Posts Tagged ‘Osteoblasts’
Glucocorticoid Induced OsteoPorosis is more common than we thought. Individuals with Rheumatoid arthritis, fibromyalgia, and other inflamatory diseases often need Prednisone and other steroids (glucocorticoids). 3 months of Prednisone 5 mg or more daily induces GIOP. 3-6 months of Prednisone at over 2.5 mg daily can also lead to GIOP. And both of these are total lifetime dose.
Many inhalers for asthma and COPD also contain steroids. Steroids suppress OsteoBlasts, the cells that make new bone to replace resorbed bone. A year or more of inhalers is thought to be the threshhold for ill effects.
Now we are finding out about “Cortisone” (glucocorticoid) Injections into knees and other joints.
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.
Human Estrogen is the natural means of preventing bone loss before menopause in women. The huge drop in estrogen levels during menopause leads to increased bone loss during and after menopause.
Estrogen stimulates the formation of Osteoblasts (the cells that make new bone). Estrogen lengthens the lifespan of Osteoblasts and Osteocytes (the cells that live in and maintain bone). Estrogen supresses the formation and activation of Osteoclasts (the cells that eat bone away).