Ep 75: Osteoporosis

Practice Bulletin #129 - Published September 2012 (Reaffirmed 2016)



1. In any hypoestrogenic state, resorption begins to overwhelm building, leading to decreased bone density.

2. Treatment is warranted if T-score ≤ 2.5 on DXA scan or if patient has history of vertebral facture or other type of fragility fracture

3. FRAX tool can be helpful in determining usefulness of treating patients in the osteopenic range (T-score < - 1 to ≥ -2.5). It predicts risk of osteoporotic fracture over next 10 years .

4. Bisphosphonates are first-line therapy for all-comers, though raloxifene is also reasonable first-line in younger postmenopausal women.

5. HRT is a great alternative to bisphosphonates in younger women at risk for osteoporotic fracture: ~35% decreased risk of hip fracture (estrogen alone or estrogen + progestin)



Show Notes



Wine pairing: 2017 Tempranillo from Baron de Ley Varietales

Theme music by Evan Handyside

Logo design by JD Dotson ([email protected])