Posts Tagged ‘Osteoporosis medication’
We are cancelling Iowa Bone Club for 24 April
We plan to reschedule for September, assuming that COVID-19 will have receded by then
Jay Ginther, MD
Why do some patients, who are already on good osteoporosis preventing or treating medications, still have a falling Bone Mineral Density? Are the medications not working? Not as well as they should! Why? Even the best medications cannot work without enough CALCIUM intake and absorption.
If you want to improve your bones you must ABSORB enough calcium. This can be a bit tricky. You need the right kind of calcium, taken in food or with food, and spread out over 3 meals or snacks. “Calcium” is Calcium Carbonate which requires lots of acid to dissolve. This often is a problem if you take antacids, have heartburn or GERD, have digestive issues like lactose sensitivity, celiac or IBS, or are just “too old”, which begins at 50.
Calcium in foods is easy to absorb. Calcium Citrate tablets or Tricalcium Phosphate Gummies require 2 tablets or gummies to total the 400 or 500 or 600 mg on the label. Adora Chocolates are 500 mg each. We recommend taking in 1200-1500 mg calcium daily. That means 400-500mg at each of 3 meals.
DXA does not show bones. DXA shows calcium. Calcium stiffens and strengthens bones. You cannot have good BMD or good bones without enough calcium! Take control of your bone health with adequate calcium in diet and supplements.
Next time a listing of Calcium in Foods
Jay Ginther, MD
FDA approved clinical trials are a well established way to gain access to medications not yet available to the general public. Most people have heard of individuals taking experimental treatments for cancers or HIV or Ebola on the news. But there is another type of FDA trials to which we now have access.
Osteoporosis medications are first tested and approved for postmenopausal women only. Men are 20-25% of the individuals with osteoporosis. However, approval for men takes a separate clinical trial. Therefore, often men have to wait an additional 3-5 years for access to a medication we know should work but has not yet been officially approved for men.
Participating in the clinical trial for men allows men with osteoporosis access to the new medication years earlier – and at no cost. The anabolic medication Tymlos (abaloparatide) is currrently conducting a national clinical trial for men. The intake process is detailed to be certain that only those men likely to benefit and not be harmed are included.
Cedar Valley Bone Health Institute of Iowa and North-East Iowa Medical Education Foundation are a test site for the clinical trial of Tymlos (abaloparatide) for Men. You may qualify. The qualification testing is all at no cost to the patient.
If you are close enough to Waterloo, IA to come in every 3 months for testing, contact us at 319-233-2663 (Shari) or 319-272-2539 (Kayla) to apply for the clinical trial.
For a bone health evaluation and treatment plan for men or women call 319-233-2663. If you are a man needing anabolic medication we will also proceed to evaluation for the clinical trial.
Jay Ginther, MD
We now have a third anabolic medication to build new bone. Evenity is really different from the other anabolics, Forteo (teriparatide) and Tymlos (abaloparatide). Forteo and Tymlos are daily shots based on the human hormones PTH and PTHrP. Evenity is an antibody to the human hormone sclerostin.
Sclerostin controls bone formation by telling osteoblasts to stop making new bone, and telling osteoclasts to gobble up old bone. This results in stable bone turnover remodeling (until menopause decreases control over the osteoclasts and they go wild). Evenity suppresses sclerostin.
Evenity markedly increases new bone matrix formation within the first month.However, the ability of Evenity to increase new bone formation diminishes month by month until it is mostly gone by one year. Therefore, it has been approved for use for only one year at a time. Like Forteo and Tymlos, Evenity must be followed by an antiresorptive to preserve the increase in bone.
Evenity also suppresses bone resorption by the second month. This is a less dramatic action, but it continues at the same level to the end of the year. The net result is a significant increase in bone matrix by the end of the year, in the same general order of magnitude as Forteo and Tymlos.
Evenity is a monthly shot into the subcutaneous fat on the back of both arms by a healthcare professional.
There is a possibility that Evenity may increase cardiac events in persons who have had a recent stroke or heart attack. This was found in only one of the 3 clinical trials of Evenity.
Preauthorization is required for insurance to cover Evenity. Most insurances will probably cover it within the first 3-12 months. More next time.
Jay Ginther, MD