I thought I had the osteoporosis issue under-control: - Take Alendronate (generic version of Fosamax)
- Take calcium tablets to get calcium intake up to 1200 mg every day
- Take Vitamin D to get up to 800 IU's every day
then in a year's time go back to my doctor and find out if bone mineral density in the spine is heading back to where it should be.
What's the problem:
- Should it be Alendronate or Boniva or Reclast ? The gastroeneterologist who's prescribing Omeprazole to deal with my acid reflux issues thinks the prescription should be Reclast or at least Boniva. If it stays at Alendrate then he says to double up on Omeprazole on the one day a week I take Alendrate. Issues still on-going.
- Is 1200 mg a day of calcium enough ? Professor Heaney at Creighton University thinks that 2400 mg a day of calcium is the better amount for anyone who has been low on calcium (possibly my issue).
- Is 800 IU's of Vitamin D enough or should I be aiming for 1000 IU's ?
Professor Heaney wrote a long paper on Calcium, Dairy Products and Osteoporosis that went through the evidence that low calcium is a big part of osteoporosis. For him, the answer is to get calcium intake up high - no thoughts about drug treatment. Medscape interviewed Prof Heaney about calcium and osteoporosis - this is a transcript.
A snippet from the interview:
Medscape: Is there an amount of calcium that would be considered excessive? For example, if someone were already taking a supplement several times per day for osteoporosis prevention (ie, 1500 mg), could they also add 3 servings of dairy products without getting too much calcium?
Dr. Heaney: That quantity of calcium you have just described would not be too much. The published upper intact limit established for calcium is 2500 mg. And although it is not explicitly stated, I can tell you (because I have served on the committee that developed the recommendation) this amount applies only to supplements and not to food. There has never been a documented instance of calcium poisoning from food.
Prof Heaney also throws in that Calcium phosphate is a better supplement than the Calcium citrate I've been taking ? Something else to think about.
Prof Healey explains the role of the Parthyroid in controlling the build up and breakdown of bones.
The total quantity of skeletal remodeling is regulated by circulating levels of parathyroid hormone (
PTH), which operates mainly by controlling the activation threshold for new remodeling loci. PTH is secreted in response to both systemic, i.e., nonskeletal, calcium demand and to the demands to mineralize bone undergoing the formation phase of the remodeling cycle. PTH secretion is reduced to low levels on high calcium intakes and rises to high levels on low intakes. As a direct consequence, the quantity of bone being remodeled at any given time is an inverse function of effective calcium intake. Thus, whenever calcium intake is raised experimentally in a group of adults, bone remodeling falls, first resorption, then, later, formation, as well. That response is an inescapable consequence of the way the system is controlled and does not necessarily have nutritional significance, particularly since it will happen even at calcium intakes well above the nutritional requirement.
Labels: osteoporosis; calcium; parathyroid hormone; alendronate; boniva; reclast;
0 Comments:
Post a Comment
Subscribe to Post Comments [Atom]
<< Home