Archive for the ‘Bone Health’ Category
A delicate balance between bone formation and bone resorption is needed for Healthy Bone. This balance is naturally present until menopause in a woman or “Low T” in a man. The main players are OsteoBlasts, OsteoClasts, and OsteoCytes.
OsteoBlasts are cells that build bone by producing bone matrix (Anabolic). OsteoClasts are cells that resorb or take away bone (Resorptive). Both live on the surface of bone. OsteoCytes live inside bone and control the balance of formation and resorption through the hormone Osteoprotegrin (OPG). OPG supresses the number and activity of OsteoClasts.
Estradiol is the hormone that tells the OsteoCytes to make enough OPG to keep the Osteoclasts under control. Women make Estradiol from Estrogen. Men make Estradiol from Testosterone. Women after menopause (about age 50) and men after about age 70 no longer make enough Estradiol to produce enough OPG. Then it is Osteoclasts Gone Wild.
Modern Hormone Replacement Therapy (HRT) is an obvious possibility in a woman. Estrogen is back on board. Prolia (Denosumab in osteoporosis dose), and Evista (Raloxifene), are two novel osteoporosis medications designed to bring unruly OsteoClasts under control. They both mimic the natural process, but in different ways. We will address each in coming posts.
Take Back Control with whatever medication works best for you.
Jay Ginther, MD
A patient had no idea why her doc sent her to me for a Complete Bone Health Evaluation. As a “baby-boomer”, she lives by the motto: “You are only as old as you choose to be.” And she chooses to remain young. If only it were possible…..
“I can’t have Osteoporosis. I used to drink milk. I am active and I plan to stay active!!! So I just can’t have Osteoporosis!” Unfortunately, she does have Osteoporosis by BMD on her DXA, by the multiple Vertebral Fractures on VFA, and by FRAX. Still, there are simple steps to rescue her Bone Health before she Fractures.
Mothers give a lot to their children – even their bones! That is a hidden sacrifice, and a great gift. That is why it is important to maximize your Bone Health before becoming pregnant. During pregnancy and nursing, the baby comes first.
Pregnant and nursing Moms literally eat for two. The baby gets first priority for Calcium, Protein, Vitamins and Minerals. If the mother does not eat enough for both, she suffers. If the mother is already deficient, both suffer.
The Second Fracture can be prevented. How? Realize that your first fracture is a “Bone Attack” – a warning to start working on your Bone Health.
The National Osteoporosis Foundation (NOF) 2014 meeting focused on identifying first fractures and preventing second fractures. Someone who has fractured once is 2 to 5 times as likely to fracture (again) than a person who has not fractured. If DXA and T-score are in “normal” or “osteopenia” range, we have to look deeper. A Complete Bone Health Evaluation is often needed to find the issues that can be corrected.