All about Osteopenia MS (Multiple sclerosis)

There is a marked increase of risk of Osteoporosis and Osteopenia MS for both men and women. The loss of bone mineral density often appears earlier that for most people who do not have this disease. A report in the journal Multiple Sclerosis suggests screeing for the condition after age 40. (Note: This article abbreviates the termsthose with Osteopenia and multiple sclerosis to Osteopenia MS. The use of this term is not meant to indicate that there is a special condition with that label. It is only done here to assist search engines trying to'read' the page.)

Awareness and treatment is important because bone loss can lead to fractures In addition, fracture risk is high among those with Osteopenia MS becauseof their compromised gait and balance. They are at greater risk of falls....and falls can lead to fractures when bone density is compromised.

NOTE: You do not have to have Osteoporosis to have a fracture. Persons with Osteopenia have fractures too.

Fractures in those with Osteopenia MS are serious:

1. The resultant fracture immobility increases deconditioning.

2. The usual treatment of fracture pain with narcotics can create problems in those with multiple sclerosis. Narcotics can bring about not only constipation but bowel obstruction in those with this condition.

3. Finally, persons with fractures from Osteopenia MS often recover function more slowly and some never regain pre-fracture mobility. A fracture can bring a person with Osteoporosis or Osteopenia MS from moderate mobility to needing a wheelchair.

Causes of Osteoporosis and Osteopenia in MS

There are the usual Risk factors that can lead to Osteopenia MS and the usual lack of weight bearing exercise and lack of mobility are prime issues leading to Osteopenia in MS.

There is additional risk because of the use of drugs known to increase bone loss in the treatment of persons with Multiple Sclerosis.

Also, a 1994 article in the Journal of Neurology noted a prevelance of Vitamin D deficieny in women with multiple sclerosis and vitamin D is necessary for the proper uptake of calcium.

An article (in Japanese) by Maruyama H, Sakata C, Harada A, Ishizaki F, Nakamura S. published in Nippon Ronen Igakkai Zasshi. 1995 Jun;32(6):442-5 titled, "A Case of Multiple Sclerosis Associated with Lateralization of Bone Change", concludes that "osteopenia results from a disorder of the central nervous system, especially through autonomic disorder."

Treatments: Osteopenia MS

• Because many persons with multiple sclerosis have difficulty swallowing, some of the most promising drug treatments for bone loss are not useful. Bisphosphonates such as alendronate (Fosamax, Boniva) or risedronate (actonel) pose real difficulties to those who have trouble swallowing.

• Some advocate Hormone replacement therapy (HRT), sometimes called Estrogen Replacement Therapy (ERT)for those with Osteopenia and MS. But since the publication of results of the Framingham study there are those who see this course of treatment as problematical.

• There is the Selective Estrogen Receptor Modulators such as Raloxifene. Raloxifene's band name is Evista and this drug is a possiblity for Osteopenia MS.

• Finally there is Protelos, the brand name for strontium ranelate, which has been approved for use in the European Union. It has been shown to be an effective medication that does not have the same problems as the bisphosphonates.

Possible natural treatments

There have been no specific studies for Osteopenia and MS with the special calcium preparation AAACA but the many scientific studies for AAACA showing its effectiveness should lead to its consideration by those using Calcium, Vitamin D supplementation.

NOTE: AAACA is sold under the brand name Advacal and Advacal comes in both a plain AAACA form as well as one with the necessary Vit. D, Magnesium etc.

Also, although there appear to be are no specific studies of the use of natural strontium by those with Osteoporosis or Osteopenia MS. But natural strontium has been shown to be effective for increasing bone density. Summaries of researchstudies at the Mayo Clinic and elsewhere can be found on theStrontium page of this site.

References for Osteopenia MS

Allen C. Bowling, MD, PhD; Ragaa Ibrahim, PhD; and Thomas M. Stewart, JD, PA-C"Alternative Medicine and Multiple SclerosisAn Objective Review From an American Perspective" International Journal of MS Care Volume 2, Issue 3 October 2000.

Robert M. Herndon, MD, and Nirupa Mohandas, MD. "Osteoporosis in Multiple Sclerosis: a Frequent, Serious, and Under-Recognized Problem". International Journal of MS Care Volume 2, Issue 2 June 2000.

Maruyama H, Sakata C, Harada A, Ishizaki F, Nakamura S. " A case of multiple sclerosis associated with lateralization of bone change", Nippon Ronen Igakkai Zasshi. 1995 Jun;32(6):442-5

J Nieves, F Cosman, J Herbert, V Shen and R Lindsay. High prevalence of vitamin D deficiency and reduced bone mass in multiple sclerosis Neurology, Vol 44, Issue 9 1687-1692,1994.

Suzanne C. Smeltzer, RN, EdD, FAAN; Vanessa Zimmerman, RN, MSN; Theresa Capriotti, RN, MSN, DO; and Lilia Fernandes, BSN, MSN" Osteoporosis Risk Factors and Bone Mineral Density in Women With MS". International Journal of MS Care Volume 4, Issue 1 March 2002.

Weinstock-Guttman B, Gallagher E, Baier M, Green L, Feichter J, Patrick K, Miller C, Wrest K, Ramanathan M. Risk of bone loss in men with multiple sclerosis. Multiple Sclerosis. 2004 Apr;10(2):170-5.

M. Zorzona, R. Zivadinova,b, L. Locatellia, D. Giuntinic, M. Toncicd, A. Boscoa, D. Nasuellia, A. Bratinaa, M. A. Tommasia, R. A. Rudicke and G. Cazzatoa. Long-term effects of intravenous high dose methylprednisolone pulses on bone mineral density in patients with multiple sclerosis European Journal of Neurology Volume 12 Issue 7 p. 550 July 2005

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