Posts Tagged ‘GERD’

No GERD with Reclast

July 23, 2014 @ 7:32 am
posted by Dr Ginther

Bisphosphonates are often associated with Gastro Esophageal Reflux Disease (GERD).  When GERD cannot be adequately controlled by medication, we cannot use oral bisphosphonates.  Yet there is an advantage to taking a medication which will accumulate in bone and last well beyond the last dose.  That is where Reclast shines.

Reclast (Zolendronate in osteoporosis dose) is given IV.  Intravenous (IV) means no Gastro-Intestinal issues at all.  Therefore persons with Irritable Bowel Syndrome (IBS), or Crohn’s, or Colitis can take Reclast.  The once a year dosing is convenient.  But giving a whole year of medication all at one time requires extra care.

Bisphosphonates are the most commonly prescribed Antiresorptive medications used to prevent or treat Ostoeporosis.  We know them as Fosamax (Alendronate), Boniva (Ibandronate), Actonel (Risendronate), Atelvia (enteric coated Risendronate), and IV Reclast (Zolendronate).  All but the last are pills taken weekly or monthly.

If your bone is strong enough that preserving it is sufficient to prevent fractures, then Antiresorptive medication is what you need.  If you are able to follow the protocol of taking the pill on an empty stomach, followed by one or more full glasses of plain water, and eating or drinking nothing else for at least 30 minutes (60 for Boniva) while remaining upright, Oral Bisphosphonates are the medication for you.

Secondary HyperParaThyroidism – Doing Their Job

January 20, 2014 @ 10:25 pm
posted by Dr Ginther

Secondary HyperParaThyroidism is the result of the ParaThyroid glands doing their job.  Their job is to keep the calcium in the blood “just right”.  Too often this requires stealing calcium from the bones.  This is necessary to make up for not absorbing enough calcium every day.  But stealing too much Calcium from bones can cause Fractures.

Most of us need 1200 mg calcium in 3 doses spread across every day.  Older individuals absorb less well and can require 1500 mg.  We also need high enough Vitamin D levels to absorb the calcium.  This usually means 1000 to 5000 units of Vit D3 daily.  Many of us fail to absorb enough calcium daily.  We need Secondary HyperParaThyroidism to keep our blood calcium high enough.

“I Fall All the Time, But I Don’t Break Anything”

October 27, 2013 @ 9:15 pm
posted by Dr. Ginther

Aunt Henrietta looked like half a raccoon with her entire left eye blackened.  She dismissed her looks as not a problem saying, “I fall all the time, but I don’t break anything.”  This is a change on both counts.  Five years ago, falls were infrequent.  Even so, she broke one wrist, then the other wrist, then her shoulder.

Two wrists, one shoulder, and half a dozen vertebral fragility fractures indicated Very Severe Osteoporosis.  That was before she took the Anabolic, Forteo, for 2 years.  She was the ideal patient for serious measures to stop her fractures.  And it has worked!!