Posts Tagged ‘DXA’
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.
Anabolic medication for osteoporosis actually increases bone thickness and strength! Antiresorptive medications for osteoporosis (Fosamax, Alendronate, Actonel, Atelvia, Boniva, Evista, Reclast, Prolia) only preserve bone.
We have talked about all of the Antiresorptive medications over the last 2 months. They are excellent treatment if slowing down the OsteoClasts (cells that eat away your bone) is sufficient. That is not always the case.
Now it is time to talk about something completely different. Anabolic medication stimulates the OsteoBlasts (cells that make new bone matrix). OsteoBlasts can rebuild your bones. If you have Fractures, your bones may need to be rebuilt.
Forteo (Teriparatide) is the only Anabolic medication for osteoporosis in the USA. Close cousins of Forteo are available in other countries.
You may need the Anabolic, Forteo, if you have a hip fracture, multiple other fractures, or if VFA testing reveals a Vertebral Compression Fracture. A DXA T-score well below -2.5 can be reason enough without fracture.
Glucocorticoid (Cortico-Steroid) medications (Prednisone, Steroid Inhalers) specifically supress OsteoBlasts (cells that make new bone). Stimulating the OsteoBlasts with the Anabolic, Forteo, can offset the bone loss from Steroid medications. Smoking also supresses OsteoBlasts, leading to bone loss. Stopping Smoking would be best, but Forteo can help.
Not everyone needs an Anabolic, but some individuals do. A Complete Bone Health Evaluation will tell you if an Anabolic is right for you.
More about Forteo (Teriparatide) next time.
Jay Ginther, MD
The American Society of Clinical Oncology received bad news about Breast Cancer Patients this week. A study of women with breast cancer, being treated with Aromatase Inhibitors (AI), was presented at the 2014 Breast Cancer Symposium. AI is a great treatment for breast cancer, however…
AI is known to decrease bone strength and to increase Fracture Risk. How many of these patients were evaluated for their bone health? Only 54%. How many got a repeat evaluation to check to be sure that their bone health was not deteriorating? Only 46%.
Of those tested, 43% had a DXA T-score in the “osteopenia” range. In this situation, FRAX is needed to calculate Fracture Risk. 41% of this group met guidelines for treatment with medication to prevent bone loss and Fractures. Of those who should have been treated, only 23% were.
24% of men over 50 will suffer a fracture due to Clinical Osteoporosis. More than 3/4 of them will have a DXA score of “osteopenia” or “normal”. DXA is not the whole story.
This is a graphic of those lucky men who will not fracture (O), and those men who will fracture (X) without treatment for their bone health:
OOOXOOOOXOOOXOXOOXOOOOOXOOOXOOXXOOOXOOOOXOOO OXOOOOXOOOXOOOOXOOOXOXOOOXOOOOXOOOXOOOXOOOOX OOXOOOXOOOOXOOOXOOOOXOOOXOOOOXOOOXOOOOXOOOXO XOOOXOOOOXOOOXOOOOOXOOOXOOXOOOOXOOOXOOOOXOOX OOOXOOOOXOOXOOOXOOOXOOOOXOOOXOOOXOOOOOXOOXOO XOOOXOOXOOOOXOOOXOOOOXOOOOXOOOXOOOXOOXOOOXOO OXOOOXOOOXOOOXOOOXOOXOOOXOOOXOOOXOOOXOOOXOOO OOOXXOOOXOOOXOOXOOOOOXOOOOXOOXOOOOXXOOOXOOOO OXOOOXOOOOXOOOXOOOXOOOOXOOOOXOOOXOOOOXXOOOOX XOOOXOOXOOOXOOOOXOOOXOOOOXOOOXOOOXOOOXOOOXOO OXOOOXOOOXOOOXOOOXOOOXOOOXOOOOXOOOXOXOOOOOOX OOXOOOXOOOXOXOOOXOOOXOOOXOOOXOOOXOOOXOOOXOOO OXOOOXOOOXOOOXOOOXOOXOOXOOOOXOOOOOXOOOXOOOXO OOXOOOOXOOOXOOOXOOOXOOXOOOXOOOXOXOOOXOOOXOOO XOOOXOOOXOOOXOOOOXOOOXOOOXOOOXOOOXOOOXOOOOOX OOOXOOOXOOOXOOOXOOOXOOOXOOOXOOOXOOOXOOOXOOXO OXOOXOOOOXOOOXOOOXOOOXOOOXOOOXOOOXOOOOXOOOOX OOOXOOOOXOOXOOXOOOXOOOOXOOOXOOOOXOOOXOOOOXOO XOOOOXOOOXOOOXOOOXOOOXOOOXOOOXOOOOOXOOOXOOOX XOOOOOXOOOOXOOOXXOOOXOOXOOOXOOOXOOOOOXOOOXOO OXOOXOOOOXOOOOXOOOXOOXOOOOXOOOXOOOXOOOXXOOOO OOXOOOXOOOXOOOXOOOOXOOOXOOOOXOOOXOOOXOOOXOXO XOOOOXOOOXOOOXOOOXOOOOXOOOOXOOOOOXOXOOOXOOOO OOXXOOOXOOOXOOOOOXOOOXOOOXOOXOOOXOOOOOXOOOOX XOOOOXOOXOOOXOOOOOOX
Fractures are not fun! This could be You. We can prevent over 2/3 of those fractures with treatment. Get a Complete Bone Health Evaluation to know your Fracture Risk.
Then Take Action to Prevent Fractures!
Jay Ginther, MD