Archive for the ‘Osteoporosis’ Category
Bisphosphonates are often associated with Gastro Esophageal Reflux Disease (GERD). When GERD cannot be adequately controlled by medication, we cannot use oral bisphosphonates. Yet there is an advantage to taking a medication which will accumulate in bone and last well beyond the last dose. That is where Reclast shines.
Reclast (Zolendronate in osteoporosis dose) is given IV. Intravenous (IV) means no Gastro-Intestinal issues at all. Therefore persons with Irritable Bowel Syndrome (IBS), or Crohn’s, or Colitis can take Reclast. The once a year dosing is convenient. But giving a whole year of medication all at one time requires extra care.
Bisphosphonates accumulate in your bone. When OsteoClasts gobble up your bone, bisphosphonates are released into the Osteoclasts and disable or kill the Osteoclasts. This is great news when the problem is Osteoclasts Gone Wild. Bisphosphonates preserve bone by slowing down bone resorption. However, after a few months, bone formation by OsteoBlasts also slows down, resulting in slow bone turnover.
Moderate and balanced bone turnover is good. You repair microcracks in your bone when OsteoClasts resorb the bone around them and OsteoBlasts fill in the void with new bone matrix. A mix of new and old bone is far stronger than all old bone. Some OsteoClast activity is necessary to heal fractures, especially incomplete (stress) fractures. That is where long term bisphosphonates can be too much of a good thing.
Bisphosphonates are the most commonly prescribed Antiresorptive medications used to prevent or treat Ostoeporosis. We know them as Fosamax (Alendronate), Boniva (Ibandronate), Actonel (Risendronate), Atelvia (enteric coated Risendronate), and IV Reclast (Zolendronate). All but the last are pills taken weekly or monthly.
If your bone is strong enough that preserving it is sufficient to prevent fractures, then Antiresorptive medication is what you need. If you are able to follow the protocol of taking the pill on an empty stomach, followed by one or more full glasses of plain water, and eating or drinking nothing else for at least 30 minutes (60 for Boniva) while remaining upright, Oral Bisphosphonates are the medication for you.
24% of men over 50 will suffer a fracture due to Clinical Osteoporosis. More than 3/4 of them will have a DXA score of “osteopenia” or “normal”. DXA is not the whole story.
This is a graphic of those lucky men who will not fracture (O), and those men who will fracture (X) without treatment for their bone health:
OOOXOOOOXOOOXOXOOXOOOOOXOOOXOOXXOOOXOOOOXOOO OXOOOOXOOOXOOOOXOOOXOXOOOXOOOOXOOOXOOOXOOOOX OOXOOOXOOOOXOOOXOOOOXOOOXOOOOXOOOXOOOOXOOOXO XOOOXOOOOXOOOXOOOOOXOOOXOOXOOOOXOOOXOOOOXOOX OOOXOOOOXOOXOOOXOOOXOOOOXOOOXOOOXOOOOOXOOXOO XOOOXOOXOOOOXOOOXOOOOXOOOOXOOOXOOOXOOXOOOXOO OXOOOXOOOXOOOXOOOXOOXOOOXOOOXOOOXOOOXOOOXOOO OOOXXOOOXOOOXOOXOOOOOXOOOOXOOXOOOOXXOOOXOOOO OXOOOXOOOOXOOOXOOOXOOOOXOOOOXOOOXOOOOXXOOOOX XOOOXOOXOOOXOOOOXOOOXOOOOXOOOXOOOXOOOXOOOXOO OXOOOXOOOXOOOXOOOXOOOXOOOXOOOOXOOOXOXOOOOOOX OOXOOOXOOOXOXOOOXOOOXOOOXOOOXOOOXOOOXOOOXOOO OXOOOXOOOXOOOXOOOXOOXOOXOOOOXOOOOOXOOOXOOOXO OOXOOOOXOOOXOOOXOOOXOOXOOOXOOOXOXOOOXOOOXOOO XOOOXOOOXOOOXOOOOXOOOXOOOXOOOXOOOXOOOXOOOOOX OOOXOOOXOOOXOOOXOOOXOOOXOOOXOOOXOOOXOOOXOOXO OXOOXOOOOXOOOXOOOXOOOXOOOXOOOXOOOXOOOOXOOOOX OOOXOOOOXOOXOOXOOOXOOOOXOOOXOOOOXOOOXOOOOXOO XOOOOXOOOXOOOXOOOXOOOXOOOXOOOXOOOOOXOOOXOOOX XOOOOOXOOOOXOOOXXOOOXOOXOOOXOOOXOOOOOXOOOXOO OXOOXOOOOXOOOOXOOOXOOXOOOOXOOOXOOOXOOOXXOOOO OOXOOOXOOOXOOOXOOOOXOOOXOOOOXOOOXOOOXOOOXOXO XOOOOXOOOXOOOXOOOXOOOOXOOOOXOOOOOXOXOOOXOOOO OOXXOOOXOOOXOOOOOXOOOXOOOXOOXOOOXOOOOOXOOOOX XOOOOXOOXOOOXOOOOOOX
Fractures are not fun! This could be You. We can prevent over 2/3 of those fractures with treatment. Get a Complete Bone Health Evaluation to know your Fracture Risk.
Then Take Action to Prevent Fractures!
Jay Ginther, MD