DEAR DR. DONOHUE: I am a 67-year-old female with osteopenia. I get the recommended amounts of vitamin D and calcium through foods and supplements. I do weight-bearing exercise four to six hours a week, and I walk regularly. During this decade of my life, I have lost 3/4 inch in height. Apparently, osteoporosis medicines are prescribed only when one has descended into full-blown osteoporosis. Do you have any suggestions that will help reverse this?

I have read that strontium, L-lysine and vitamin K slow bone loss. Do you agree? — M.L.

ANSWER: DEXA (dual-energy X-ray absorptiometry) is the test taken to diagnose osteoporosis. The X-rays assess the calcium content of the bones. Measurements are taken in a couple of places. If the T-score, the number derived from the test, is equal to or less than -2.5, that person has osteoporosis. If the score falls between -2.5 and -1, the person is said to have osteopenia. That’s not osteoporosis, but it’s the next step toward osteoporosis.

Doctors do prescribe osteoporosis medicines for many people with osteopenia. A number of formulas predict with good accuracy which osteopenia patients are likely to suffer from an osteoporosis fracture. The formulas take into account the person’s age, sex, height, weight, previous bone fractures, family history of fractures, the patient’s record of past or present smoking, the early onset of menopause (younger than 45), illnesses like diabetes, liver or kidney disease, alcohol intake and any medicines that contribute to bone loss. The T-score is also entered into the equation. All these factors are considered in such a way that they produce a value that indicates the person’s likelihood of suffering an osteoporosis fracture in the next 10 years. If the percentage of risk is very low, no medicine needs to be taken. If it’s high according to the standards of the test, then medicine is prescribed. One such formula used is FRAX, which can be located on the Internet at www.sheffield.ac.uk/FRAX/. I haven’t seen widespread use of strontium or L-lysine. Vitamin K might be effective.

TO READERS: The booklet on fibroids provides answers to this common and difficult problem. Readers can order a copy by writing: Dr. Donohue — No. 1106, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Allow four weeks for delivery.

DEAR DR. DONOHUE: Last week, I had a scope exam of my stomach related to GERD. I read an article in The New York Times saying that people with GERD should sleep on their right side, never on the left, and my doctor confirmed that information. Your article says the opposite. Was that a typo? — D.G.

ANSWER: A radiologist wrote me about that too. My information came from the Archives of Internal medicine, volume 166, page 969. It says: “Several studies have shown that reflux (the upward spurting of stomach acid into the esophagus) is increased in the right, lateral decubitus position.” The right lateral decubitus position is lying on the right side. The article goes on to say: “The reason isn’t clear why. It might be that the lower esophageal sphincter (the muscle that keeps the esophagus tightly shut) relaxes in the right-sided position.”

I am not going to make any recommendation as to which side is the better one to sleep on for those who have heartburn. Sleep on the side that gives you better results. What is best for those with heartburn is to elevate the bed by putting 6-inch blocks under the bedposts at the head of the bed. That keeps gastric juices in the stomach.

DEAR DR. DONOHUE: I am enclosing weight-loss junk mail. This ad is too good to be true. I want to read your remarks in the paper. — J.W.

ANSWER: It is too good to be true. The ad offers no proof, other than testimonials, of the product’s effectiveness. It never explains how these crystals that are to be put on food cut down the food’s calories by three-quarters. It never says what the magic ingredient is.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

Copy the Story Link