Bone Health and Vaccination Queries

Dear Dr. Roach: I’m looking into a new supplement to support my bone health. My recent DEXA scan indicated osteopenia, with a T-score of 1.1 in my lower back and -1.5 in my hips. Additionally, my FRAX 10-year risk score for hip fractures is 3.4%. This supplement includes plant-based calcium, magnesium, vitamin D3, vitamin K3, boron, selenium, and other trace minerals. Do you think this is a good choice?

— M.C.

Dear M.C.: One expert suggests considering pharmacologic treatment, like a bisphosphonate, for individuals with a 10-year hip fracture risk above 3%. So, your doctor might want to evaluate that option. Regardless, it’s really important to ensure you’re getting enough calcium and vitamin D, as nearly all studies involving prescription medications included these supplements too.

For those deficient in magnesium, supplementing is key, as a lack can result in metabolic bone issues. Although some research in Japan shows promise for vitamin K3, studies here haven’t confirmed any benefits. Boron isn’t recommended as a treatment option. On the other hand, while strontium can increase bone density and is absorbed into bones effectively, the only type that reliably reduces fractures isn’t available in the U.S. So, strontium supplements might not be helpful either.

In short, while the calcium and vitamin D in the supplement you’re considering are indeed beneficial, the other ingredients lack solid proof for fracture risk reduction. You’ll likely save money by purchasing calcium and vitamin D separately.

Dear Dr. Roach: I’m a healthy 63-year-old man, and I’m interested in the measles vaccine. The CDC states I need one booster for protection, but my pharmacist insists on a full series of three shots. What should I do?

— R.R.

Dear R.R.: With the rising measles outbreaks in the U.S. and Canada, it makes sense that many people are curious about adult vaccination guidelines. Given that you were born in 1961 or 1962, you can’t automatically assume you’ve had measles, especially since those born before 1957 are likely to have had it.

You could start by getting your measles blood levels tested (called the IgG titer). If it’s positive, you don’t need a booster. A negative result would suggest you should get two doses; I’m unsure why the pharmacist mentioned three doses when the standard is two.

If you have proof of receiving two doses as a child, you won’t need a booster. Unfortunately, many in their 60s no longer have their vaccination records. One dose of the measles vaccine is fine for low-risk adults, but during an outbreak, two doses provide better protection.

Dr. Roach Writes: A recent discussion about rosacea prompted a couple of readers to share their experiences of being misdiagnosed. They actually had serious conditions, like polycythemia vera and neuroendocrine cancer, instead. While they’re rare, persistent rosacea that doesn’t respond to typical treatments should raise concerns for potentially serious conditions.