If you are thinking about reading this book, you probably recently got a diagnosis of "osteopenia" or "osteoporosis" via a DEXA scan, and your doctor is urging you to take drugs to "heal" your "disease." If so, this well-written, well-researched and well-annotated book can be invaluable to you in making an informed decision about a medical choice that could affect your health--and your pocketbook--the rest of your life. Some of the most important insights this book offers in that direction are the following:
First, since there is no consistent, world-wide standard for determining what is "normal" bone density for either females or males, it is a crapshoot as to what standard any given maker of a DEXA machine will employ to measure your bones against--and therefore a crapshoot as to what diagnosis you might get, whether "normal" or "diseased." Second, there seems to be no consideration in the prevailing standard of care for creating and interpreting DEXA results of these crucial concepts about bone health: (a) Loss of bone density is a normal aspect of growing older and for the vast majority of people, it will never either cause or contribute to bone disease. (b) Virtually any adult over the age of 30 randomly selected to have a DEXA scan would find herself diagnosed as either imminently "diseased" (osteopenia) or currently "diseased" (osteoporosis). This is because few people over 30 have the bones of someone in their 20's, and certainly not the bones of elite athletes in their 20's--a comparison group too often held as the "norm" by DEXA machine manufacturers. (c) The definition of true osteoporosis is a disease of poor quality bones in which the internal, inter-linked trabecular structure of the bone has eroded to such an extent that the bones are subject to fracture from low-force impact. A case of true osteoporosis is sometimes extreme enough to reveal itself on a regular high-radiation x-ray, but, unfortunately, it will never show up via a low-radiation DEXA scan. This is because the DEXA is incapable of identifying anything other than raw bone mass AKA "bone mineral density" or BMD. It cannot inform the physician about the micro-architecture of bone, its crystal size and shape, the degree of brittleness, the state of the connectivity of the trabecular network, the vitality of the bone cells, the ability to repair micro-cracks, or the structure of the bone proteins--there is currently no medical test that can do that. (d) As the book emphasizes again and again: BMD is only one of multiple symptoms of the disease of osteoporosis--not the disease itself.
If the author's assertion about BMD is true, you might well wonder why the World Health Organization (WHO) in the not-so-distant past altered its official definition of osteoporosis to a low BMD score on a DEXA test. The author wondered, too, and her research uncovered that this change came about due to successful lobbying of WHO by Big Pharma. She also discovered that Big Pharma moved on from that strategic victory to an equally successful lobbying effort to get doctors in the prosperous West to consistently engage in two inter-connected, DEXA-related actions: (1) urge their patients at increasingly younger ages to get an initial "precautionary" DEXA exam, from which the vast majority of them will inevitably receive "abnormal" readings for the reasons cited above, (2) encourage these newly bone-disease-labeled patients to embark on a lifetime regimen of expensive "bone-building" drugs in order to become and stay "cured" of their "disease."
On reading all this, I could not resist doing the math (which the author did not go so far as to include in her fascinating book): As long-lived as people are these days in the prosperous West, the kind of money Big Pharma could potentially make over time off 30-50 years of drug usage per DEXA-scammed patient could run as much as $50-75,000--or even more, if one factors in inflation and the price gouging Big Pharma is notorious for. If one multiples that figure by potentially tens of millions of patients, the profits could amount to not just billions, but trillions of dollars over time. This is what is known in the world of multi-national-corporate wheeler-dealing as a proverbial "cash cow."
The conclusion is as inevitable as the rigged results of the DEXA machines: if you don't want to be milked by Big Pharma's osteoporosis machine, this book will help you in multiple ways. Chief among them are numerous tips on inexpensive, medically documented ways to protect your bones under your own steam and a list of the major predictive factors of fractures in the elderly (the only authentic reason for alarm at a true diagnosis of osteoporosis). This comprehensive list will show you that BMD is only one among many crucial risk factors for osteoporosis, and reassure you that all of them--including BMD--can be controlled without expensive drugs with serious side effects.
Update November 11, 2010: Lawsuits are coming in thick and fast for oral bisphosphonates such as Fosamax, Actonel, Boniva, Reclast and Atelvia and their generic alternatives because women on these drugs are experiencing "jawbone death," where the bone in the jaw is destroyed, as well as unusual and unexpected breaks in the thigh bone. The FDA is now forcing Big Pharma to post a warning on these drugs stating that "the optimal period for using the drugs is unknown." In addition, doctors are beginning to rethink urging women over 50 to stay on these dangerous drugs the rest of their lives.