Osteoporosis & Osteopenia
treatment and prevention
Osteoporosis is a disorder of abnormal bone remodeling. The condition is characterized by low bone mass and microarchitectural deterioration of bone tissue. This results in increased bone fragility and susceptibility to fracture. In normal bone, bone formation and resorption are closely meshed. When osteoporosis is present, however, the net rate of bone resorption exceeds the rate of bone formation. This results in a decrease in bone mass without an actual defect in bone mineralization. At some point during the progression of osteoporosis, the amount of bone providing mechanical support falls below a certain threshold (known as the "fracture threshold"), and the patient may sustain a fracture. The fracture threshold is different for each individual. Osteoporosis causes the loss of both cortical and trabecular bone, with trabecular bone loss predominant in typical postmenopausal osteoporosis.
CAUSAL FACTORS
Bone mass is affected by many factors, including level of physical activity (physical stress increases bone mass); weight (thin patients with low muscle mass have reduced bone mass); dietary intake of calcium, phosphorus and vitamin D; cigarette smoking, the body's acid/base balance (alkalization of the blood with bicarbonate has been shown to retard bone loss); caffeine intake, race and sex (Blacks and Hispanics have greater bone mass than Asians and Caucasians and men have higher greater mass than women).
Genetics also play an important role in the development of osteoporosis. A family history of fractures among postmenopausal women may predict future problems. (Roughly 80 percent of bone mass at any given age is determined by the patient's genetics.)
TREATMENT MODALITIES
Although osteoporosis risk fractures may be reduced through correct diet and exercise, cessation of smoking and reduction of caffeine intake, the silent nature of the disease, and the fact it is often only diagnosed once a fracture has taken place, means medication is often required to help reduce bone loss.
Click here to view osteoporosis risk factors, prevention & wellness tips for your patients.
Click here to view general wellness tips for your patients.
Medications
Osteoporosis medications have one goal: to restore this delicate balance through inhibiting the activity of osteoclast cells.
Hormone Replacement Therapy
Physicians have traditionally prescribed HRT as a means of reducing osteoporosis risk in postmenopausal patients. While the results of cohort studies suggest that estrogen substitution over a period of at least five years can diminish the risk of spine, forearm or hip fractures, there are no prospective placebo-controlled studies to confirm this. HRT is effective as long as it is maintained, but bone loss resumes upon discontinuance of treatment.
Undesirable side effects of HRT include return of menstrual flow, breast tenderness, mood swings, bloating, migraine headaches, gallstones and an increased of breast and/or endometrial cancer in those who have a family history of these diseases. Deep vein thrombosis (DVT) is a potential side effect particularly in those with a history of abnormal blood clotting.
Biphosphonates
These drugs inhibit the activity of osteoclast cells and so prevent bone breakdown. They are often prescribed to patients for whom HRT is contraindicated. Bisphosphonates can also be useful in treating osteoporosis that has resulted from steroid use. The most commonly prescribed bisphosphonates are risedronate and etidronate. Side effects are uncommon and may include abdominal or musculoskeletal pain, nausea, heartburn, or irritation of the esophagus.
Calcitonin
Calcitonin has an antiresorptive effect, preventing further bone loss and is a centrally acting analgesic. Calcitonin is available for subcutaneous and intranasal administration. It is particularly beneficial in postmenopausal women with substantial bone loss. Calcitonin is an alternative treatment option for patients who do not tolerate other therapies.
Injectable calcitonin may cause an allergic reaction and unpleasant side effects including flushing of the face and hands, urinary frequency, nausea, vomiting and skin rash. The side effects reported with the nasal spray are runny nose, nosebleed, bone pain and headaches.
SERMs
SERMs or special estrogen receptor modulators, help increase bone mass by slowing down the rate at which osteoclasts break down bone. While studies show that SERMs reduce the risk of spine fractures, it is not yet known if this class of drugs can reduce the risk of hip and other fractures. As with all SERMs, the commonly prescribed raloxifene can only be taken after menopause. Raloxifene does not have any stimulating effect on the post-menopausal endometrium and hence does not induce endometrial hyperplasia. Side effects may include spotting, hot flashes, sinusitis, weight gain, muscle pain, leg cramps and ankle swelling. These drugs are contraindicated in patients with recent venous thromboembolic events or a history of thromboembolism.
Nutricol®
Available as the OTC supplement Recovery® in many pharmacies, Nutricol® is proposed to prevent breakdown of the body's cells and tissues by stabilizing their structures.
Recovery® contains the active ingredient Nutricol®, a disease modifying anti-catabolic agent (DMAC), which Biomedica Laboratories is proud to introduce to health care professionals.
Biomedica Laboratories, Inc., also believes that this proprietary blending of plant nutrients naturally increases the cells' receptivity to hormones such as insulin which are required to speed the repair of tissues.
Biostructural® Medicine goes beyond simply addressing symptoms and focuses on the degenerative process and optimal healing.
Nutricol® (Recovery®) may be safely combined with other medications or taken on its own to help counter inflammation and improve the quality and rate of healing.
Information for Doctors: Print an 6-page detailed information package that provides the following:
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Click here to view feedback from health professionals and users about the results noted from Recovery® with Nutricol®.