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:
- The Bare-bones Truth About Osteoporosis
- Exercises To Do (And Exercises To Avoid) If You Have Osteoporosis
- We Are Such Stuff As Fish Are Made Of
- Vit D + Calcium: Too Much Of A Good Thing?
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)
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What are house dust mites and how do I know if I’m allergic to them?
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People often believe they are allergic to house dust. But of the 20% of Australians suffereing with allergies, a number are are actually allergic to microscopic house dust mites.
House dust mites belong to the same family as spiders and ticks. They measure just 0.2-0.3 mm, with 50 fitting on a single pinhead. They live for 65–100 days, and females lay 60–100 eggs in their life.
Some 50 house dust mites can fit on one pinhead. Choksawatdikorn/Shutterstock House dust mites love temperate climates and humidity. They feed off the skin cells we and animals shed, as well as mould, which they digest using special enzymes. These enzymes are excreted in their poo about 20 times a day. They also shed fragments of their exoskeletons.
All these fragments trigger allergies in people with this type of allergic rhinitis (which is also known as hay fever)
shuttertock. PeopleImages.com – Yuri A/Shutterstock What are the symptoms?
When people with house dust mite allergy inhale the allergens, they penetrate the mucous membranes of the airways and eyes. Their body recognises the allergens as a threat, releasing chemicals including one called histamine.
This causes symptoms including a runny nose, an itchy nose, eyes and throat, sneezing, coughing and a feeling of mucus at the back of your throat (known as a post-nasal drip).
People with this type of allergy usually mouth breath, snore, rub their nose constantly (creating a nasal crease called the “dust mite salute”) and have dark shadows under their eyes.
House dust mite allergy can also cause poor sleep, constant tiredness, reduced concentration at work or school and lower quality of life.
For people with eczema, their damaged skin barrier can allow house dust mite proteins in. This prompts immune cells in the skin to release chemicals which make already flared skin become redder, sorer and itchier, especially in children.
Symptoms of house dust mite allergy occur year round, and are often worse after going to bed and when waking in the morning. But people with house dust mite allergy and pollen allergies find their year-round symptoms worsen in spring.
How is it diagnosed?
House dust mite allergy symptoms often build up over months, or even years before people seek help. But an accurate diagnosis means you can not only access the right treatment – it’s also vital for minimising exposure.
Your clinician can talk you through treatment options and how to minimise exposure. Monkey Business Images/Shutterstock Doctor and nurse practitioners can order a blood test to check for house dust mite allergy.
Alternatively, health care providers with specialised allergy training can perform skin prick tests. This involves placing drops of the allergens on the arm, along with a positive and negative “control”. After 15 minutes, those who test positive will have developed a mosquito bite-like mark.
How is it treated?
Medication options include one or a combination of:
- daily non-sedating antihistamines
- a steroid nasal spray
- allergy eye drops.
Your health care professional will work with you to develop a rhinitis (hay fever) medical management plan to reduce your symptoms. If you’re using a nasal spray, your health provider will show you how to use it, as people often use it incorrectly.
If you also have asthma or eczema which is worsened by dust mites, your health provider will adapt your asthma action plan or eczema care plan accordingly.
If you experience severe symptoms, a longer-term option is immunotherapy. This aims to gradually turn off your immune system’s ability to recognise house dust mites as a harmful allergen.
Immunotherapy involves taking either a daily sublingual tablet, under the tongue, or a series of injections. Injections require monthly attendances over three years, after the initial weekly build-up phase.
These are effective, but are costly (as well as time-consuming). So it’s important to weigh up the potential benefits and downsides with your health-care provider.
How can you minimise house dust mites?
There are also important allergy minimisation measures you can take to reduce allergens in your home.
Each week, wash your bedding and pyjamas in hot water (over 60°C). This removes house dust mite eggs and debris.
Opt for doonas, covers or quilts that can be washed in hot water above 60°C. Alternatively, low-cost waterproof or leak proof covers can keep house dust mites out.
If you can, favour blinds and wood floors over curtains and carpet. Dust blinds and surfaces with a damp cloth each week and vacuum while wearing a mask, or have someone else do it, as house dust mites can become airborne during cleaning.
But beware of costly products with big marketing budgets and little evidence to support their use. A new mattress, for example, will always be house dust mite-free. But once slept on, the house dust mite life cycle can start.
Mattress protectors and toppers commonly claim to be “hypoallergenic”, “anti-allergy” or “allergy free”. But their pore sizes are not small enough to keep house dust mites and their poo out, or shed skin going through.
Sprays claiming to kill mites require so much spray to penetrate the product that it’s likely to become wet, may smell like the spray and, unless dried properly, may grow mould.
Finally, claims that expensive vacuum cleaners can extract all the house dust mites are unsubstantiated.
For more information, visit healthdirect.gov.au or the Australian Society of Clinical Immunology and Allergy.
Deryn Lee Thompson, Eczema and Allergy Nurse; Lecturer, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How Exercise Rewires Your Brain for Better Mental Wellbeing
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Dr. Tracey Marks, psychiatrist, explains what happens immediately, and what happens over the long term:
For now and for later
First of all, a single workout can already alter brain chemistry and protect against stress. In the longer term, exercise promotes neurogenesis, primarily in the hippocampus, improving memory and reversing brain aging. It also strengthens the prefrontal cortex, which is critical for decision-making, focus, and emotional regulation.
In more general terms, exercise boosts brain-derived neurotrophic factor (BDNF) levels, which in turn boost neuron growth and connectivity.
Exercise also promotes angiogenesis (blood vessel construction), improving oxygen and nutrient delivery to the brain.
Timeline of benefits:
- Immediate: increased blood flow and temporary BDNF spike.
- Weeks: new neurons, connections, and blood vessel growth.
- Months: visible brain volume changes and better brain connectivity.
Dr. Marks’ Timing Tips
- Morning: boosts energy and helps regulate the circadian rhythm.
- Midday: resets stress levels (specifically: to low)
- Evening: helps process emotions (but it’s still recommended to avoid high-intensity exercise close to bedtime)
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Wondering what kind of exercise is best?
You might also like to read:
The Neuroscientist In The Gym: Dr. Wendy Suzuki Explains The Exercise That Protects Your Brain
Take care!
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Avocado vs Blueberries – Which is Healthier?
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Our Verdict
When comparing avocado to blueberries, we picked the avocado.
Why?
These two fruits aren’t as similar as some of the comparisons we’ve made—we often go for “can be used in the same way culinarily” comparisons. But! They are both popularly in the “superfood” category, so it’s interesting to consider:
In terms of macros, avocado has more protein, (healthy!) fat, and fiber, while blueberries have more carbs. An easy win for avocado here, unless you’re on a calorie-controlled diet perhaps, since avocado is also higher in those. About that fat; it’s mostly monounsaturated, with some polyunsaturated and saturated, and is famously a good source of omega-3 in the form of ALA.
In the category of vitamins, avocado has more of vitamins A, B1, B2, B3, B5, B6, B7, B9, C, E, K, and choline, while blueberries are not higher in any vitamins. So, not a tricky decision here.
When it comes to minerals, avocado has more calcium, copper, iron, magnesium, phosphorus, potassium, selenium, and zinc, while blueberries are higher in manganese. Another win for avocados.
There is one other category that’s important to consider in this case, and that’s polyphenols. We’d be here all day if we listed them all, but in total, blueberries have about 1193x the polyphenol content that avocados do. Blueberries got the reputation for antioxidant properties for a reason; it is well-deserved!
So, out of the two, we declare avocado the overall more nutritious of the two, but blueberries absolutely deserve the acclaim they get also.
Want to learn more?
You might like to read:
Give Us This Day Our Daily Dozen
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How to Prevent Dementia – by Dr. Richard Restak
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We’ve written about this topic here, we know. But there’s a lot more we can do to be on guard against, and pre-emptively strengthen ourselves against, dementia.
The author, a neurologist, takes us on a detailed exploration of dementia in general, with a strong focus on Alzheimer’s in particular, as that accounts for more than half of all dementia cases.
But what if you can’t avoid it? It could be that with the wrong genes and some other factor(s) outside of your control, it will get you if something else doesn’t get you first.
Rather than scaremongering, Dr. Restak tackles this head-on too, and discusses how symptoms can be managed, to make the illness less anxiety-inducing, and look to maintain quality of life as much as possible.
The style of the book is… it reads a lot like an essay compilation. Good essays, then organized and arranged in a sensible order for reading, but distinct self-contained pieces. There are ten or eleven chapters (depending on how we count them), each divided into few or many sections. All this makes for:
- A very “read a bit now and a bit later and a bit the next day” book, if you like
- A feeling of a very quick pace, if you prefer to sit down and read it in one go
Either way, it’s a very informative read.
Bottom line: if you’d like to better understand the many-headed beast that is dementia, this book gives a far more comprehensive overview than we could here, and also explains the prophylactic interventions available.
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Older adults need another COVID-19 vaccine
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What you need to know
- The CDC recommends people 65 and older and immunocompromised people receive an additional dose of the updated COVID-19 vaccine this spring—if at least four months have passed since they received a COVID-19 vaccine.
- Updated COVID-19 vaccines are effective at protecting against severe illness, hospitalization, death, and long COVID.
- The CDC also shortened the isolation period for people who are sick with COVID-19.
Last week, the CDC said people 65 and older should receive an additional dose of the updated COVID-19 vaccine this spring. The recommendation also applies to immunocompromised people, who were already eligible for an additional dose.
Older adults made up two-thirds of COVID-19-related hospitalizations between October 2023 and January 2024, so enhancing protection for this group is critical.
The CDC also shortened the isolation period for people who are sick with COVID-19, although the contagiousness of COVID-19 has not changed.
Read on to learn more about the CDC’s updated vaccination and isolation recommendations.
Who is eligible for another COVID-19 vaccine this spring?
The CDC recommends that people ages 65 and older and immunocompromised people receive an additional dose of the updated COVID-19 vaccine this spring—if at least four months have passed since they received a COVID-19 vaccine. It’s safe to receive an updated COVID-19 vaccine from Pfizer, Moderna, or Novavax, regardless of which COVID-19 vaccines you received in the past.
Updated COVID-19 vaccines are available at pharmacies, local clinics, or doctor’s offices. Visit Vaccines.gov to find an appointment near you.
Under- and uninsured adults can get the updated COVID-19 vaccine for free through the CDC’s Bridge Access Program. If you’re over 60 and unable to leave your home, call the Aging Network at 1-800-677-1116 to learn about free at-home vaccination options.
What are the benefits of staying up to date on COVID-19 vaccines?
Staying up to date on COVID-19 vaccines prevents severe illness, hospitalization, death, and long COVID.
Additionally, the CDC says staying up to date on COVID-19 vaccines is a safer and more reliable way to build protection against COVID-19 than getting sick from COVID-19.
What are the new COVID-19 isolation guidelines?
According to the CDC’s general respiratory virus guidance, people who are sick with COVID-19 or another common respiratory illness, like the flu or RSV, should isolate until they’ve been fever-free for at least 24 hours without the use of fever-reducing medication and their symptoms improve.
After that, the CDC recommends taking additional precautions for the next five days: wearing a well-fitting mask, limiting close contact with others, and improving ventilation in your home if you live with others.
If you’re sick with COVID-19, you can infect others for five to 12 days, or longer. Moderately or severely immunocompromised patients may remain infectious beyond 20 days.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Strength training has a range of benefits for women. Here are 4 ways to get into weights
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Picture a gym ten years ago: the weights room was largely a male-dominated space, with women mostly doing cardio exercise. Fast-forward to today and you’re likely to see women of all ages and backgrounds confidently navigating weights equipment.
This is more than just anecdotal. According to data from the Australian Sports Commission, the number of women participating in weightlifting (either competitively or not) grew nearly five-fold between 2016 and 2022.
Women are discovering what research has long shown: strength training offers benefits beyond sculpted muscles.
John Arano/Unsplash Health benefits
Osteoporosis, a disease in which the bones become weak and brittle, affects more women than men. Strength training increases bone density, a crucial factor for preventing osteoporosis, especially for women negotiating menopause.
Strength training also improves insulin sensitivity, which means your body gets better at using insulin to manage blood sugar levels, reducing the risk of type 2 diabetes. Regular strength training contributes to better heart health too.
There’s a mental health boost as well. Strength training has been linked to reduced symptoms of depression and anxiety.
Strength training can have a variety of health benefits. Ground Picture/Shutterstock Improved confidence and body image
Unlike some forms of exercise where progress can feel elusive, strength training offers clear and tangible measures of success. Each time you add more weight to a bar, you are reminded of your ability to meet your goals and conquer challenges.
This sense of achievement doesn’t just stay in the gym – it can change how women see themselves. A recent study found women who regularly lift weights often feel more empowered to make positive changes in their lives and feel ready to face life’s challenges outside the gym.
Strength training also has the potential to positively impact body image. In a world where women are often judged on appearance, lifting weights can shift the focus to function.
Instead of worrying about the number on the scale or fitting into a certain dress size, women often come to appreciate their bodies for what they can do. “Am I lifting more than I could last month?” and “can I carry all my groceries in a single trip?” may become new measures of physical success.
Strength training can have positive effects on women’s body image. Drazen Zigic/Shutterstock Lifting weights can also be about challenging outdated ideas of how women “should” be. Qualitative research I conducted with colleagues found that, for many women, strength training becomes a powerful form of rebellion against unrealistic beauty standards. As one participant told us:
I wanted something that would allow me to train that just didn’t have anything to do with how I looked.
Society has long told women to be small, quiet and not take up space. But when a woman steps up to a barbell, she’s pushing back against these outdated rules. One woman in our study said:
We don’t have to […] look a certain way, or […] be scared that we can lift heavier weights than some men. Why should we?
This shift in mindset helps women see themselves differently. Instead of worrying about being objects for others to look at, they begin to see their bodies as capable and strong. Another participant explained:
Powerlifting changed my life. It made me see myself, or my body. My body wasn’t my value, it was the vehicle that I was in to execute whatever it was that I was executing in life.
This newfound confidence often spills over into other areas of life. As one woman said:
I love being a strong woman. It’s like going against the grain, and it empowers me. When I’m physically strong, everything in the world seems lighter.
Feeling inspired? Here’s how to get started
1. Take things slow
Begin with bodyweight exercises like squats, lunges and push-ups to build a foundation of strength. Once you’re comfortable, add external weights, but keep them light at first. Focus on mastering compound movements, such as deadlifts, squats and overhead presses. These exercises engage multiple joints and muscle groups simultaneously, making your workouts more efficient.
2. Prioritise proper form
Always prioritise proper form over lifting heavier weights. Poor technique can lead to injuries, so learning the correct way to perform each exercise is crucial. To help with this, consider working with an exercise professional who can provide personalised guidance and ensure you’re performing exercises correctly, at least initially.
Bodyweight exercises, such as lunges, are a good way to get started before lifting weights. antoniodiaz/Shutterstock 3. Consistency is key
Like any fitness regimen, consistency is key. Two to three sessions a week are plenty for most women to see benefits. And don’t be afraid to occupy space in the weights room – remember you belong there just as much as anyone else.
4. Find a community
Finally, join a community. There’s nothing like being surrounded by a group of strong women to inspire and motivate you. Engaging with a supportive community can make your strength-training journey more enjoyable and rewarding, whether it’s an in-person class or an online forum.
Are there any downsides?
Gym memberships can be expensive, especially for specialist weightlifting gyms. Home equipment is an option, but quality barbells and weightlifting equipment can come with a hefty price tag.
Also, for women juggling work and family responsibilities, finding time to get to the gym two to three times per week can be challenging.
If you’re concerned about getting too “bulky”, it’s very difficult for women to bulk up like male bodybuilders without pharmaceutical assistance.
The main risks come from poor technique or trying to lift too much too soon – issues that can be easily avoided with some guidance.
Erin Kelly, Lecturer and PhD Candidate, Discipline of Sport and Exercise Science, University of Canberra
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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