it works? |
|
Calcitonin
|
Taken as a daily nasal spray or injection
|
Retards the progression of bone loss
|
|
Zoledronic acids
|
Taken once a year via a 15 minute IV infusion
|
Improves bone strength
Decreases fractures in:
- Hip
- Spine
- Ribs
- Legs
- Arms
- Wrists
|
|
Synthetic parathyroid hormones
|
Self-injected daily for 24 months
|
Stimulates new bone formation
Increases BMD (bone mineral density)
Used for those at high risk of fracture
|
|
Hormonal Replacement Therapies (estrogen & progesterone)
|
Daily oral dose of estrogen alone or with progesterone, or through a vaginal insert or dermal patch
|
Used for bone loss prevention as well as treatment
Decreases the incidence of fractures
|
|
Monoclonal Antibodies
|
One injection is given subcutaneously (just under the skin) of the upper arm, abdomen or upper thigh once every 6 months.
|
Deactivates the mechanism to breakdown bone
First biological therapy
Used when other treatments failed
Used in those with high risk for fracture
|
