Posts Tagged ‘Calcium Citrate’
The goal of Bone Health Evaluation and Treatment is Fracture Prevention! DXA and Bone Mineral Density (BMD) are useful tools for evaluation. But DXA and BMD are only one out of many tools for bone health evaluation. DXA t-score and BMD should never be the sole goal of treatment.
As an orthopedic surgeon, my goal is always Decreasing Fracture Risk. In the USA we sometimes seem to have forgotten that real goal. We focus too much on DXA t-scores. We should focus on the patient. We should treat “Clinical Osteoporosis”. The patient deserves a complete Bone Health evaluation.
Once again we are warned of the dangers of calcium supplements. Once again those studies cited prescribed supplements without regard to total calcium intake, including diet. What matters is total calcium intake, including diet.
I prescribe a lot of Calcium Citrate for my patients. I would prefer not to. Dietary Calcium is more easily digested than supplements, and appears to hold fewer dangers than Calcium Carbonate or other calcium supplements. Unfortunately, we have lost our taste for calcium rich foods. There are tasty choices.
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.