osteoporosis news

[mimitabby]

first, there's this great webpage;
http://www.womentowomen.com/boneheal...eoporosis.aspx
here's an excerpt:
The Women to Women approach

Your bones, including your hair, teeth and nails, are mirrors of what you put into your body and the balance in your life. At Women to Women, we encourage our patients to try a combination approach to preventing and treating osteoporosis that begins with optimal nutrition. In short, this means:

* Take a daily medical-grade nutritional supplement rich in the minerals and nutrients that support bone health. Your vitamin should contain calcium and magnesium, vitamins A, D, K, B6, and B12, folic acid, and essential fatty acids. A calcium supplement is only as good as its rate of absorption, so buy the best quality you can afford.
* Exercise daily; include weight-training exercises at least twice a week. Bones are kept healthy with use! The more you ask of them, the stronger they’ll become, especially if you feed them well.
* Eat a balanced diet rich in leafy green vegetables, fruit, whole grains, and seaweed products. These are much richer sources of calcium and vitamins than dairy products. If you consume dairy, try to buy organic.
* Have protein as part of every meal and snack, but don’t overdo it.
* Avoid refined carbohydrates and simple sugars. Minimize sodas and limit caffeine too — both are bone weakeners.
* Include healthy fats in every meal. Bone building vitamins A, D and K are fat-soluble and a certain amount of fat is needed for proper hormone and immune function.
* Maintain hormonal balance during perimenopause. This is critical to healthy bone formation. Healthy adrenal balance is especially important. And if you get a low bone density reading, have your hormones checked, including your free and total testosterone levels.
* Support your body’s detoxification functions, especially for your liver.
* Maintain a healthy ratio of body fat: 20–25% body fat is normal.
* Get some daily sun exposure to trigger natural production of vitamin D, at least 15 minutes of unprotected sun in the early morning and late afternoon.
* Get a baseline bone density scan in your 40’s if you have any of the risk factors for osteoporosis. That way you’ll have something to compare yourself to later on. After 65, continue to get bone scans every couple of years to check your own individual progress.
* Examine your feelings about aging and weakness. Strength comes in many forms. Don’t let other people’s definitions limit you and your experience.
* Listen to your body and respect its desire to heal itself — in many ways it often knows best and may need just a little more support.



and then there's an interesting article in the NYTIMES:
http://www.nytimes.com/2008/07/15/health/15well.html

Drugs to Build Bones May Weaken Them
By TARA PARKER-POPE

New questions have emerged about whether long-term use of bone-building drugs for osteoporosis may actually lead to weaker bones in a small number of people who use them.

The concern rises mainly from a series of case reports showing a rare type of leg fracture that shears straight across the upper thighbone after little or no trauma. Fractures in this sturdy part of the bone typically result from car accidents, or in the elderly and frail. But the case reports show the unusual fracture pattern in people who have used bone-building drugs called bisphosphonates for five years or more.

Some patients have reported that after weeks or months of unexplained aching, their thighbones simply snapped while they were walking or standing.

“Many of these women will tell you they thought the bone broke before they hit the ground,” said Dr. Dean G. Lorich, associate director of orthopedic trauma surgery at NewYork-Presbyterian/Weill Cornell and the Hospital for Special Surgery. Dr. Lorich and his colleagues published a study in The Journal of Orthopaedic Trauma last month reporting on 20 patients with the fracture. Nineteen had been using the bone drug Fosamax for an average of 6.9 years.

Last year, The Journal of Bone and Joint Surgery published a Singapore report of 13 women with low-trauma fractures, including 9 who had been on long-term Fosamax therapy.

The doctors emphasize that the problem appears to be rare for a class of drug that clearly prevents fractures and has been life-saving for women with severe osteoporosis. Every year, American adults suffer 300,000 hip fractures.

Merck, which makes Fosamax, says it will study whether the unusual fracture pattern is really more common in bone-drug users. Arthur Santora, Merck’s executive director for clinical research, noted that the fracture accounted for only about 5 or 6 percent of all broken hips, while drugs like Fosamax reduced the risk for the other 95 percent.

The fracture pattern did not emerge in placebo-controlled studies of bone drugs. But those studies have lasted only three to five years, although follow-up studies of the drug users have lasted longer. Now that the fracture pattern has been identified, researchers expect more doctors to publish reports.

“I have several similar patients myself,” said Dr. Susan M. Ott, associate professor of medicine at the University of Washington. “Prior to these recent articles, there were a few cases here and a few cases there, but they are kind of starting to add up.”

Bones are in a constant state of remodeling — dissolving microscopic bits of old bone, a process called resorption, and rebuilding new bone. After age 30 or so, a woman’s bones start to dissolve faster than they can be rebuilt, and after menopause she may develop thin, brittle bones that are easily broken. Bisphosphonates, including Fosamax, Procter & Gamble’s Actonel and GlaxoSmithKline’s Boniva, slow this process.

But some experts are concerned that microscopic bone cracks that result from normal wear and tear are not repaired when the bone remodeling process is suppressed. A 2001 study of beagles taking high doses of bisphosphonates found an accumulation of microscopic damage, though there was no evidence that their bones were weaker.

Last September, the medical journal Bone reported on a study of 66 women, financed by Eli Lilly, that showed an association between Fosamax use and an accumulation of microdamage in bones.

In January 2006, the medical journal Geriatrics published an unusual autobiographical case report. Dr. Jennifer Schneider, a 59-year-old physician from Tucson, wrote that she was riding a New York City subway when the train lurched. “I felt a crack and I fell,” she recalled in an interview. “I knew I’d fractured my femur.”

Dr. Schneider, who had been taking Fosamax for seven years, said she had had pain in her thigh, but X-rays and scans had not found a problem.

In recent years, another rare side effect has been associated with bone drugs: osteonecrosis of the jaw, in which a patient’s jawbone rots and dies. Most victims are cancer patients taking a potent intravenous form of the drug, but a small number of cases from ordinary users have been reported.

Notably, studies suggest there is little extra benefit in taking the bone drugs more than five years. Dr. Lorich says that doctors should monitor the bone metabolism of long-term users and that some patients may want to consider taking time off the drugs. When fractures do occur, surgeons need to be alerted about long-term drug use, because the fracture may require more aggressive treatment and be slower to heal.

Dr. Ott says the focus should be on using bone drugs only in patients with a fracture risk of at least 3 percent over the next 10 years. (An online fracture risk tool is at www.shef.ac.uk/FRAX.)

“Too many of these people are not getting adequate treatment that definitely is beneficial,” Dr. Ott said. “My major caution is that the bisphosphonates should not be used in people who don’t have a high risk of fracture.”

well@nytimes.com

[kelownagirl]

Thanks Mimi - good stuff!

[mimitabby]

I think i'm going to get off my prescription; actonel. it interferes with bone growth. how stupid is that?

[KnottedYet]

I had a patient with one of those spontaneous femur fractures.

Really weird stuff.

[BleeckerSt_Girl]

Thank you Mimi- some very good information there!

[Zen]

I recently had a dexa scan and got a phone call today from the Dr.'s office.
They wanted to phone in a scrip for me to start Actonel.
I said no.

Mimi, if you hadn't posted this I would have no idea. A web search turned up some alarming results.

Thank you.

[shootingstar]

admittedly i was recommended to take a calcium tablet daily. Haven't gotten around to it.

[firenze11]

Thank you for posting this. I had no clue.

My Grandmother has very bad osteoporosis, now I'm wondering if she is on any of these drugs. And my Mother has osteopenia. So I feel strongly about trying to keep it from happening to me. The article about from Women to Women is great for that.

[mimitabby]

Firenze, your mother is probably the one on those drugs! I'd talk to both your mother and your grandmother.
Balance, balance! it's an easy exercise to do!

[Crankin]

I'm glad I had a bad reaction to Fosomax about 7-8 years ago! I had a bone scan in my forties, since osteoporosis runs in my family. Sure enough, I was well on my way, despite years of weight bearing exercise before I started cycling. I was prescribed Evista, which has its own set of side effects; I never took it consistently because I was truly convinced it was the cause of my weird medical things last year. However, I have been taking regularly for over a year and I will be having another bone scan in September. My last one, two years ago, showed that both my spine and hips are affected now. But, I think the drug is working because I can see the difference in my nails. I am trying to weight train 2x a week, but it is the first thing to go when I am pressed for time.
I've had a couple of bike crashes with no ill effects, the last being in April when someone stopped short in front of me and I touched wheels. Other than bruises and a bit a of road rash, no bone problems. I've cut down on coffee, too. I never have been much of a soda drinker, and now I never have it.

[OakLeaf]

grrr

As you all know this is my particular soapbox right now, but recent news stories and research I did in the past has been leading me this way all along, and I'm just more confirmed in my beliefs.

Mass screening of asymptomatic individuals is just a way for the medical/industrial complex to get people signed up on expensive and dangerous treatments for conditions that may never become symptomatic. For every one individual who may be identified by screening AND helped by treatment, there are dozens and possibly even hundreds who are harmed by the process.

(And to clarify - I believe that most health practitioners who are involved in direct patient care DO have their patients' best interests at heart - it's just that access to information is tightly controlled by drug and imaging corporations - companies whose primary focus may be defense contracts or agriculture, not medicine, BTW - who by law are REQUIRED to make their shareholders' interests primary. But also that many health care providers have a very narrow definition of what constitutes a favorable outcome.)

Prevention (i.e. a healthy life with good nutrition and hydration, avoiding toxins and endocrine disruptors, plenty of natural light exposure, exercise both cardio and weight bearing) can happen regardless of whether someone's at particular risk.

[han-grrl]

Oakleaf - you read my mind!

Woot!

[NbyNW]

Been lurking on this thread as I'm in a risk factor group as well . . .

Oakleaf outlines a very interesting & broad ranging dilemma -- and I don't know what the answer is, but I do know this:

Bad things happen in spite of our best efforts

Maybe over time and as testing technology & knowledge improves the med. establishment will change its opinion as to who needs a test . . . .

It could happen, right?

[Grog]

I strongly encourage you all to check out Alan Cassels' web site:
http://alancassels.com/index.cfm
go into his database and search for osteoporosis.

Most interesting finds.

Cassels is a researcher at the University of Victoria in Canada and a frequent contributor to medical journals. He has published a wonderful book with Ray Moynihan called "Selling Sickness" about the marketing and branding of diseases. He addresses osteoporosis and the change in guidelines for treatment in much detail in the book, and to some degree on the web site. (Also good chapters on high blood pressure, cholesterol, and psychiatry in general... all those high-return on investment areas...)

A good source to balance some other types of information...

[firenze11]

Firenze, your mother is probably the one on those drugs! I'd talk to both your mother and your grandmother.
Balance, balance! it's an easy exercise to do!

I will definitely be bringing it up to both of them. My grandmother did have a fall that broke her hip a few years ago so I can't image that she isn't on one of these. I'm not sure my Mom would be on one because she pretty much refuses to take any medication unless absolutely necessary.

I'll be taking my calcium plus D and magnesium more often now, thats for sure. I've been trying to really cut down on refined/processed stuff and need to get some weight training going.

You're right about balance!