Osteoporosis Fracture Risk Assessment Tool

[angy]

Gloria thats an interesting article thanks for that..

Bifcus...funny u mention tumeric cos ive been reading about that concerning ibd and the trials there has been with that. Apparently they are pretty positive ....I love tumeric on my stir frys...guess im going to use it more...

[Gloria]

The doctor's office called with the results from my bone density test. Here is the progression of my osteoporosis:

Left Hip T-scores
Nov 1998: - 0.87 (baseline) fracture risk is very low
Sep 2006: - 2.1 (decrease in density of 18.5%) fracture risk is moderate
Feb 2009: -2.1

Lumber Spine T-scores
Nov 1998: -1.84 (baseline) fracture risk is low to moderate
Sep 2006: -2.6 (decrease in density of 8.7%) fracture risk is high
Feb 2009: -2.8

I only have the numbers from the nurse, but I can draw conclusions from them. My risk for spinal fractures has gotten even higher. The first thing out of the nurse's mouth after telling me my scores was "The doctor wants you to go on Fosamax." To which I responded that I first wanted to compare the scores with previous years.

I've made an appointment in two weeks with a doctor from the Illinois Bone and Joint Institute. He's board certified in Internal Medicine and Rheumatology and specializes in osteoarthritis, osteoporosis and rheumatoid arthritis. He's also overseen many trial studies of medications, which could be a good thing and/or a bad thing. I'm hoping he will be up on the latest treatment. I've found conflicting reports about Fosamax.

I found this on the website of:
Susan Ott, MD, Associate Professor
Department of Medicine
University of Washington
http://courses.washington.edu/bonephys/

Bisphosphonates have been approved by the FDA for prevention of osteoporosis, and they are widely used in women younger than 65. However, I am reluctant to use them in young or low-risk women, and reserve these drugs for those with established osteoporosis or those with osteoporosis taking prednisone. I have a more conservative view about long-term safety issues than many other physicians, perhaps because I have a physiological perspective. Bone biopsies from patients taking bisphosphonates show 95% reduction in the bone formation rate, so I usually stop after 5 years of treatment.

The bisphosphonates get deposited in the bone and will accumulate for years. It is possible that many years of continuous medicine would make bone more brittle or impair the ability to repair damage. Bisphosphonates do reduce fractures and improve measurements of bone strength for the first five years in both animal studies and in women who have osteoporosis. After 5 years, the fracture rates are as high in the women who keep taking alendronate as in the women who quit.

But the National Osteoporosis Foundation posts this on their website:

Bisphosphonates, calcitonin, estrogen and estrogen agonists/antagonists are antiresorptive medications. They slow the bone loss that occurs in the breakdown part of the remodeling cycle. When people first start taking these medications, they stop losing bone as quickly as before, but still make new bone at a normal pace. Therefore, bone density may increase. The goal of treatment with antiresorptive medications is to prevent bone loss and lower the risk of breaking bones.

(Brand name Fosamax® and Fosamax Plus D™)

Alendronate is approved for the prevention and treatment of osteoporosis in postmenopausal women and for treatment of osteoporosis in men. It also is approved for the treatment of glucocorticoid-induced osteoporosis in men and women as a result of long-term use of steroid medications (examples are prednisone and cortisone). Alendronate reduces bone loss, increases bone density and reduces the risk of spine, hip and other fractures by about 50 percent over two to four years.

Past Experience and Studies

Past experience with bisphosphonates (Actonel®, Boniva® and Fosamax®) suggests that upon discontinuation of any of these drugs, the benefits may continue for several years or longer. This is because the drugs remain in the bone for a long time. Eventually, however, the beneficial effect begins to lessen, bone remodeling rates increase and bone loss may occur.

One study found that alendronate (Fosamax®) continued to have a beneficial effect on bone mineral density for up to 10 years in postmenopausal women taking the medication. Biopsies of bone tissue in women on alendronate for 10 years show that bone tissue looks healthy and normal. Other studies show that treating with alendronate for more than five years improves bone strength and reduces clinical fractures of the spine.

I've underlined what appear to be inconsistencies between the two reports. I viewed a video on the Internet of Dr. Ott presenting to a group of other doctors, so I'm assuming she's well-respected. But the National Osteoporosis Foundation must also be well-respected. After reading both sites, I decided to contact a doctor in the field.

Gloria

[Lucy]

Hi all,
I only found mention of one study, and that was on "IBS" not M.C. The article said it needed more studies to confirm, but that this particular study showed no statistically significant difference between the control group and the I.B.S. group. Since we tend to think that IBS'ers are really M.C.'rs around here, that doesn't look to promising, based on that one study, does it? We can only hope!
Still, there sure are alot of other things we might be able to prevent by upping our non-prescription amounts of tumeric in our diets. How much, it would be difficult to say. That would take a professional opinion, but if we were to take no more than the average person in India...it doesn't seem to do them any harm, and for millinea, it's seemed to do their bodies good! (Can't believe I said that! Ha!).
Interesting reading! Thanks!
Yours, Luce

[Bifcus16]

Hi Angy,

The catch with curcumin is you need a lot for it to have much effect.

Somewhere I read the minimum amount to be measurable in vivo is 4grams a day (yes grams). The studies suggested less than that is unlikely to have a significant effect. Many of those who are taking it for myeloma are going for 8g day, based on research done at MD Anderson. With your average curcumin tablet being 500mg, that is 16 tablets a day.

My naturopath dropped me a note just this week to say she has found a new source for me - Nalgesic Forte - it is 2400mg per tablet. Since I am currently on 4g a day that means dropping from 8 tablets to just 2!! Still not cheap though. Bioavailability is a big issue, but apparently this brand has some special technique to improve this. Hopefully I'll find out more when I get to pick it up.

As for taking just the spice turmeric, you aren't going to get to a therapeutic dose easily. Turmeric has 5-8% curcumin. So to get to the minimum amount you would need 50g of turmeric, which is going to taste very strong. I guess you could candy it like ginger, since it is very closely related and looks similar.

Of course, there is no proof that small amounts won't do some good. It's just that we know from other products, like entocort, that doses do matter. I guess using a spice that has good properties beats by a long way using something we know has issues, like msg.

Lyn

[angy]

thanks for explaining the dose amounts there lyn...guess were talking about a sack of tumeric a day lol!!

ill still eat it in my stir frys though...good luck with the Nalgesic Forte..