Posts Tagged ‘anabolic’
Ann spends a week in Florida each winter with several friends and was stronger, more agile and more confident this year than last. She stepped in and out of the hot-tub easily instead of slowly and awkwardly. She zoomed up and down stairs. She had to slow down when walking with her friends. What has happened?
A year ago she followed a fragility fracture with below average and decreasing BMD on DXA, and a newly crumbling vertebral fracture on VFA. She has Clinical Osteoporosis. That got her attention. She was determined to play on the floor with her active preschool grandchildren. You cannot do that if you are crumbling. She was ready to do whatever it took to get back in the game.
She added Adora Chocolates (500mg calcium in each) to her usual diet. She added Protein shakes (chocolate) and increased intake of chicken, fish, and beef to meet the new protein guidelines. She remembered to take extra Vitamin D3 and her Multiple Vitamins & Minerals almost every day.
She got serious about her “10,000 steps” every day and went up and down stairs frequently instead of saving up things for a single trip. She did not actually join an exercise class as promised.
She started the anabolic, Forteo, to build her bone density and strength. A daily little shot is a nuisance, especially keeping it cold while travelling, but she wanted results.
This year repeat DXA showed increased BMD. VFA confirmed no further crumbling. She zoomed through airports and left her friends in the dust in Florida. These results have made her even more determined.
She has Taken Control of her Future Life. You can too.
Jay Ginther, MD
Recently a patient asked me to review all osteoporosis medications for her to consider and choose from. We had already optimized her Calcium intake, 25-hydroxy Vitamin D level, Protein intake, Multiple Vitamins & Minerals, and Exercise program. These had all helped substantially, but not enough for her peace of mind. She feels that she needs osteoporosis medication too. Here they are:
Forteo is a daily shot. That is a nuicence, but a small price to pay for the only Anabolic, the only osteoporosis medication which will increase bone mass in spongy (cancellous) bone. Diabetics give themselves a daily shot for the rest of their lives. Forteo is for only 2 years and uses a tiny insulin needle.
People worry about the warning that lab rats got Osteosarcoma after being given very high doses of Teriparatide for the equivalent of 70 human years. We have not seen this in humans, or chimps, or monkeys, or dogs. Rats have bones that grow all their lives. We do not give Forteo to growing humans, pregnant women, nursing women, persons with Paget’s Disease or unexplained elevated Alkaline Phosphatase, or persons who have had radiation to their bones.
Remember that you must take adequate Calcium, with food, spread out over 3 meals. You must take enough Vitamin D3 to be able to absorb Calcium. You must eat enough Protein for your OsteoBlasts to make new bone matrix.
Forteo (Teriparatide) increases the thickness of the struts making up spongy (cancellous) bone. Forteo is the only osteoporosis medication to do that. It also makes the hard outer shell (cortical bone) thicker. How? Forteo stimulates OsteoBlasts. They make bone matrix, the collagen protein that is more than 80% of bone.
Forteo also stimulates bone turnover. Healthy bone is constantly being resorbed and replaced. This allows bone to eliminate the micro-cracks that gradually accumulate with activity. Bone is strongest when it is a mixture of older more calcified (stiffer) material mixed thoroughly with younger less calcified (somewhat bendable) material. Cracks cannot enlarge. Strength is better. More force is required to fracture the bone.