Endocrinologist: Osteoporosis Can Be Treated Even at 70 and Older

Osteoporosis, a disease that makes bones fragile and raises the risk of fractures, can be treated today. This is what endocrinologist Maija Gureviča, a board member of the Latvian Osteoporosis and Bone Metabolic Diseases Association, tells the magazine “Par Veselību”. She notes that many people still believe a diagnosis means there is nothing to do but accept it, which is not true.

What treatment achieves

Standard therapy has been available to patients since the 1990s, and treatment guidelines have been developed. Bone formation and breakdown go on throughout life, but their pace changes: in women, breakdown speeds up after menopause, and in men it can accelerate after the age of 70–75. Medication can slow or stop this process, and in many cases bone density improves as well. Sufficient intake of calcium, vitamin D and protein, along with regular exercise, also matters.

The doctor stresses that osteoporosis cannot be cured completely, but remission can be achieved. If bone density returns to the osteopenia range (a milder stage of bone loss before osteoporosis) or to normal, medication can in certain cases be stopped and the check repeated later. In her words, age alone is not a reason to refuse treatment, including at 70 and older.

New options

In recent years new groups of drugs have appeared, including therapy with the active substance romosozumab, but in Latvia it is currently not on the state reimbursed medicines list. Diagnostics are advancing too: studies presented at an international congress showed artificial intelligence detecting a vertebral compression fracture from X-ray or CT scans. Growing attention is also given to muscle weakness, or sarcopenia, which often accompanies osteoporosis.

Which doctor to see

Latvia has no separate specialty of “osteoporosis specialist”. In many cases a family doctor can begin diagnosis and treatment, and the reimbursed medicines list does not require that only an endocrinologist or internist prescribe the drugs. Patients are referred to a specialist in more complex cases, for example after several fractures, especially vertebral ones, when a more complicated treatment sequence is needed, or when earlier therapy has not been effective.

Gureviča says queues to specialists are long, and some patients have waited as long as a year and a half. A new fracture can occur while waiting, so the association organises lectures and events for doctors to help them feel more confident treating osteoporosis.