Stand Strong Against Osteoporosis
Facts on Endocrinologists and Their Role in Osteoporosis Care
Ask the average person to tell you who treats osteoporosis, and they'll probably say, "a bone doctor." The truth is, there are doctors with expertise in the management of osteoporosis, a disease marked by thinning and weakened bones. Endocrinologists are the medical experts best qualified to provide osteoporosis care because of their expertise in treating conditions known to be associated with an increased risk for the disease.
It's Not Just a Bone Thing...
Osteoporosis is not just about weak or aging bones. Actually, it is a complex metabolic bone disorder that may result from underlying dysfunction of the endocrine system - the interrelated glands and tissues that produce the body's hormones.
Hormones such as estrogen promote calcium absorption from the blood to the bones, protecting them from calcium loss and encouraging activity of vitamin D. Hormones promote bone building and also control bone breakdown. (This is of particular concern during menopause, when estrogen levels drop.) Other endocrine disorders that can impact bone health include:
- Abnormal ovarian function or cessation of ovarian function due to menopause, excessive exercise, dieting or surgical removal of the ovaries
- Testosterone or androgen deficiency in men
- Excess thyroid hormone or overactive thyroid
- Type 1 diabetes
- Eating disorders such as anorexia nervosa or bulimia
When Should You See an Endocrinologist?
To effectively manage osteoporosis, physicians must first identify the underlying cause of the disease. Without this critical information, effective therapy is unlikely. Patients with the following conditions should see an endocrinologist:
- Osteoporosis that is severe or has unusual features
- Osteoporosis at a young age (pre-menopausal for women)
- Very low bone density
- Low baseline bone density despite estrogen intake
- Fractures despite borderline or normal bone density test results
- Fractures despite treatment
- An endocrine disorder such as hyperthyroidism, hyperparathyroidism, Cushing's syndrome or hypogonadism
- Failure to respond to initial treatment of osteoporosis
Endocrinologists Treat Patients Right Though there is no cure for osteoporosis, effective management of the disease can reduce the incidence of fractures, a known cause of disability and mortality for sufferers. Once the cause of osteoporosis has been established, endocrinologists will begin treating the disease and addressing underlying conditions.
To ensure a consistent and unified approach to osteoporosis management, and improve the lives of millions of women who have or are at risk for osteoporosis, the American Association of Clinical Endocrinologists (AACE) has released new clinical practice guidelines. The 2001 AACE Medical Guidelines for Clinical Practice for the Prevention and Management of Postmenopausal Osteoporosis were developed to improve diagnosis and treatment and reduce the incidence of fracture related to osteoporosis. In light of the complexity of osteoporosis, the guidelines also offer recommendations on when to refer patients to endocrinologists.