Dr. Bray Links

Wednesday, September 24, 2014

Osteoporosis prevention starts much earlier than most think

"ABSTRACT: Osteoporosis is a preventable, potentially crippling disease characterized by low bone density and increased bone fragility that affects millions of people. The seeds of this pernicious disease are sown during adolescence, when the skeleton is most active in absorbing dietary calcium and building up nearly all the bone mass that will carry the teenager throughout life. Dietary intake of calcium, vitamin D and vitamin K, particularly vitamin K2, is critical during this life stage for optimal bone growth; unfortunately, the majority of adolescents in the USA do not consume adequate amounts. In addition, many adolescents are now using oral contraceptives or intrauterine devices that prevent ovulation, thus inhibiting formation of progesterone required for the development of osteoblasts. Oral contraceptives also lower blood levels of vitamins B6 and B12, both of which are necessary to prevent elevated levels of homocysteine, whose impact on bone can be significant. In addition to "the pill," many commonly prescribed medications disrupt normal bone remodeling and promote osteoporosis. Other remediable factors that cause excessive bone loss include insufficiencies of key nutrients, such as vitamin D3, vitamin K2, and calcium, required for healthy bone remodeling. It is important to recognize key risk factors and manage those that can be modified to prevent disease and/or minimize risk of fracture. This article presents an overview of osteoporosis, pathophysiology of disease, diagnostic tests, risk factors, and clinical recommendations for healthy bones."
Many commonly prescribed medications disrupt normal bone remodeling and promote osteoporosis. These include benzodiazepines used to manage epilepsy, anxiety, insomnia, depression, schizophrenia, and restless leg syndrome; selective serotonin reuptake inhibitors and atypical antipsychotics used to manage anxiety and depression; thiazolidinediones prescribed to manage type 2 diabetes; opioids (e.g., morphine, codeine, hydrocodone, oxycodone, methadone, tramadol) used to manage chronic pain; glucocorticoids (e.g., prednisone, prednisolone, kenalog, dexamethasone) used to manage allergies, asthma and autoimmune diseases; and antacids, histamine H2-receptor blockers, proton-pump inhibitors used to manage indigestion and gastroesophageal reflux disease (GERD)."

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