Friday, September 11, 2009

Treating "pre-osteoporosis"

First the definition of “overweight” was changed, making 35 million more Americans overweight overnight. Then normal blood pressure was redefined, and everyone just above it became “pre-hypertensive”. And now, millions of women with a bone density just slightly below normal (for a 30-year-old!) are being told they have a condition called “pre-osteoporosis”, or “osteopenia”. This is like telling a middle-aged woman she has a skin disease because her skin is not as smooth as her daughter’s. In fact, a woman’s bone density normally declines with age – its just part of the aging process. Bone density declines very slowly after 30 but before menopause, and then accelerates after menopause.

The pharmaceutical industry helped to define osteopenia, and it also has the pills to treat it. Call me a skeptic, but I’m guessing they had an interest in seeing a lot of women diagnosed with the condition. Some doctors are suggesting that the drugs used to treat osteopenia are being over-marketed to younger post-menopausal women who may still be at relatively low risk for bone fractures. They argue that the benefits of the drugs used to treat osteopenia are exaggerated and the risks generally are downplayed. If you're still young, consult your physician before taking drugs to treat osteopenia. Otherwise you could be trying to treat a problem that you don’t really have yet.

REFERENCE: P. Alonso-Coello, et al. Drugs for pre-osteoporosis – prevention or disease-mongering? British Medical Journal 336:126-129, 2008.

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