Osteoporosis care in Munich

Osteoporosis, also called bone loss, is a disease of the skeleton. Bone mass and bone structure decrease, the bones become less able to bear loads and break more easily – sometimes after just a minor fall or for no apparent reason. The vertebrae, hip, wrist and upper arm are mainly affected. For a long time, osteoporosis causes no symptoms. Signs can include a loss of height, an increasingly rounded back or sudden back pain from a vertebral fracture. Women in particular are affected, because their bone mass is lower and oestrogen deficiency after the menopause speeds up bone loss. The important thing is that the risk can be assessed early, and a lot can be done with exercise, diet and targeted treatment.

Oestrogen protects the bones by slowing bone loss. With the menopause, oestrogen levels fall, and bone loss speeds up markedly in the first years afterwards. Women with an early menopause, after removal of the ovaries or on anti-hormone therapy after breast cancer therefore have a higher risk. Other risk factors are osteoporosis or hip fractures in the family, very low body weight, smoking, lack of exercise, an overactive thyroid and the long-term use of cortisone. Hormone therapy during the menopause can counteract bone loss. Whether it is an option for you depends on your symptoms, your age and your risks. We weigh up benefits and risks with you – including for natural hormone therapy.

Vitamin D ensures that the gut absorbs calcium and that it can be built into the bones. The body produces it mainly in the skin under sunlight; in the winter months in Germany, this is often not enough. You should preferably take in calcium through your diet, for example with dairy products, green vegetables, nuts or calcium-rich mineral water. More is not always better: very high amounts can be harmful, which is why we adjust vitamin D according to your laboratory values. Prof. Schulte-Uebbing has worked on vitamin D for many years, for example in “Vitamin D – an important and interesting hormone” (Your Health, 2015; published in German) and “Vitamin D Substitution and Treatment in Menopause and in Anti Aging Medicine” (Anti Aging Symposion, University of Oradea, 2011). Magnesium, vitamin K and protein also play a role for the bones.

Bone density measurement is the standard test for diagnosing osteoporosis. It uses a very low dose of X-ray radiation to determine the density of the lumbar spine and hip. The test is quick and places little strain on you. The guideline recommends it when your personal fracture risk is increased, not as a routine test for everyone. That is why we first record your risk factors. Blood tests also provide clues to causes and deficiencies, for example calcium, phosphate, kidney and liver values, thyroid and vitamin D. From the measurement, your age and your risk factors, it is possible to estimate how high the risk of fracture is over the next few years. This determines whether exercise, diet and vitamin D are enough or whether bone-strengthening medication makes sense.

Under this name we offer infusions with micronutrients that are put together individually. The concept: vitamins and minerals enter the blood directly through a vein, independently of absorption in the gut. The aim is to support the supply to the bones, for example in the case of a proven deficiency or impaired absorption. It is important to be clear about the distinction: these micronutrient infusions are not osteoporosis medicines. There are guideline-based bone-strengthening active ingredients that can also be given as an infusion – that is something different. That micronutrient infusions prevent fractures is not scientifically proven. We therefore use them only as a complement and discuss openly with you whether they make sense in your situation.

Bones need load to stay strong. Strength training, brisk walking and exercises for balance and coordination are therefore part of every osteoporosis prevention and treatment plan. It is just as important to avoid falls: remove trip hazards at home, wear good footwear, have your eyesight checked and review any medication that can make you dizzy. Smoking and heavy alcohol consumption harm the bones. For back pain, for example after a vertebral fracture, we offer acupuncture alongside conventional treatment; at our practice it is also used in pain therapy for osteoporosis. Prof. Schulte-Uebbing has been a member and lecturer of the German Medical Society for Acupuncture (DÄGfA) for decades. The effectiveness of acupuncture is not proven for every application.