(Note to blokes - don't go away; there's much more to this than osteoporosis.)


What is an index as to how quickly or slowly one ages?


Lets just think about this for a moment. Insurance companies subject applicants to a battery of tests in a bid to see how much money they can get out of a body before it falls off the perch, when their 'unit profit' is thus realised. They refer to this by the politically correct and elegant euphemism of 'risk assessment', whereas a  more honest term might in fact be 'greed anticipation factor' or perhaps 'Scrooge unit'. The hapless applicant has a full Multiple Biochemical Analysis (MBA - patients are no doubt well aware of it's shortcomings), stress test with ECG, twenty-four hour urology study and so forth. Said 'hapless applicant' is marched from the GP to the cardiologist, thence to one or two more 'ologists' and finally back to the GP, depending on how much money his descendants anticipate getting from his insurer. 


Then he is honoured and congratulated with the acceptance of his policy application, pays his first premium, and  promptly drops dead. (Well, it might not quite happen like that, but let's just illustrate a point.) :-)


Now, the most overlooked assessment of an individual's health is skeletal changes. Insurance companies never look at it. That is to say, you can't really compare one person's skeleton with another person's, but what you can do is determine how an individual's skeleton is changing and yet this is so seldom done! Yet, this is an index for ageing! When there is some attempt at skeletal interpretation, it usually isn't very thorough in the older person and the only information imparted to the patient is 'risk of fracture'. However, this overlooks a lot of useful information in respect to speed of ageing and abdominal assessment. If you are losing bone too quickly, you are ageing too quickly, and often the increased risk of fracture is the least of your problems. It's not a complicated equation.


In men, moreso, the increased risks come from calcification of the arteries, heart valves, and osteophyte (spur) formation, particularly to the spine. In women these considerations also apply, but there is of course higher risk of osteoporosis due to decreased testosterone, but no-one discusses with female patients osteopaenia (which comes before osteoporosis) and kyphosis which is the forward curvature of the thoracic (mid) spine. Early kyphotic changes are an indicator of rapid ageing.


So, what happens, put simply, is this: The skeleton is constantly re-modelling itself in an attempt to keep itself healthy, but in doing so it can be mis-shaped from poor nutrition, lack of exercise, hormonal changes and so forth. When this happens, some skeletal minerals get deposited in the wrong places. This can result in spur formation, calcification of tendons and muscles** , hardened arteries (arteriosclerosis), cerebrosclerosis (hardening of the brain), calcification of breast tissue, various glandular tissues, and so forth. If your skeleton dynamics aren't working properly, it can cause you quite a bit of trouble!


And yet, this is so seldom discussed with patients. Western medicine pays it so little attention - nor does my wife who is an osteopath. It seems her patients just want to come in to her clinic and flop onto her treatment table. She has tried to get them to come and see me and get fixed up, but they aren't interested. The GP just doesn't seem to think it can be done at all! Some time ago, I had a sixteen year old boy who was brought to me with an osteophyte on the back of his femur which was over two centremetres long and scheduled for surgery. He'd been kicked in the back of the leg, and the bruised bone and clotting had given rise to the spur. A GP had told his mother there was absolutely nothing for it but surgery, yet we managed to re-configure the bone and decrease it's size and profile so that it was no longer painful. This had taken about three months. (This case was a referral from another osteopath.) Many years ago, I met a five your old boy who had had the end phalanx of his little finger completely amputated in a bicycle accident, and the entire joint had subsequently grown back - complete with the nail! It truly is quite amazing how the body can reconfigure itself given the right circumstances. Of course, the boy had youth on his side.


In terms of skeletal health, mostly all that's done is a bone density scan, and provided the density is within normal parameters for age and gender, the matter is considered to have been dealt with. Not so: the bone density needs to be considered in terms of the RATE of bone loss. A patient may well have relatively good bone density, however, it may be CHANGING quickly and it is this rate of change we need to look at. 


In part two, I'll go into this in a little more detail and explain to you changes you need to keep watch for.


As a matter of interest, naturopaths and herbalists have been improving bone density and re-configuring skeletons for many decades, and yet when I had been in practice for only a couple of years, I had a GP severely criticise me for suggesting to a patient that her osteoporosis could be cured. How times change.


More in part two next week...


*I once had a patient who was a very successful life assurance salesman who said the reason he came to me and had a Bolen's CRT blood test done every two years was because he'd seen so many assurance applicants passed as fit and healthy pass away not long after being thoroughly investigated by medical specialists.


** I have actually seen muscles on a cadaver calcified for well over two centremetres away from a rib along a (scalene) muscle - very painful.