Posts Tagged ‘Bone Matrix’
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.
Are your bones still good enough and just need to be maintained? Or have you fractured several times and need to rebuild your bones? Are Steroid Inhalers supressing your Osteoblasts – the cells that build new bone? (not good) Or have your Osteoclasts – the cells that eat away bone – gone wild (even worse) now that you are post-menopausal or an older guy?
Different problems require different classes of medication. Bisphosphonates, Hormone Replacement Therapy, Synthetic Estrogen Receptor Modifier – Evista, and RANK-Ligand Antibody – Prolia, are all Antiresorptives, which act in different ways. They slow down the Osteoclasts that have gone wild and are eating up the bone. The Anabolic, Forteo, stimulates the Osteoblasts that make new bone matrix. Antiresorptive and Anabolic are radically diferent actions.
A patient was very disappointed recently, that his Bone Mineral Density (BMD) had NOT IMPROVED, despite anabolic medication for his Osteoporosis. The reason for failure became obvious as soon as we reviewed his diet and supplements.
His total Calcium intake is 500 mg daily in diet, with NO supplements. He prefers to avoid supplements as “unnatural”. This is OK. Natural Calcium in Foods is actually better than supplements. But you have to consume it. And you need to take it properly spaced throughout the day.