Dr. Keith Roach
 |  To Your Health

Dear Dr. Roach: I am considering a new supplement to help my bones. My recent DEXA scan shows osteopenia with a T-score of 1.1 in my lumbar spine. My hips have a T-score of -1.5, and my FRAX 10-year risk score for hip fracture is 3.4%. The supplement contains plant-based calcium, magnesium, vitamin D3, vitamin K3, boron, selenium, and other trace minerals. Is this a good idea?

— M.C.

Dear M.C.: One authority recommends pharmacologic treatment, such as a bisphosphonate drug, for people with a 10-year risk for hip fracture above 3%, so your doctor should give consideration to this kind of treatment. With or without the treatment of a prescription drug, I do believe that getting adequate calcium and vitamin D is important for bone health. Essentially every study including prescription medication also used supplemental calcium and vitamin D.

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People with magnesium deficiency should get magnesium as deficiency can lead to metabolic bone problems. The data on vitamin K3 in Japan has been promising, but the studies in the United States haven’t shown a benefit. Boron is not recommended as a treatment. Strontium supplements do increase bone density as strontium is taken up into the bone and blocks X-rays better than calcium.

However, the only type of strontium shown to reduce fractures is not available in the U.S. Strontium sold as supplements may not have a benefit at all.

In summary, the vitamin D and calcium in the supplement you are considering are important, but the other components are unproven to be of benefit in reducing fracture risk. You will save money by just buying calcium and vitamin D separately.

Dear Dr. Roach: I am a 63-year-old healthy male. I am interested in getting the measles vaccine. The Centers for Disease Control say that I need one booster to be protected. The pharmacist says that I must take the full course of three shots. What gives?

— R.R.

Dear R.R.: Because of the ongoing outbreaks of measles in the U.S. and Canada, many readers and patients are asking me about vaccination guidelines for adults. Since you were born in 1961 or 1962, you cannot be assumed to have had measles, whereas people born before 1957 are extremely likely to have had measles.

One approach would be to check your blood levels for measles (called the IgG titer). If this is positive, you don’t need a booster, but if it is negative, it’s recommended to get two doses. (I’m not sure why the pharmacist said three doses since a full course is two.)

If you have documentation of two doses of the measles vaccine from when you were a child, you don’t need a booster. Unfortunately many people in their 60s no longer have their childhood records. One dose of the measles vaccine is reasonable for low-risk adults, but in an outbreak situation, having high protection from two doses is the safest measure.

Dr. Roach Writes: A recent column on rosacea prompted two readers to write in that they had been misdiagnosed as having rosacea, when they had serious diseases instead (polycythemia vera and neuroendocrine cancer). Although these are rare, rosacea that doesn’t clear up with standard treatments should lead to a consideration of more serious conditions. Readers may email questions to ToYourGoodHealth@med.cornell.edu.