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.
Biphosphonates 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 biphosphonates help tip things back into balance.
Common biphosphonates 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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Food for Life – by Dr. Tim Spector
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This book is, as the author puts it, “an eater’s guide to food and nutrition”. Rather than telling us what to eat or not eat, he provides an overview of what the latest science has to say about various foods, and leaves us to make our own informed decisions.
He also stands firmly by the “personalized nutrition” idea that he introduced in his previous book which we reviewed the other day, and gives advice on what tests we might like to perform.
The writing style is accessible, without shying away from reference to hard science. Dr. Spector provides lots of information about key chemicals, genes, gut bacteria, and more—as well as simply providing a very enjoyable read along the way.
Bottom line: if you’d like a much better idea of what food is (and isn’t) doing what, this book is an invaluable resource.
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Not quite an introvert or an extrovert? Maybe you’re an ambivert
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Our personalities are generally thought to consist of five primary factors: openness to experience, conscientiousness, extroversion, agreeableness and neuroticism, with each of us ranking low to high for each.
Extroversion is one of the Big Five personality traits. Big 5 personality traits graphic Those who rank high in extroversion, known as extroverts, typically focus on their external world. They tend to be more optimistic, recharge by socialising and enjoy social interaction.
On the other end of the spectrum, introverts are more likely to be quiet, deep thinkers, who recharge by being alone and learn by observing (but aren’t necessarily shy).
But what if you’re neither an introvert or extrovert – or you’re a bit of both? Another category might fit better: ambiverts. They’re the middle of the spectrum and are also called “social introverts”.
What exactly is an ambivert?
The term ambivert emerged in 1923. While it was not initially embraced as part of the introvert-extrovert spectrum, more recent research suggests ambiverts are a distinct category.
Ambiverts exhibit traits of both extroverts and introverts, adapting their behaviour based on the situation. It may be that they socialise well but need solitude and rest to recharge, and they intuitively know when to do this.
Ambiverts seems to have the following characteristics:
- good communication skills, as a listener and speaker
- ability to be a peacemaker if conflict occurs
- leadership and negotiation skills, especially in teams
- compassion and understanding for others.
Some research suggests ambiverts make up a significant portion of the population, with about two-thirds of people falling into this category.
What makes someone an ambivert?
Personality is thought to be 50% inherited, with the remaining being influenced by environmental factors and individual experiences.
Emerging research has found physical locations of genes on chromosomes closely aligned with extroversion-introversion traits.
So, chances are, if you are a blend of the two styles as an ambivert, one of your parents may be too.
What do ambiverts tend to be good at?
Ambiverts are flexible with talking and also listening. Cotton Bro Studios/Pexels One area of research focus in recent decades has been personality type and job satisfaction. One study examined 340 introverts, extroverts and ambiverts in sales careers.
It has always been thought extroverts were more successful with sales. However, the author found ambiverts were more influential and successful.
They may have a sales advantage because of their ability to read the situation and modify their behaviour if they notice a customer is not interested, as they’re able to reflect and adapt.
Ambiverts stress less than introverts
Generally, people lower in extroversion have higher stress levels. One study found introverts experience more stress than both ambiverts and extroverts.
It may be that highly sensitive or introverted individuals are more susceptible to worry and stress due to being more perfectionistic.
Ambiverts are adept at knowing when to be outgoing and when to be reflective, showcasing a high degree of situational awareness. This may contribute to their overall wellbeing because of how they handle stress.
What do ambiverts tend to struggle with?
Ambiverts may overextend themselves attempting to conform or fit in with many social settings. This is termed “overadaptation” and may force ambiverts to feel uncomfortable and strained, ultimately resulting in stress or burnout.
Ambiverts tend to handle stress well but feel strained when overadapting. Cottonbro Studios/Pexels But personality traits aren’t fixed
Regardless of where you sit on the scale of introversion through to extroversion, the reality is it may not be fixed. Different situations may be more comfortable for introverts to be social, and extroverts may be content with quieter moments.
And there are also four other key personality traits – openness to experience, conscientiousness, agreeableness and neuroticism – which we all possess in varying levels, and are expressed in different ways, alongside our levels of extroversion.
There is also evidence our personality traits can change throughout our life spans are indeed open to change.
Peta Stapleton, Associate Professor in Psychology, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Natural Facelift – by Sophie Perry
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First, what this book isn’t: it’s mostly not about beauty, and it’s certainly not about ageist ideals of “hiding” aging.
The author herself discusses the privilege that is aging (not everyone gets to do it) and the importance of taking thankful pride in our lived-in bodies.
The title and blurb belie the contents of the book rather. Doubtlessly the publisher felt that extrinsic beauty would sell better than intrinsic wellbeing. As for what it’s actually more about…
Ever splashed your face in cold water to feel better? This book’s about revitalising the complex array of facial muscles (there are anatomical diagrams) and the often-tired and very diverse tissues that cover them, complete with the array of nerve endings very close to your CNS (not to mention the vagus nerve running just behind your jaw), and some of the most important blood vessels of your body, serving your brain.
With all that in mind, this book, full of useful therapeutic techniques, is a very, very far cry from “massage like this and you’ll look like you got photoshopped”.
The style varies, as some parts of explanation of principles, or anatomy, and others are hands-on (literally) guides to the exercises, but it is all very clear and easy to understand/follow.
Bottom line: aspects of conventional beauty may be a side-effect of applying the invigorating exercises described in this book. The real beauty is—literally—more than skin-deep.
Click here to check out The Natural Facelift, and order yours!
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The CBT Workbook for Mental Health – by Dr. Simon Rego & Sarah Fader
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The authors outline specific solutions to many common quantifiable problems, with simple exercises that are well-explained and easy to implement.
Cognitive Behavioral Therapy (CBT) is not a panacea, but for the things it can be used for, it’s very effective and is a very good “first thing to reach for” to see if it works, because its success rate for a lot of problems is very high.
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Bottom line: if CBT isn’t something already in your toolbox, this book will help you add all its best tips and tricks.
Click here to check out The CBT Workbook for Mental Health, and get tooled up!
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Scheduling Tips for Overrunning Tasks
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Your Questions, Our Answers!
Q: Often I schedule time for things, but the task takes longer than I think, or multiplies while I’m doing it, and then my schedule gets thrown out. Any ideas?
A: A relatable struggle! Happily, there are remedies:
- Does the task really absolutely need to be finished today? If not, just continue it in scheduled timeslots until it’s completed.
- Some tasks do indeed need to be finished today (hi, writer of a daily newsletter here!), so it can be useful to have an idea of how long things really take, in advance. While new tasks can catch us unawares, recurring or similar-to-previous tasks can be estimated based on how long they took previously. For this reason, we recommend doing a time audit every now and again, to see how you really use your time.
- A great resource that you should include in your schedule is a “spare” timeslot, ideally at least one per day. Call it a “buffer” or a “backup” or whatever (in my schedule it’s labelled “discretionary”), but the basic idea is that it’s a scheduled timeslot with nothing scheduled in it, and it works as an “overflow” catch-all.
Additionally:
- You can usually cut down the time it takes you to do tasks by setting “Deep Work” rules for yourself. For example: cut out distractions, single-task, work in for example 25-minute bursts with 5-minute breaks, etc
- You can also usually cut down the time it takes you to do tasks by making sure you’re prepared for them. Not just task-specific preparation, either! A clear head on, plenty of energy, the resources you’ll need (including refreshments!) to hand, etc can make a huge difference to efficiency.
See Also: Time Optimism and the Planning Fallacy
Do you have a question you’d like to see answered here? Hit reply or use the feedback widget at the bottom; we’d love to hear from you!
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Super Joints – by Pavel Tsatsouline
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For those of us for whom mobility and pain-free movement are top priorities, this book has us covered. So what’s different here, compared to your average stretching book?
It’s about functional strength with the stretches. The author’s background as a special forces soldier means that his interest was not in doing arcane yoga positions so much as being able to change direction quickly without losing speed or balance, get thrown down and get back up without injury, twist suddenly without unpleasantly wrenching anything (of one’s own, at least), and generally be able to take knocks without taking damage.
While we are hopefully not having to deal with such violence in our everyday lives, the robustness of body that results from these exercises is one that certainly can go a long way to keep us injury-free.
The exercises themselves are well-described, clearly and succinctly, with equally clear illustrations.
Note: the paperback version is currently expensive, probably due to supply and demand, but if you select the Kindle version, it’s much cheaper with no loss of quality (because the illustrations are black-on-white line-drawings and very clear; perfect for Kindle e-ink)
The style of the book is very casual and conversational, yet somehow doesn’t let that distract it from being incredibly information dense; there is no fluff here, just valuable guidance.
Bottom line: if you would like to be more robust with non-nonsense exercises, then this book is a fine choice.
Click here to check out Super Joints, and make yours flexible and strong!
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