Osteoporosis, testing and prevention
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Your dentist may soon have another job to do – testing you for osteoporosis in addition to looking for cavities! Some British researchers have a developed a method for detecting bone thinning in the lower jaw with x-rays. Currently people who are high risk are checked for osteoporosis with a test called a dual energy X-ray absorptiometry (DXA). It is expensive and insurance coverage for it could be better. As an alternative these researchers have showed that software that can analyze dental X-rays may do just as well. They examined both the dental x-rays and DXA scans of over 600 women and found that the x-rays were able to detect osteoporosis in over half of the women with it. This research was in the journal Bone in December.
Of course preventing the development of osteoporosis altogether would be preferable to most people. But that may be more difficult to do if you also have acid reflux problems. New research in the Journal of the American Medical Association has evidence that use of some medications for acid reflux is associated with a greater chance of hip fractures possibly due to the drugs inhibiting the absorption of calcium. This study at the University of Pennsylvania School of Medicine examined data from close to 150,000 people. Those who were taking proton pump inhibitors had a 44% higher chance of a hip fracture than those that weren’t. The risk was increased for those taking a higher dose and taking it for a longer period of time. So what do you do if you are high risk for osteoporosis and have bad acid reflux problems? I don’t know – I wish I did because I am high risk and can’t go without my Nexium without getting really sick.
At least there is some good news for those who want to increase their calcium intake and are concerned about weight gain. A report in the American Journal of Clinical Nutrition has published research showing that adults who consume whole dairy products tend to gain less weight over time than people who don’t. Then again this another one of those correlational studies that really don’t prove anything. All the women in the study were of normal weight to start with and other research has not shown any connection. So once again – be careful when listening to short health stories on the news or in magazines – they often don’t tell the whole story.
Another thing to be careful of is who is funding the research. Or who is influencing it. The FDA is considering letting food products with calcium and vitamin D state on their labels that they may help reduce the risk of osteoporosis. Orange juice companies who sell juice with calcium added have a lot to benefit from a label like this. Not that getting calcium from orange juice is bad but that alone is unlikely to prevent osteoporosis. Doesn’t do a lot of good for those of us with acid reflux problems either!
If you do get osteoporosis despite taking all precautions to prevent it – another study in the Journal of the American Medical Association shows that a break from some osteoporosis drugs might be ok. It seems the drugs provide protection for some time after taking them.
But better yet – now that you are almost done reading this – get up and walk around or run up and down some stairs for a few minutes! Then drink a glass of milk. Or eat some cheese. Weight bearing exercise and regular calcium intake is still probably the best way to keep your bones healthy.
(Technorati Tags: osteoporosis, calcium, bones, acid reflux, health, exercise)
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2 Responses to 'Osteoporosis, testing and prevention'
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on June 18th, 2007 at 8:19 am
Bisphosphonate drugs for Osteoporosis, like Fosamax and Actonel, are taken up by osteoclasts with resulting loss of osteoclast activity and inhibition of bone resorption, and bone remodeling.
Although DEXA scanning confirms increased bone density and studies such as the FIT suggest reduced fracture rate, Susan Ott, MD raises questions about the long term safety of bisphosphonates. Although the bisphosphonates appear to have short term benefits, she speculates that after 5 years of use, there is severe suppression of bone formation with negative effects such as microdamage and brittleness.
Spontaneous Fractures of the Mid-Femur
Jennifer P. Schneider, MD, PhD reports a 59-year old previously healthy woman on long-term alendronate. While on a subway train in New York City one morning, the train jolted, and the woman shifted all her weight to one leg, felt a bone snap, and fell to the floor, suffering a spontaneous mid -femur fracture. This is not an isolated report.
Avacular Necrosis of the Jaw
Dimitrakopoulos reports on 11 patients presenting with necrosis of the jaw, claiming this to be a new complication of bisphosphonate therapy administration, i.e. osteonecrosis of jaws. He advised clinicians to reconsider the merits of the rampant use of bisphosphonates. Osteonecrosis of the jaw is a common finding in pycnodysostosis. The bisphosphonates recreate the same clinical profile of spontaneous mid femur fractures, failure of bone healing and jaw necrosis which tormented the famous French artist, Toulouse Lautrec.
The bottom line is that bishosphonate drugs are creating a generation of women with Toulouse Lautrc’s Diseae.
For links to references and more information see my newsletter:
http://jeffreydach.com/2007/05/14/fosamax-actonel-osteoporosis-and-toulouse-lautrec-by-jeffrey-dach-md.aspx“>Fosamax, Actonel, Osteoporosis and Toulouse Lautrec’s Disease
http://www.drdach.com/wst_page6.html
Jeffrey Dach MD
on July 28th, 2007 at 4:02 am
Using Proton Pump Inhibitors for acid reflux disease does decreases calcium absorption which can lead to Osteoporosis. However this is not the only mineral that is not absorbed into the body. By stopping the production of stomach acid, acid reflux medication also stops the ionization of other essentials like vitamin B-12, folic acid, vitamin D, iron and zinc. It is also thought that magnesium deficiency may be more involved in bone loss than calcium deficiency.
Taking Proton Pump Inhibitors long term can lead to even worse conditions than acid reflux disease.
It is hard to balance one against the other but trying to find a natural cure that suits you may be more helpful in the future.
There is also surgery as an option to rid you of acid reflux.