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Re: Bone Density From: Joanne Bulley, MD (islesannie@yahoo.com) Wed Dec 17 16:44:05 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Garry E. Siegel, M.D.: "Real Ob" Previous message: Joanne Bulley, MD: "Re: OB: Missed Ab medical treatment" I agree with the others - the orthopod and internist are doing their usual "oh - a female with low bone density - it is a gyn problem - blame estrogen" - they just don't put on their thinking caps. It is like the hypothyroidism that is missed - they blame it on being in "the perimenopause" and forget to check a TSH. If she has not been on steroids for some disease (and maybe even if she has) then she needs a PTH, TSH, Calcium, Alk Phos and probably a 24 hour urinary calcium. She could have a renal defect contributing. Joanne At Tue, 16 Dec 2003, Lynn D. Montgomery, M.D. wrote: > >Happy Holidays To One and All: >I have a 29 y.o. patient who is anovulatory (folliculogram >confirmations), but has monthly periods. She recently sustained a >spiral fracture of her tibia during minimal activity and subsequent bone >scan revealed marginal density for age in her spine. > >Both orthopedist and internist are telling the patient that her >decreased bone density and subsequent fracture are the result of her >anovulation - I say no, as long as she is having her periods, she >doesn't fit the classic I haven't had the chance to check her labs and >they haven't evaluated any cause they feel they have the answer. > >I have certainly seen this in truly amenorrheic patients who are >anorexic, or extreme fitness with very low body fat percentile, but not >in regularly menstruating females who are not ovulating. > >Comments... >Lynn > >-- >Lynn D. Montgomery, M.D. >Rocky Mountain Women's Health >2835 Fort Missoula Rd., Suite 303 >Missoula, Montana, 59804 >406-549-0978 >fax 406-549-0987 >e-mail: apgar10@montanadsl.net > -- Joanne Bulley, MD Keene, NH, USA ----- Work to create peace everywhere you go and with everything you do. ----- Let us accept truth, even when it surprises us and alters our views. -George Sand Next message: Garry E. Siegel, M.D.: "Real Ob" Previous message: Joanne Bulley, MD: "Re: OB: Missed Ab medical treatment"

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