Which Osteoporosis Medication, If Any, Is Right For You?

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Which Osteoporosis Medication, If Any, Is Right For You?

We’ve written about osteoporosis before, so here’s a quick recap first in case you missed these:

All of those look and diet and/or exercise, with “diet” including supplementation. But what of medications?

So many choices (not all of them right for everyone)

The UK’s Royal Osteoporosis Society says of the very many osteoporosis meds available:

❝In terms of effectiveness, they all reduce your risk of broken bones by roughly the same amount.

Which treatment is right for you will depend on a number of things.❞

…before then going on to list a pageful of things it will depend on, and giving no specific information about what prescriptions or proscriptions may be made based on those factors.

Source: Royal Osteoporosis Society | Which medication should I take?

We’ll try to do better than that here, though we have less space. So let’s get down to it…

First line drug offerings

After diet/supplementation and (if applicable) hormones, the first line of actual drug offerings are generally biphosphates.

Biphosphates work by slowing down your osteoclasts—the cells that break down your bones. They may sound like terrible things to have in the body at all, but remember, your body is always rebuilding itself and destruction is a necessary act to facilitate creation. However, sometimes things can get out of balance, and biphosphates help tip things back into balance.

Common biphosphates include Alendronate/Fosamax, Risedronate/Actonel, Ibandronate/Boniva, and Zolendronic acid/Reclast.

A common downside is that they aren’t absorbed well by the stomach (despite being mostly oral administration, though IV versions exist too) and can cause heartburn / general stomach upset.

An uncommon downside is that messing with the body’s ability to break down bones can cause bones to be rebuilt-in-place slightly incorrectly, which can—paradoxically—cause fractures. But that’s rare and is more common if the drugs are taken in much higher doses (as for bone cancer rather than osteoporosis).

Bone-builders

If you already have low bone density (so you’re fighting to rebuild your bones, not just slow deterioration), then you may need more of a boost.

Bone-building medications include Teriparatide/Forteo, Abaloparatide/Tymlos, and Romosozumab/Evenity.

These are usually given by injection, usually for a course of one or two years.

Once the bone has been built up, it’ll probably be recommended that you switch to a biphosphate or other bone-stabilizing medication.

Estrogen-like effects, without estrogen

If your osteoporosis (or osteoporosis risk) comes from being post-menopausal, estrogen is a very common (and effective!) prescription. However, some people may wish to avoid it, if for example you have a heightened breast cancer risk, which estrogen can exacerbate.

So, medications that have estrogen-like effects post-menopause, but without actually increasing estrogen levels, include: Raloxifene/Evista, and also all the meds we mentioned in the bone-building category above.

Raloxifene/Evista specifically mimics the action of estrogen on bones, while at the same time blocking the effect of estrogen on other tissues.

Learn more…

Want a more thorough grounding than we have room for here? You might find the following resource useful:

List of 82 Osteoporosis Medications Compared (this has a big table which is sortable by various variables)

Take care!

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  • Which Magnesium? (And: When?)

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝Good morning! I have been waiting for this day to ask: the magnesium in my calcium supplement is neither of the two versions you mentioned in a recent email newsletter. Is this a good type of magnesium and is it efficiently bioavailable in this composition? I also take magnesium that says it is elemental (oxide, gluconate, and lactate). Are these absorbable and useful in these sources? I am not interested in taking things if they aren’t helping me or making me healthier. Thank you for your wonderful, informative newsletter. It’s so nice to get non-biased information❞

    Thank you for the kind words! We certainly do our best.

    For reference: the attached image showed a supplement containing “Magnesium (as Magnesium Oxide & AlgaeCal® l.superpositum)”

    Also for reference: the two versions we compared head-to-head were these very good options:

    Magnesium Glycinate vs Magnesium Citrate – Which is Healthier?

    Let’s first borrow from the above, where we mentioned: magnesium oxide is probably the most widely-sold magnesium supplement because it’s cheapest to make. It also has woeful bioavailability, to the point that there seems to be negligible benefit to taking it. So we don’t recommend that.

    As for magnesium gluconate and magnesium lactate:

    • Magnesium lactate has very good bioavailability and in cases where people have problems with other types (e.g. gastrointestinal side effects), this will probably not trigger those.
    • Magnesium gluconate has excellent bioavailability, probably coming second only to magnesium glycinate.

    The “AlgaeCal® l.superpositum” supplement is a little opaque (and we did ntoice they didn’t specify what percentage of the magnesium is magnesium oxide, and what percentage is from the algae, meaning it could be a 99:1 ratio split, just so that they can claim it’s in there), but we can say Lithothamnion superpositum is indeed an algae and magnesium from green things is usually good.

    Except…

    It’s generally best not to take magnesium and calcium together (as that supplement contains). While they do work synergistically once absorbed, they compete for absorption first so it’s best to take them separately. Because of magnesium’s sleep-improving qualities, many people take calcium in the morning, and magnesium in the evening, for this reason.

    Some previous articles you might enjoy meanwhile:

    Take care!

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  • The Procrastination Cure – by Jeffery Combs

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Why do we procrastinate? It’s not usually because we are lazy, and in fact we can often make ourselves very busy while procrastinating. And at some point, the bad feelings about procrastinating become worse than the experience of actually doing the thing. And still we often procrastinate. So, why?

    Jeffery Combs notes that the reasons can vary, but generally fall into six mostly-distinct categories. He calls them:

    1. The neurotic perfectionist
    2. The big deal chaser
    3. The chronic worrier
    4. The rebellious rebel
    5. The drama addict
    6. The angry giver

    These may overlap somewhat, but the differences are important when it comes to differences of tackling them.

    Giving many illustrative examples, Combs gives the reader all we’ll need to know which category (or categories!) we fall into.

    Then, he draws heavily on the work of Dr. Albert Ellis to find ways to change the feelings that we have that are holding us back.

    Those feelings might be fear, shame, resentment, overwhelm, or something else entirely, but the tools are in this book.

    A particular strength of this book is that it takes an approach that’s essentially Rational Emotive Behavior Therapy (REBT) repackaged for a less clinically-inclined audience (Combs’ own background is in marketing, not pyschology). Thus, for many readers, this will tend to make the ideas more relatable, and the implementations more accessible.

    Bottom line: if you’ve been meaning to figure out how to beat your procrastination, but have been putting it off, now’s the time to do it.

    Click here to check out The Procrastination Cure sooner rather than later!

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  • Rosehip’s Benefits, Inside & Out

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s In The Hips

    Rosehip (often also written: “rose hip”, “rosehips”, or “rose hips”, but we’ll use the singular compound here to cover its use as a supplement) is often found as an extra ingredient in various supplements, and also various herbal teas. But what is it and what does it actually do?

    What it is: it’s the fruiting body that appears on rose plants underneath where the petals appear. They are seasonal.

    As for what it does, read on…

    Anti-inflammatory

    Rosehip is widely sought for (and has been well-studied for) its anti-inflammatory powers.

    Because osteoarthritis is one of the most common inflammatory chronic diseases around, a lot of the studies are about OA, but the mechanism of action is well-established as being antioxidant and anti-inflammatory in general:

    ❝Potent antioxidant radical scavenging effects are well documented for numerous rose hip constituents besides Vitamin C.

    Furthermore, anti-inflammatory activities include the reduction of pro-inflammatory cytokines and chemokines, reduction of NF-kB signaling, inhibition of pro-inflammatory enzymes, including COX1/2, 5-LOX and iNOS, reduction of C-reactive protein levels, reduction of chemotaxis and chemoluminescence of PMNs, and an inhibition of pro-inflammatory metalloproteases.❞

    ~ Dr. Margret Moré et al.

    Source: Rosa canina – Rose hip pharmacological ingredients and molecular mechanics counteracting osteoarthritis – A systematic review

    Note that while rosehip significantly reduces inflammation, it doesn’t affect the range of movement in OA—further making clear its mechanism of action:

    Read: Rosa canina fruit (rosehip) for osteoarthritis: a cochrane review

    Anti-aging

    This is partly about its antioxidant effect, but when it comes to skin, also partly its high vitamin C content. In this 8-week study, for example, taking 3mg/day resulted in significant reductions of many measures of skin aging:

    The effectiveness of a standardized rose hip powder, containing seeds and shells of Rosa canina, on cell longevity, skin wrinkles, moisture, and elasticity

    Heart healthy

    The dose required to achieve this benefit is much higher, but nonetheless its effectiveness is clear, for example:

    ❝Daily consumption of 40 g of rose hip powder for 6 weeks can significantly reduce cardiovascular risk in obese people through lowering of systolic blood pressure and plasma cholesterol levels. ❞

    ~ Dr. Mona Landin-Olsson et al.

    Read in full: Effects of rose hip intake on risk markers of type 2 diabetes and cardiovascular disease: a randomized, double-blind, cross-over investigation in obese persons

    Want to try some?

    We don’t sell it, but here for your convenience is an example product on Amazon

    Enjoy!

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  • The Snooze-Button Controversy

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    To Snooze Or Not To Snooze? (Science Has Answers)

    This is Dr. Jennifer Kanaan. She’s a medical doctor with a focus on pulmonary critical care, sleep disorders, and sleep medicine.

    What does she want to tell us?

    She wants us to be wary of the many news articles that have jumped on a certain recent sleep study, such as:

    For the curious, here is the paper itself, by Dr. Tina Sundelin et al. It’s actually two studies, by the way, but one paper:

    Is snoozing losing? Why intermittent morning alarms are used and how they affect sleep, cognition, cortisol, and mood

    The authors of this study concluded:

    ❝There were no clear effects of snoozing on the cortisol awakening response, morning sleepiness, mood, or overnight sleep architecture.

    A brief snooze period may thus help alleviate sleep inertia, without substantially disturbing sleep, for late chronotypes and those with morning drowsiness.❞

    Notably, people tend to snooze because an alarm clock will, if not “smart” about it, wake us up mid sleep-cycle more often than not, and that will produce a short “sleep hangover”. By snoozing, we are basically re-rolling the dice on being woken up between sleep cycles, and thus feeling more refreshed.

    What’s Dr. Kanaan’s counterpoint?

    Dr. Kanaan says:

    ❝If you’re coming in and out of sleep for 30 minutes, after the alarm goes off the first time, you’re costing yourself 30 minutes of uninterrupted, quality, restorative sleep. This study doesn’t change that fact.❞

    She advises that rather than snoozing, we should prioritize getting good sleep in the first place, and once we do wake up, mid sleep-cycle or not, get sunlight. That way, our brain will start promptly scrubbing melatonin and producing the appropriate wakefulness hormones instead. That means serotonin, and also a spike of cortisol.

    Remember: cortisol is only bad when it’s chronically elevated. It’s fine, and even beneficial, to have a short spike of cortisol. We make it for a reason!

    If you’d like to hear more from Dr. Kanaan, you might like this interview with her at the University of Connecticut:

    You Snooze, You (Still) Lose: health sleep disorders specialist warns of misleading takeaway from study suggesting snooze button benefits

    Want the best of both worlds?

    A great option to avoid getting woken in the middle of a sleep cycle, and also not needing to hit snooze, is a sunrise alarm clock. Specifics of these devices vary, but for example, the kind this writer has starts gently glowing an hour before the set alarm time,and gradually gets brighter and lighter over the course of the hour.

    We don’t sell them, but here’s an example sunrise alarm clock on Amazon, for your convenience

    Don’t Forget…

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  • Exercises for Aging-Ankles

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Can Ankles Deterioration be Stopped?

    As we all know (or have experienced!), Ankle mobility deteriorates with age.

    We’re here to argue that it’s not all doom and gloom!

    (In fact, we’ve written about keeping our feet, and associated body parts, healthy here).

    This video by “Livinleggings” (below) provides a great argument that yes, ankle deterioration can be stopped, or even reversed. It’s a must-watch for anyone from yoga enthusiasts to gym warriors who might be unknowingly crippling their ankle-health.

    How We Can Prioritise Our Ankles

    Poor ankle flexibility isn’t just an inconvenience – it’s a direct route to knee issues, hip hiccups, and back pain. More importantly, ankle strength is a core component of building overall mobility.

    With 12 muscles in the ankle, it can be overwhelming to work out which to strengthen – and how. But fear not, we can prioritise three of the twelve: the calf duo (gastrocnemius and soleus) and the shin’s main muscle, the tibialis anterior.

    The first step is to test yourself! A simple wall test reveals any hidden truths about your ankle flexibility. Go to the 1:55 point in the video to see how it’s done.

    If you can’t do it, you’ve got work to be done.

    If you read the book we recommended on great functional exercises for seniors, then you may already be familiar with some super ankle exercises.

    Otherwise, these four ankle exercises are a great starting point:

    How did you find that video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • What We Don’t Talk About When We Talk About Fat – by Aubrey Gordon

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    There are books aplenty to encourage and help you to lose weight. This isn’t one of those.

    There are also books aplenty to encourage and help you to accept yourself and your body at the weight you are, and forge self-esteem. This isn’t one of those, either—in fact, it starts by assuming you already have that.

    There are fair arguments for body neutrality, and fat acceptance. Very worthy also is the constant fight for bodily sovereignty.

    These are worthy causes, but they’re for the most-part not what our author concerns herself with here. Instead, she cares for a different and very practical goal: fat justice.

    In a world where you may be turned away from medical treatment if you are over a certain size, told to lose half your bodyweight before you can have something you need, she demands better. The battle extends further than healthcare though, and indeed to all areas of life.

    Ultimately, she argues, any society that will disregard the needs of the few because they’re a marginal demographic, is a society that will absolutely fail you if you ever differ from the norm in some way.

    All in all, an important (and for many, perhaps eye-opening) book to read if you are fat, care about fat people, are a person of any size, or care about people in general.

    Pick Up Your Copy of “What We Don’t Talk About When We Talk About Fat”, on Amazon Today!

    Don’t Forget…

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    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: