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What if everything your doctor told you about osteoporosis and osteopenia was wrong?
What if osteoporosis were not the primary cause of fractures in aging populations? What if both the definitions of osteoporosis and osteopenia used to justify pharmaceutical treatment were both misleading and age inappropriate?
These are questions we explored in a previous exposé titled, "Osteoporosis Myth: The Dangers of High Bone Mineral Density," wherein we explored evidence showing the so-called "osteoporosis epidemic" is not an evidence-based concept but a manufactured one designed to serve the interests of a growing industrial medical/pharmaceutical complex.
Now, a powerful new paper published in the Journal of Internal Medicine titled, "Osteoporosis: the emperor has no clothes," confirms that the primary cause of what are normally labeled "osteoporotic fractures" are falls and related modifiable lifestyle factors and not osteoporosis, i.e. abnormally "porous" or low-density bones.
The new study pointed out three false notions that can be disputed:
Mistaken pathophysiology: "Most fracture patients have fallen, but actually do not have osteoporosis. A high likelihood of falling, in turn, is attributable to an ageing-related decline in physical functioning and general frailty."
Ineffective screening: "Currently available fracture risk prediction strategies including bone densitometry and multifactorial prediction tools are unable to identify a large proportion of patients who will sustain a fracture, whereas many of those with a high fracture risk score will not sustain a fracture."
Unproven and unsafe treatment: "The evidence for the viability of bone-targeted pharmacotherapy in preventing hip fracture and other clinical fragility fractures is mainly limited to women aged 65–80 years with osteoporosis, whereas the proof of hip fracture-preventing efficacy in women over 80 years of age and in men at all ages is meagre or absent. Further, the antihip fracture efficacy shown in clinical trials is absent in real-life studies. Many drugs for the treatment of osteoporosis have also been associated with increased risks of serious adverse events. There are also considerable uncertainties related to the efficacy of drug therapy in preventing clinical vertebral fractures, whereas the efficacy for preventing other fractures (relative risk reductions of 20–25%) remains moderate, particularly in terms of the low absolute risk reduction in fractures with this treatment"
The open access study is well worth reading in its entirety, but below are a few takeaways that we want to highlight.
Falling and Not Low Bone Mineral Density Is The Primary Cause of Fractures
Millions of men and women whose bones are actually normal for their age group (Z-score) are being manipulated into thinking that their bones should remain as dense as an approximately 30-year-old young adult (T-score) despite the natural process of bone thinning and reduction of density that attends the aging process. This T-score based bone density system pathologizes/over-medicalizes normal bone density variations, creating disease diagnoses where none should be found -- a situation that is incredibly lucrative from the perspective of the bottom line of pharmaceutical and medical services companies. This has lead to a massive problem with overdiagnosis and overtreatment -- two euphemistic technical terms to describe what happens when asymptomatic and otherwise healthy populations are told they have a 'specific disease' that they do not have (overdiagnosis), and subsequently pressured into taking pharmaceuticals (overtreatment), whose adverse effects often contribute to morbidity and premature mortality.