Doc waging war against osteoporosis

Diana Rossetti

You might have seen board-certified internal medicine physician Pam Peeke on the Discovery Health network discussing women’s health issues. But Peeke has one passion above all others -- the prevention of osteoporosis in postmenopausal women.

“I’m traveling the country trying to get the word out about prevention treatment. There are 10 million people here that we know of with osteoporosis, and 8 million are women,” Peeke said.

“Osteoporosis thins and weakens bones, and women often don’t know they are at risk until a sudden bump or fall causes a fracture,” she said. “Women need to know the facts. The survey (a Harris interactive  poll of over 1,000 women in which she partnered) showed that women who are the most knowledgeable about osteoporosis are the most likely to follow a healthy diet, do regular weight-bearing  exercise and have regular bone density testing.”

The lack of knowledge and action related to bone health revealed by the survey, she stressed, could have serious consequences, because one in two women over 50 is predicted to break a bone due to osteoporosis in her remaining lifetime. Fractures could be directly or indirectly responsible for pain or disability.

Lifestyle changes

Peeke drives home her point that lifestyle changes can go a long way in helping to prevent osteoporosis. An active athlete herself, she not only enjoys fitness activities for their own sake but also for the health benefits she derives from them.

She pointed to current osteoporosis treatments such as daily supplements including calcium and Vitamin D and osteoporosis prescription drugs available in daily, weekly and monthly form. There also is a new once-yearly, 15-minute intravenous treatment available.

But medical treatments that can rebuild bone, though effective, cannot be done in isolation without the lifestyle changes.

“You have to take your health into your own hands. The survey showed that women are not taking responsibility for monitoring their own future health. If they put it on the back burner, they’ll never have the bone density scan.

“We found that 57 percent of women are not doing any weight-bearing activities even though over 90 percent assured us they want to live long and live well, alert and vertical for life,” she said.

At Mercy Medical Center, board-certified pharmacist Julie Drake works as an acute-care pharmacist.

“I wear many hats and I get a lot of questions about osteoporosis wherever I go,” Drake said. “Of course, the lifestyle changes and the calcium with Vitamin D supplements are the first line. But when women do need prescription medications, they have so many choices that I think many are pretty excited.”

Because those medications now can be taken daily, weekly, monthly or yearly, she said some patients were surprised that all of them cost about the same year by year.

“Some people thought if they just took it once a month, it would be cheaper, but it does pretty much even out. And there is light at the end of the tunnel for women who are concerned about the costs. Osteoporosis medications are so long-acting, that they are saying now that five years of treatment provides 10 years of protection for the average woman who is not at high risk,” she said.

Of the new intravenous treatments that can be taken once a year or every three months, Drake added that some women who have opted for them have experienced flu-like symptoms for up to four days. Now physicians often recommend a nonprescription pain reliever like Tylenol if this occurs.

Osteo complications

The brutal truth is that 20 percent of the women older than 50 who suffer hip fractures will die from related complications.

“We have to think of it this way. Women are more likely to keep their salon appointments or manicures times than they are to take the supplement they really need to stem bone loss. You need 1,200 to 1,400 milligrams of calcium supplements with Vitamin D daily,” Peeke said.

In a perfect world, women would have a painless baseline bone density scan starting at age 40.

“If it’s a great bone scan, keep it that way. The good news for women are the many therapeutic options available to them. The prescriptions are covered by insurance. You can’t believe you can get all the calcium you need from dairy because it is not as readily bio-available.

“Our bodies are built for obsolescence,” she said. “After age 50, we are going way beyond what we anticipated in being alive and doing the vital things in life. Women need to talk with their family practitioners, their internists, their gynecologists and get going.”

Contact Diana Rossetti at (330) 580-8322 or


Women who ignore the recommendations for regular bone density scans and supplements or prescription therapy after menopause are at high risk for fractures. There are no advance symptoms and when the fracture occurs, the future bone health of the patient hangs in the balance.

Risk factors include:

-- Caucasian or Asian descent

-- Family history of osteoporosis

-- Eating disorders

-- Excessive alcohol use

-- Smoking

-- Menopause before age 45

-- Slight body frame

-- Sedentary lifestyle

-- Long-term use of certain medications including thyroid hormone, some antiseizure medications and cortisone)