Tests for Osteoporosis: prevention and treatment monitoring
(continued)

Although these measures have some side effects, the benefits (prevention of hip fracture) usually outweigh these side effects in severe cases.[8,9]

Caveat
While a high bone density is great news for bone health, it is important to consider the fact that bone mass in women appears to be a very sensitive indicator of cumulative exposure to estrogen. Therefore, a higher bone density may also mean a greater risk for breast cancer. There is evidence to support this hypothesis. Results from the Framingham Study indicated that after adjustments for age and other potential confounding factors, the rate ratios for the risk of breast cancer were 1.0, 1.3, 1.3, and 3.5 from the lowest to the highest bone density measurements.

[10] These results indicate that while a high bone density signifies protection against osteoporosis it may also signify cumulative estrogen exposure and, therefore, be associated with an increased risk of breast cancer.

An addendum from the Denver Naturopathic Clinic:
The two different urine tests for bone loss described in this article can be ordered through our office:

Clinical Labs of Colorado Test Code # 121550 NTX:
Bone resorption rate
Price $85.00 This is a local lab. We give you a requisition and you collect a urine sample as directed by the lab and drop it off at one of their collection sites. Fee for the lab is billed to our account and you pay us.

Great Smokies Diagnostic Laboratory Bone Resorption Assessment [measurement of pyridinium (Pyd) and Deoxypyridinium (D-pyd)] Price: $ 66.00 This is an out of state lab which we use frequently.
You pick up a test kit from our office. You collect the sample at home, put it in the package and call Airborne Express. You give the lab your credit card number and they bill you directly. A little cheaper, a little less hassle, and just as accurate.

It is important to note that once you use one test, you'll need to stick with that test for accurate comparisons.

References:
1. Kanis J: Bone density measurements and osteoporosis. J Int Med 241:173-5, 1997.
2. de la Piedra C, et al: New biochemical markers of bone resorption in the study of postmenopausal osteoporosis. Clinica Chimica Acta 265:225-34, 1997.
3. Russell RGG: The assessment of bone metabolism in vivo using biochemical approaches. Horm Met Res 29:138-44, 1997.
4. Eyre DR: Bone biomarkers as tools in osteoporosis management. Spine 22:17S-24S, 1997.
5. Ross PD and Knowlton W: Rapid bone loss is associated with increased levels of biochemical markers. J Bone Min Res 13:297-302, 1998.
6. Chestnut CH, et al.: Hormone replacement therapy in postmenopausal women: Urinary N-telopeptide of type I collagen monitors therapeutic effect and predicts response of bone mineral density. Am J Med 102:29-37, 1997.
7. Zhang Y, et al.: Bone mass and the risk of breast cancer among postmenopausal women. N Engl J Med 336:611-7, 1997.
8. Zhang Y, et al.: Bone mass and the risk of breast cancer among postmenopausal women. N Engl J Med 336:611-7, 1997.
9. Liberman UA, et al.: Effect of oral endronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. New Engl J Med 333:1437-43, 1995
10. Reginster JY: Calcitonin for prevention and treatment of osteoporosis. Am J Med 95(Suppl.5A):44S-7S, 1993