Archive for the ‘Take Control Naturally’ Category
There Ain’t No Such Thing As A Free Lunch. As true now as when Robert Heinlein shortened it to TANSTAAFL.
Every medication has benefits and risks. Every decision to not take medication has increased risks as well as the avoidance of those risks medications may carry. The trick is to put the benefits and risks into a proper balance based on your individual pre-existing risks.
The NIH definition of Osteoporosis is an Increased Risk of Fracture. Genetics, age, smoking status, steroid medications, low calcium intake, low Vitamin D levels all contribute to Fracture Risk. Some of these are addressed in FRAX. A full bone health evaluation can determine the magnitude of your fracture risk.
Perhaps you can Take Control Naturally with the right amount of Calcium, Vitamin D3, exercise, avoiding smoking, etc. These measures are often sufficient when fracture risk is low. They are necessary in all cases.
The benefit of every osteoporosis medication is to Decrease Fracture Risk when the risk is high. Your risk for each medication is determined by the details of your medical conditions. The FDA warnings cover many risks which are extremely rare, as well as some more common. A full discussion with your doctor or PA or NP will help you determine which risks apply to you.
Every action and inaction carries risks. Take control by getting a full evaluation and full consultation.
Jay Ginther, MD
Last week NEJM published a study that looked at actual total Vitamin D intake by individuals (65 and older) in the study. No previous study had divided individuals by their total Vitamin D intake (their assigned supplement + what they were already taking) and also asked how often they actually took their meds.
Those taking total 800 IU Vit D or more daily showed a 30% decrease in hip fractures. This is highly significant. This is also the first time persons taking 800 IU daily were studied. When all individuals assigned to (400 IU) Vit D were combined (including those rarely taking their assigned dose) the 10% decrease in hip fractures was not statistically significant.
I see many patients who have failed to improve on osteoporosis medications. The vast majority of those patients are not getting enough Calcium and Vitamin D to succeed.
Osteoporosis medication alone is not adequate. A study released last week of patients in France in 2010 brought this home again. Patients receiving medication AND Enough Calcium in Diet and Supplements Together AND Enough Vitamin D, maintained Bone Mineral Density significantly better than those who did not get all 3.
TV Newsies have reported a story about some Europeans having problems when given Vitamin D supplements. But they did not report that these patients received 500,000 units of Vitamin D as a single dose. This is ten times the recommended maximum daily dose. Of course there was a problem!
Their theory was that the national health service would save money and assure compliance by giving Vitamin D just once a year. Unfortunately there were increased falls in the first week after this HUGE dose. Falls increase fracture risk.