Posts Tagged ‘antiresorptive’
GIOP is Glucocorticoid Induced OsteoPorosis. Cortisone, Prednisone, and many Inhalers for Asthma or COPD are glucocorticoids. Therefore, Glucocorticoid Induced OsteoPorosis is a particularly aggressive form of osteoporosis that affects all ages, not just older adults.
Glucocorticoids suppress OsteoBlasts, the cells that make new bone. Even the normal rate of bone turnover required for good bone maintenence and repair of microcracks becomes a problem when new bone formation is suppressed. Persons with GIOP have a rapid decline in bone quality and strength. What can be done?
Bone that has Fractured = Bone NOT Good Enough = Bone which requires the Anabolic, Forteo. Any fracture, especially vertebral compression fracture, can mean that the bone is NOT Good Enough. A Falling Bone Mineral Density (BMD) can mean that the bone is NOT Good Enough.
Orthopedic Surgeons see patients because their bone has fractured. Often this is a Fragility Fracture – a fracture due to a fall from standing height. I treat osteoporosis because of the patients I saw as an orthopedic surgeon. My orthopedic training makes Fracture Prevention my #1 goal.
How do you know when an Antiresorptive medication is best? First, the situation needs to be beyond the capability to Take Control Naturally with Calcium Citrate and Vitamin D3 alone. A dropping Bone Mineral Density (BMD) or a worsening Vertebral Fracture Assessment (VFA) despite adequate Calcium and Vit D3 indicates the need for medication.
Second, the bone needs to be Good Enough that preserving it at current levels will prevent fractures. Good enough means no Fragility Fractures and no Vertebral Compression Fractures detectable on the VFA by DXA machine or by lateral spine x-ray.