Osteoporosis - The Silent Disease
Osteoporosis is often called “the silent disease” because bone loss usually occurs gradually over the years without symptoms. Many people aren't aware that they have osteoporosis until they either have a bone densitometry test (DXA) or have a minor fall which causes a bone to break. Often, this “fragility fracture” (a fracture resulting from a mild fall from standing height) is the first sign of osteoporosis.
Dr. Streeten says that when someone is diagnosed with osteoporosis, it is important to investigate for causes of osteoporosis other than aging.
“After diagnosing osteoporosis, it is important to do a complete history, physical exam and lab work to look for secondary causes of osteoporosis other than age, such as vitamin D deficiency, excessive loss of calcium in the urine and chronic use of medications that weaken bone, such as prednisone. Up to one-half of men and one-third of women have an underlying secondary cause of their osteoporosis.”
According to Dr. Streeten, patients diagnosed with osteoporosis should have lab tests including a chemistry panel (for kidney and liver function, blood calcium), a complete blood count (to evaluate for anemia), a vitamin D level [called 25(OH)D], a thyroid test (TSH) and a spot urine or 24-hour urine test for calcium. Patients with severe osteoporosis with multiple fractures often require further tests.