On August 5, 2010, I posted “My Daily Supplements,” a list of the many supplements I take. You can access it at http://strontiumforbones.blogspot.com/search?updated-max=2010-08-21T15%3A28%3A00-04%3A00&max-results=6. Here are the three supplements I take specifically for osteoporosis and to which I attribute my significant gain in bone mineral density. The multivitamin is for general health, but, with 1000 IU vitamin D3, 200 mg calcium, 100 mg magnesium and 80 mcg vitamin K, it is an important part of my bone-building strategy. This list may help you get started on your own supplement program.
Because each one of us is unique, each will have to individually tailor his/her own program. Some people, for example, will need much more vitamin D3 than the 1000 IU I take. If your blood calcium level is low and/or your 25-hyroxy vitamin D test is low, and/or you live in a northern climate or an area of high smog density where your sun exposure is limited, you may have to take much higher vitamin D dosages. Corticosteroids, diuretics, anticonvulsants, and some heartburn medications may interfere with vitamin D. If you take any of these medicines, you may need to increase your vitamin D intake. I spend considerable time outdoors in a southern climate and my blood calcium levels tend to run high normal; therefore, 1000 IU vitamin D3 is plenty for me.
Doctor’s Best Strontium Bone Maker, 1944 mg strontium citrate, 680 mg elemental strontium in two capsules. I buy this at www.iherb.com.
Nature Made Multi For Her 50+ (contains 22 key nutrients, including 1000 IU vitamin D3, 200 mg calcium, 100 mg magnesium, 80 mcg vitamin K, 2500 IU vitamin A with 60% as beta carotene, 25 mcg vitamin B12, 180 mg vitamin C, 60 IU vitamin E, 15 mg zinc, 70 mcg selenium). I buy this at www.walgreens.com when they have two-for-one specials. Walgreens drugstores have the same specials.
Kal Extra-Strength Calcium Magnesium (I take one tablet, which contains 500 mg calcium and 250 mg magnesium.) The multivitamin listed above contains 200 mg calcium and 100 mg magnesium. I get approximately 500 mg calcium from food to total the 1200 mg recommended for a woman over 50 years old. I do eat dairy products. I am currently buying this supplement at www.vitaminshoppe.com.
Skeleton Pirate
Artist: LindaB
Friday, September 30, 2011
Tuesday, September 27, 2011
New BONIVA Advertisement Features Correction
Have you seen the latest BONIVA ad? Apparently, the Food and Drug Administration (FDA) has forced Roche Therapeutics Inc. to recant a previous unsubstantiated claim about their product, which contains ibandronate sodium, a bisphosphonate. I saw this ad in the September 25, 2011, Parade magazine, which is included with my Sunday newspaper. The title and first two paragraphs of the advertisement concern the correction:
“An important correction from BONIVA for women with postmenopausal osteoporosis”
“You may have seen an ad about BONIVA for the treatment and prevention of postmenopausal osteoporosis that may have given you the wrong impression. Our ads stated that ‘After one year on BONIVA, 9 out of 10 women stopped and reversed their bone loss.’ The FDA has found that there is not enough evidence to support this statement and wants us to clear up any misunderstanding you may have had about these ads and make sure you have the correct information about BONIVA.”
“BONIVA has not been proven to stop and reverse bone loss in 9 out of 10 women and is not a cure for postmenopausal osteoporosis. BONIVA has been shown to help increase bone mass and help reduce the chance of having a spinal fracture (break). We encourage all patients to discuss their treatment with their healthcare provider. Only your doctor can determine if BONIVA is right for you.”
“An important correction from BONIVA for women with postmenopausal osteoporosis”
“You may have seen an ad about BONIVA for the treatment and prevention of postmenopausal osteoporosis that may have given you the wrong impression. Our ads stated that ‘After one year on BONIVA, 9 out of 10 women stopped and reversed their bone loss.’ The FDA has found that there is not enough evidence to support this statement and wants us to clear up any misunderstanding you may have had about these ads and make sure you have the correct information about BONIVA.”
“BONIVA has not been proven to stop and reverse bone loss in 9 out of 10 women and is not a cure for postmenopausal osteoporosis. BONIVA has been shown to help increase bone mass and help reduce the chance of having a spinal fracture (break). We encourage all patients to discuss their treatment with their healthcare provider. Only your doctor can determine if BONIVA is right for you.”
Tuesday, September 13, 2011
Antiresorptive, Anabolic, And Dual-Action Osteoporosis Drugs
Osteoporosis drugs can be divided into three categories: antiresorptive drugs that slow bone breakdown (resorption), anabolic drugs that build new bone, and dual-action drugs that both slow bone resorption and build new bone. Most approved osteoporosis drugs are antiresorptive. These slow bone loss and help fill in the remodeling spaces. All antiresorptive agents reduce the risk of vertebral (spinal) fractures and reduce markers of bone turnover. These markers are substances in the blood and urine that reflect the activity of the bone cells involved in breakdown and formation.
Antiresorptive medications include bisphosphonates, selective estrogen receptor modulators (SERMs), hormone replacement therapy (HRT), and calcitonin. Bisphosphonates include alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva), and zoledronic acid (Reclast). The only approved SERM is raloxifene (Evista). HRT includes several agents: Premarin, Prempro, Estrace, Estraderm, and Climara. Calcitonin is a polypeptide hormone secreted by the parafollicular cells of the thyroid gland in mammals and by the ultimobranchial gland of birds and fish. Miacalcin® (calcitonin-salmon) Nasal Spray is a synthetic polypeptide of 32 amino acids in the same linear sequence that is found in calcitonin of salmon origin. Miacalcin is also available as an injection.
The newest drug in the antiresorptive category is denosumab (Prolia), an injection administered subcutaneously once every six months. Prolia binds to RANKL, a transmembrane or soluble protein essential for the formation, function, and survival of osteoclasts, the cells responsible for bone resorption. Prolia prevents RANKL from activating its receptor, RANK, on the surface of osteoclasts and their precursors. Prevention of the RANKL/RANK interaction inhibits osteoclast formation, function, and survival, thereby decreasing bone resorption and increasing bone mass and strength in both cortical and trabecular bone.
In clinical trials in women with postmenopausal osteoporosis, treatment with Prolia resulted in significant suppression of bone remodeling as evidenced by markers of bone turnover and bone histomorphometry. The significance of these findings and the effect of long-term treatment with Prolia are unknown. The long-term consequences of the degree of suppression of bone remodeling observed with Prolia may contribute to adverse outcomes such as osteonecrosis of the jaw, atypical fractures, and delayed fracture healing.
Antiresorptives do not build bone beyond what is produced to help fill the remodeling spaces. Bone-building (anabolic) drugs, on the other hand, stimulate bone formation by increasing the activity of the cells known as osteoblasts. The only such medication approved in the U.S.A. for treating osteoporosis is teriparatide (Forteo), a form of human parathyroid hormone (PTH). The drug comes as a daily injection, which can be self-administered. PTH produces larger increases in BMD than antiresorptives do. It also improves bone microarchitecture. However, it is prescribed for no more than about two years because its long-term safety and efficacy are unknown. Most experts recommend that antiresorptive drugs be stopped during PTH therapy and restarted after the course of PTH is complete.
Strontium ranelate is a compound that incorporates the element strontium, which is found in trace amounts throughout the skeleton. Results from Phase III trials conducted by French researchers suggest that strontium ranelate may reduce vertebral fractures about as well as bisphosphonates. The drug is believed to work by decreasing bone breakdown and increasing bone buildup. This prescription drug is not available in the U.S.A., but strontium citrate can be purchased as a supplement.
My opinion is that the antiresorptive drugs are flawed models as osteoporosis drugs. If we keep slowing bone breakdown without building new bone, we eventually end up with very old, weak bones. Long-term suppression of bone remodeling by Fosamax and other bisphosphonates has led to osteonecrosis of the jaw and atypical femur fractures in some patients. Better models are bone-building (anabolic) drugs (i.e. Forteo) and dual-action agents (i.e. strontium ranelate, strontium citrate) that decrease bone breakdown and increase bone buildup.
http://www.health.harvard.edu/newsweek/Update_on_osteoporosis_drugs.htm
http://www.rxlist.com/miacalcin-drug.htm
http://www.rxlist.com/prolia-drug.htm
Antiresorptive medications include bisphosphonates, selective estrogen receptor modulators (SERMs), hormone replacement therapy (HRT), and calcitonin. Bisphosphonates include alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva), and zoledronic acid (Reclast). The only approved SERM is raloxifene (Evista). HRT includes several agents: Premarin, Prempro, Estrace, Estraderm, and Climara. Calcitonin is a polypeptide hormone secreted by the parafollicular cells of the thyroid gland in mammals and by the ultimobranchial gland of birds and fish. Miacalcin® (calcitonin-salmon) Nasal Spray is a synthetic polypeptide of 32 amino acids in the same linear sequence that is found in calcitonin of salmon origin. Miacalcin is also available as an injection.
The newest drug in the antiresorptive category is denosumab (Prolia), an injection administered subcutaneously once every six months. Prolia binds to RANKL, a transmembrane or soluble protein essential for the formation, function, and survival of osteoclasts, the cells responsible for bone resorption. Prolia prevents RANKL from activating its receptor, RANK, on the surface of osteoclasts and their precursors. Prevention of the RANKL/RANK interaction inhibits osteoclast formation, function, and survival, thereby decreasing bone resorption and increasing bone mass and strength in both cortical and trabecular bone.
In clinical trials in women with postmenopausal osteoporosis, treatment with Prolia resulted in significant suppression of bone remodeling as evidenced by markers of bone turnover and bone histomorphometry. The significance of these findings and the effect of long-term treatment with Prolia are unknown. The long-term consequences of the degree of suppression of bone remodeling observed with Prolia may contribute to adverse outcomes such as osteonecrosis of the jaw, atypical fractures, and delayed fracture healing.
Antiresorptives do not build bone beyond what is produced to help fill the remodeling spaces. Bone-building (anabolic) drugs, on the other hand, stimulate bone formation by increasing the activity of the cells known as osteoblasts. The only such medication approved in the U.S.A. for treating osteoporosis is teriparatide (Forteo), a form of human parathyroid hormone (PTH). The drug comes as a daily injection, which can be self-administered. PTH produces larger increases in BMD than antiresorptives do. It also improves bone microarchitecture. However, it is prescribed for no more than about two years because its long-term safety and efficacy are unknown. Most experts recommend that antiresorptive drugs be stopped during PTH therapy and restarted after the course of PTH is complete.
Strontium ranelate is a compound that incorporates the element strontium, which is found in trace amounts throughout the skeleton. Results from Phase III trials conducted by French researchers suggest that strontium ranelate may reduce vertebral fractures about as well as bisphosphonates. The drug is believed to work by decreasing bone breakdown and increasing bone buildup. This prescription drug is not available in the U.S.A., but strontium citrate can be purchased as a supplement.
My opinion is that the antiresorptive drugs are flawed models as osteoporosis drugs. If we keep slowing bone breakdown without building new bone, we eventually end up with very old, weak bones. Long-term suppression of bone remodeling by Fosamax and other bisphosphonates has led to osteonecrosis of the jaw and atypical femur fractures in some patients. Better models are bone-building (anabolic) drugs (i.e. Forteo) and dual-action agents (i.e. strontium ranelate, strontium citrate) that decrease bone breakdown and increase bone buildup.
http://www.health.harvard.edu/newsweek/Update_on_osteoporosis_drugs.htm
http://www.rxlist.com/miacalcin-drug.htm
http://www.rxlist.com/prolia-drug.htm
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Wandering Skeleton
Artist: Joel Hoekstra
Osteoporotic Bone
Source: www.mayoclinic.com