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IMG_0159I came into the ED the other evening and could hear a new patient being moved into the stretcher by the ambulance staff, and even the most subtle movements caused her to cry out in pain.  She was in her 90s and had tons of spunk (her comment of “well, if you’re old enough to be a doctor, then I’m the pope!” clued me into that), but had just stepped “badly” when getting out of her chair, twisted her leg, and broken her hip.  She had such bad osteoporosis that it took only a minor trauma to cause a fracture, and now she was in immense pain.  She wasn’t alone–the lady next door had so many compression fractures in her spine from osteoporosis that her neck curved at a 90 degree angle to her back, and she was in constant pain.

So, while I know that osteoporosis may <seem> like a long way off for many of you, I want you to take steps to prevent it as much as possible.

Maybe you’ve been hearing about a new report saying that Calcium and Vitamin D were NOT effective for osteoporosis and hip fractures (read the USPTF report here)? If you were confused, I was too, especially with the recent WHI report recommending them) so I went to the source. Here are my conclusions and what I plan to do:

  • Premenopausal women and men below 70: The USPTF study did NOT say anything about this population, which is definitely confusing from what the news outlets were saying.  Calcium and vitamin D are really the only things that we have to prevent osteoporosis.  Remember, it’s MUCH better to get it from your diet than from pills, so aim for that first.  Me? I’m drinking my milk, eating my leafy greens, and taking a supplement every day.  ALSO, your bones are in their peak growth BEFORE the age of 30, so anyone with young daughters–the greatest impact you can have is when they’re young! 
    • Stick to 1000mg Calcium + 400-800 iU Vitamin D daily.
  • Post-menopausal women and men over 70 : The USPTF saw no benefit, but the WHI did show some benefit in people who had been taking these supplements for over 5 years (sorry, still waiting for that miracle pill!) There was a small increased incidence in kidney stones, so people with kidney stones already definitely should talk to their doctor before taking these.
    • Stick to 1200mg Calcium and 800-1000 IU Vitamin D.  
    • Of course, always check with your own doctor for your own condition and before starting or changing supplements.
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