Low bone mass and menopause.
Unless there is a history of low trauma fracture or a known secondary cause of bone loss or osteoporosis, a measurement of bone mass density is not indicated in healthy premenopausal women. Osteoporosis, as defined by microarchitectural deterioration and reduced bone strength, is more likely in premenopausal women with a known secondary cause of bone fragility or bone loss, such as estrogen deficiency or glucocorticoid excess. An isolated low BMD measurment on a DXA scan should not be used to predict fracture risk or make treatment decisions in premenopausal women the same way it is used in postmenopausal women. Osteomalacia may also present with low BMD, decreased bone strength and fractures. In osteomalacia, the collagen matrix of bone is undermineralized, most commonly due to severe vitamin D deficiency or hypophosphatemia. Rarely, severe calcium deficiency may be implicated. Unusual fractures may also be related to underlying local bone pathology at the fracture site, such as malignancy, avascular necrosis, fibrous dysplasia, and other conditions.
American women have been victim to The Big Calcium Lie as promoted by The American Dairy Council. In fact, drinking cow's milk is linked to fractures, microbleeds in the gut and prostate cancer. You can get high quality absorbable calcium through your diet with plant and nut milks. Everyone needs Vitamin D and some K for bone health. Xymogen makes a great combo in OsaPlex, OsaPlex MK-7 and the newest one without calcium made from Olive extract which delivers all of the benefits of a calcium-free nutraceutical. This is the one I recommend for post-menopausal women.
Second Nature patients with osteoporosis remove inflammatory foods that cause bone demineralization. Of course, Second Nature patients take GOOD GUT products to recolonize, repair and restore gut function becuase you need healthy microbial diversity in your intestines to produce healthy bone tissue. We also offer full bone health testing and treatment. Vitamin D and Vitamin K play a role in bone preservation. These levels are tested as part of diagnostics. Better to know your baseline levels and make corrections then to experience a terrifying breathing event or create unnecessary fractures.
1. Bone mineral density (BMD) measurement indicated in a premenopausal woman with a _______________________________.
A. History of low trauma fracture
B. Known secondary cause of bone loss or osteoporosis
C. A or B
2. Secondary causes of bone fragility or bone loss may include which of the following factors?
A. Estrogen deficiency
B. Glucocorticoid deficiency
C. A or B
3. True or False. An isolated low BMD measurement on a dual energy x-ray absorptiometry (DXA) scan can be used to predict fracture risk and make treatment decisions in premenopausal women in the same way it is used in postmenopausal women.
4. An alternative diagnosis to low bone mass is osteomalacia, which is most commonly due to which issue(s)?
A. Severe vitamin D deficiency
B. Severe calcium deficiency
C. A or B
5. True or False. Unusual fractures may also be related to underlying local bone pathology at the fracture site, such as malignancy, avascular necrosis, fibrous dysplasia, and other conditions.
1. C. A or B
2. A. Estrogen deficiency
3. B. False
4. A. Severe vitamin D deficiency
5. A. True
For complete information, see:
“Decision Support in Medicine: Low bone mass in premenopausal women.”