Alternate therapies to prevent bone loss:
Ipriflavone, a synthetic isoflavone. Equol is a bacterial metabolite of soy phytoestrogen.
Its formation totally dependent on intestinal microflora.
Isoflavone rich soy milk inc spinal bone mass in the 45% of the subjects who are equol producers.
Statins: Can be used but no proven results.
Thiazides: Reduce the urinary loss of calcium. Estrogen and thiazides are additive.
Growth hormone: Stimulates bone remodeling but does not produce a significant inc in bone density.
Lifestyle modifications:
Physical activity (weight bearing) as little as 30 minutes a day for 3 days a week inc mineral content in bone. Weight better for spine, running helps hip bone mass.
Walking improves cardiovascular status and reduce body mass.
Exercise imp balance and dec the risk of falling.
Women require the full combination of pharmacological therapy, calcium, vit D supplementation and exercise in order to minimize fracture risk.
For each of this beneficial effect lasts only as long as the therapy is continued.
Cigarette smoking and excessive alcohol consumption are ass with inc risk of osteoporosis.
Smokers need higher estrogen levels to maintain bone density.
A high coffee intake has been reported to ass with inc risk of osteoporosis.
If adequate milk (300 mg cal) taken risk can be decreased. Interventions that reduce the odds of falling and enhancing the ability to withstand the impact of falling are important.
In women, whom demonstrated to be losing bone despite hormone therapy, the following steps are recommended:
-Check compliance and dose by measuring estrogen levels.
-Rule out other causes of bone loss: E.g. eating disorders,
Drugs: heparin, anticonvulsants, high intake of alcohol.
Chronic disease: renal and hepatic. Endocrine diseases. Nutritional def. Add a bisphosphonate if poor response continues despite maintenance of blood estradiol levels in the range of 50 to 100 pg/ml.
Follow with markers of bone turnover or bone density measurements.
Menopause to be taken as signal to start something positive, a good health program.
Postmenopausal hormone therapy to be taken as a legitimate part of preventive health program.
Changes of bone remodeling
Pathophysiology
Signs and symptoms
Risk factors and investigations
Investigations
Diagnostic tests and biochemical markers
Hormonal treatment
Estrogen modulators, calcium
Vitamin D
Bisphosphonates
Calcitonin, Fluoride, Tibolone
Prevention
Ipriflavone, a synthetic isoflavone. Equol is a bacterial metabolite of soy phytoestrogen.
Its formation totally dependent on intestinal microflora.
Isoflavone rich soy milk inc spinal bone mass in the 45% of the subjects who are equol producers.
Statins: Can be used but no proven results.
Thiazides: Reduce the urinary loss of calcium. Estrogen and thiazides are additive.
Growth hormone: Stimulates bone remodeling but does not produce a significant inc in bone density.
Lifestyle modifications:
Physical activity (weight bearing) as little as 30 minutes a day for 3 days a week inc mineral content in bone. Weight better for spine, running helps hip bone mass.
Walking improves cardiovascular status and reduce body mass.
Exercise imp balance and dec the risk of falling.
Women require the full combination of pharmacological therapy, calcium, vit D supplementation and exercise in order to minimize fracture risk.
For each of this beneficial effect lasts only as long as the therapy is continued.
Cigarette smoking and excessive alcohol consumption are ass with inc risk of osteoporosis.
Smokers need higher estrogen levels to maintain bone density.
A high coffee intake has been reported to ass with inc risk of osteoporosis.
If adequate milk (300 mg cal) taken risk can be decreased. Interventions that reduce the odds of falling and enhancing the ability to withstand the impact of falling are important.
In women, whom demonstrated to be losing bone despite hormone therapy, the following steps are recommended:
-Check compliance and dose by measuring estrogen levels.
-Rule out other causes of bone loss: E.g. eating disorders,
Drugs: heparin, anticonvulsants, high intake of alcohol.
Chronic disease: renal and hepatic. Endocrine diseases. Nutritional def. Add a bisphosphonate if poor response continues despite maintenance of blood estradiol levels in the range of 50 to 100 pg/ml.
Follow with markers of bone turnover or bone density measurements.
Menopause to be taken as signal to start something positive, a good health program.
Postmenopausal hormone therapy to be taken as a legitimate part of preventive health program.
Changes of bone remodeling
Pathophysiology
Signs and symptoms
Risk factors and investigations
Investigations
Diagnostic tests and biochemical markers
Hormonal treatment
Estrogen modulators, calcium
Vitamin D
Bisphosphonates
Calcitonin, Fluoride, Tibolone
Prevention
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