Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.

How Can I Safely Improve My Bone Strength?

Tuesday, 08 June 2010 04:42 PM

Question: I’m a 5’1” 77 year old female in great physical condition who weighs 101.6. I recently had a bone density test which showed a 3% bone loss, which I feel is probably normal considering my age. My doctor wants me to take Fosamax, which I understand strengthens bone, but does not allow new bone cells to help heal a possible future broken bone.
Dr. Hibberd's Answer:
A bone density reading of 3% loss is a remarkably good reading at your age. But if you have a 3% loss over a short period, such as one year, that is a different situation and a significant loss that can be arrested by supplementation with Fosamax.
Always look for underlying medical reasons for changes in bone density in addition to osteoporosis. Is your calcium and vitamin D intake adequate? Do you receive adequate sunlight daily so your body can make its own vitamin D?
I am not a huge proponent of using medications without knowing all the facts. This is where your Z scores and T scores as well as any trend in your BMD (bone mineral density) readings, as well as your general health and family health history, become important in drug decisions.
You are correct that Fosamax does not appear to hasten the healing of fractures once they occur, but it does decrease the incidence of fractures in those with underlying weakened bone matrix from osteoporosis. It strengthens the bone matrix itself by depositing calcium in the bone. Hip, extremity, and compression fractures of our spines are very common causes of disability. Even deaths occur from complications that are preventable by maintaining strong, healthy bones.
Not everyone will benefit from using products such as Fosamax, so consult your doctor for an individualized re-appraisal of your risk/benefit ratios. If you are met with reluctance or abruptness, it may be time to seek out another opinion. You are quite correct to question the use of prescription medications used for osteoporosis, since they are not risk free. It is very important for you to understand your treatment goals as well as other ways to meet these goals.

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