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)
Take care!
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Mung Beans vs Soy Beans – Which is Healthier?
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Our Verdict
When comparing mung beans to soy beans, we picked the soy.
Why?
Mung beans are great, but honestly, it’s not close:
In terms of macronutrients, soy has more than 2x the protein (of which, it’s also a complete protein, containing significant amounts of all essential amino acids) while mung beans have more than 2x the carbs. In their defense, mung beans also have very slightly more fiber, but the carb:fiber ratio is such that soy beans have the lower GI by far.
When it comes to vitamins, mung beans have more of vitamins A, B3, B5, and, B9, while soy beans have more of vitamins B2, B6, C, E, K, and choline, making for a moderate win for soy beans, especially as that vitamin K is more than 7x as much as mung beans have.
In the category of minerals, soy wins even more convincingly; soy beans have more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. On the other hand, mung beans have more sodium.
In short, while mung beans are a very respectable option, they don’t come close to meaningfully competing with soy.
Want to learn more?
You might like to read:
How To Sprout Your Seeds, Grains, Beans, Etc
Take care!
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Who you are and where you live shouldn’t determine your ability to survive cancer
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In Canada, nearly everyone has a cancer story to share. It affects one in every two people, and despite improvements in cancer survivorship, one out of every four people affected by cancer still will die from it.
As a scientist dedicated to cancer care, I work directly with patients to reimagine a system that was never designed for them in the first place – a system in which your quality of care depends on social drivers like your appearance, your bank statements and your postal code.
We know that poverty, poor nutrition, housing instability and limited access to education and employment can contribute to both the development and progression of cancer. Quality nutrition and regular exercise reduce cancer risk but are contingent on affordable food options and the ability to stay active in safe, walkable neighbourhoods. Environmental hazards like air pollution and toxic waste elevate the risk of specific cancers, but are contingent on the built environment, laws safeguarding workers and the availability of affordable housing.
On a health-system level, we face implicit biases among care providers, a lack of health workforce competence in addressing the social determinants of health, and services that do not cater to the needs of marginalized individuals.
Indigenous peoples, racialized communities, those with low income and gender diverse individuals face the most discrimination in health care, resulting in inadequate experiences, missed diagnosis and avoidance of care. One patient living in subsidized housing told me, “You get treated like a piece of garbage – you come out and feel twice as bad.”
As Canadians, we benefit from a taxpayer funded health-care system that encompasses cancer care services. The average Canadian enjoys a life expectancy of more than 80 years and Canada boasts high cancer survival rates. While we have made incredible strides in cancer care, we must work together to ensure these benefits are equally shared amongst all people in Canada. We need to redesign systems of care so that they are:
- Anti-oppressive. We must begin by understanding and responding to historical and systemic racism that shapes cancer risk, access to care and quality of life for individuals facing marginalizing conditions. Without tackling the root causes, we will never be able to fully close the cancer care gap. This commitment involves undoing intergenerational trauma and harm through public policies that elevate the living and working conditions of all people.
- Patient-centric. We need to prioritize patient needs, preferences and values in all aspects of their health-care experience. This means tailoring treatments and services to individual patient needs. In policymaking, it involves creating policies that are informed by and responsive to the real-life experiences of patients. In research, it involves engaging patients in the research process and ensuring studies are relevant to and respectful of their unique perspectives and needs. This holistic approach ensures that patients’ perspectives are central to all aspects of health care.
- Socially just. We must strive for a society in which everyone has equal access to resources, opportunities and rights, and systemic inequalities and injustices are actively challenged and addressed. When redesigning the cancer care system, this involves proactive practices that create opportunities for all people, particularly those experiencing the most marginalization, to become involved in systemic health-care decision-making. A system that is responsive to the needs of the most marginalized will ultimately work better for all people.
Who you are, how you look, where you live and how much money you make should never be the difference between life and death. Let us commit to a future in which all people have the resources and support to prevent and treat cancer so that no one is left behind.
This article is republished from HealthyDebate under a Creative Commons license. Read the original article.
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Is Your Gut Leading You Into Osteoporosis?
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Bacterioides Vulgatus & Bone Health
We’ve talked before about the importance of gut health:
And we’ve shared quite some information and resources on osteoporosis:
- The Bare-bones Truth: Osteoporosis Mythbusting
- Osteoporosis Exercises (What To Do, And What To Avoid)
- Vit D + Calcium: Too Much Of A Good Thing?
- Collagen For Bones: We Are Such Stuff As Fish Are Made Of
- Which Osteoporosis Medication, If Any, Is Right For You?
How the two are connected
A recent study looked at Bacterioides vulgatus, a very common gut bacterium, and found that it suppresses the gut’s production of valeric acid, a short-chain fatty acid that enhances bone density:
❝For the study, researchers analyzed the gut bacteria of more than 500 peri- and post-menopausal women in China and further confirmed the link between B. vulgatus and a loss of bone density in a smaller cohort of non-Hispanic White women in the United States.❞
Pop-sci source: Does gut bacteria cause osteoporosis?
The study didn’t stop there, though. They proceeded to test, with a rodent model, the effect of giving them either:
- more B. vulgatus, or
- valeric acid supplements
The results of this were as expected:
- Those who were given more B. vulgatus got worse bone microstructure
- Those who were given valeric acid supplements got stronger bones overall
Study source: Gut microbiota impacts bone via Bacteroides vulgatus-valeric acid-related pathways
Where can I get valeric acid?
We couldn’t find a handy supplement for this, but it is in many foods, including avocados, blueberries, cocoa beans, and an assortment of birds.
Click here to see a more extensive food list (you’ll need to scroll down a little)
Bonus: if you happen to be on HRT in the form of Estradiol valerate (e.g: Progynova), then that “valerate” is an ester of valeric acid, that your body can metabolize and use as such.
Enjoy!
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Hard to Kill – by Dr. Jaime Seeman
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We’ve written before about Dr. Seeman’s method for robust health at all ages, focussing on:
- Nutrition
- Movement
- Sleep
- Mindset
- Environment
In this book, she expands on these things far more than we have room to in our little newsletter, including (importantly!) how each interplays with the others. She also follows up with an invitation to take the “Hard to Kill 30-Day Challenge”.
That said, in the category of criticism, it’s only 152 pages, and she takes some of that to advertise her online services in an effort to upsell the reader.
Nevertheless, there’s a lot of worth in the book itself, and the writing style is certainly easy-reading and compelling.
Bottom line: this book is half instructional, half motivational, and covers some very important areas of health.
Click here to check out “Hard to Kill”, and enjoy robust health at every age!
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Brain Food? The Eyes Have It!
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Brain Food? The Eyes Have It!
This is Dr. Michael Greger, M.D. FACLM, of “Dr. Greger’s Daily Dozen” and “How Not To Die” fame, and he wants us to protect our brains (and while we’re at it, our eyesight).
And the secret is…
Lutein.
This is a carotenoid, which is super important for the eyes and brain. Not to be confused with carrots, which despite the name are usually not a good source of carotenoids!
They do however contain lots of beta-carotene, a form of vitamin A, but that (and the famous WW2-era myth born of deliberate disinformation by the British government) isn’t what we’re covering today.
We say “eyes and brain” but really, the eyes are just an extension of the brain in any case.
Pedantry aside, what Dr. Greger wants you to know about lutein is how important it is for the protection of your brain/eyes, both against cognitive decline and against age-related macular degeneration (the most common cause of eyesight loss in old age).
Important take-away info:
- Two things that hasten brain aging are inflammation and oxidative stress. Antioxidant and anti-inflammatory foods mitigate those.
- Researchers investigated eight different dietary antioxidants, including vitamins A and E. Only lutein was “significantly related to better cognition”.
- The macula in the middle of our retina is packed with lutein, and levels in the retina correspond to levels in the rest of our brain.
- Alzheimer’s patients have significantly less lutein in their eyes and in their blood, and a higher occurrence of macular degeneration.
- Dark green leafy vegetables are lutein superstars. A half cup of kale has 50 times more lutein than an egg.
Want to know more about the Dr. Greger’s Daily Dozen approach to health?
See the Website / Get the App (Android & iOS) / Get the Science Book / Get the Cookbook!
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Holding Back The Clock on Aging
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Holding Back The Clock on Aging
This is Dr. Eric Verdin, President and CEO of the Buck Institute of Research on Aging. He’s also held faculty positions at the University of Brussels, the NIH, and the Picower Institute for Medical Research. Dr. Verdin is also a professor of medicine at University of California, San Francisco.
Dr. Verdin’s laboratory focuses on the role of epigenetic regulators (especially the behaviors of certain enzymes) in the aging process. He studies how metabolism, diet, and chemical factors regulate the aging process and its associated diseases, including Alzheimer’s.
He has published more than 210 scientific papers and holds more than 15 patents. He is a highly cited scientist and has been recognized for his research with a Glenn Award for Research in Biological Mechanisms of Aging.
And that’s just what we could fit here! Basically, he knows his stuff.
What we can do
Dr. Verdin’s position is bold, but rooted in evidence:
❝Lifestyle is responsible for about 93% of our longevity—only about 7% is genetics. Based on the data, if implementing health lifestyle choices, most people could live to 95 in good health. So there’s 15 to 17 extra years of healthy life that is up for grabs❞
~ Dr. Eric Verdin
See for example:
- From discoveries in aging research to therapeutics for healthy aging
- Optimism, lifestyle, and longevity in a racially diverse cohort of women
- Well-being, food habits, and lifestyle for longevity—evidence from supercentenarians
How we can do it
Well, we all know “the big five”:
- Good diet (Mediterranean Diet as usual is recommended)
- Good exercise (more on this in a moment)
- Good sleep (more on this in a moment)
- Avoid alcohol (not controversial)
- Don’t smoke (need we say more)
When it comes to exercise, generally recognized as good is at least 150 minutes per week of moderate intensity exercise (for example, a brisk walk, or doing the gardening), and at least three small sessions a week of high intensity exercise, unless contraindicated by some medical condition.
As for Dr. Verdin’s take on this…
What Dr. Verdin recommends is:
- make it personalized
- make it pre-emptive
- make it better
The perfect exercise plan is only perfect if you actually do it. And if you actually can do it, for that matter.
Prevention is so much better (and easier) than cure for a whole array of maladies. So while there may be merit in thinking “what needs fixing”, Dr. Verdin encourages us to take extra care to not neglect factors of our health that seem “good enough”. Because, give them time and neglect, and they won’t be!
Wherever we’re at in life and health, there’s always at least some little way we could make it a bit better. Dr. Verdin advises us to seek out those little improvements, even if it’s just a nudge better here, a nudge better there, all those nudges add up!
About sleep…
It’s perhaps the easiest one to neglect (writer’s note: as a writer, I certainly feel that way!), but his biggest take-away tip for this is:
Worry less about what time you set an alarm for in the morning. Instead, set an alarm for the evening—to remind you when to go to bed.
Want to hear directly from the man himself?
Here he is speaking on progress we can expect for the next decade in the field of aging research, as part of the 100 Minutes of Longevity session at The Longevity Forum, a few months ago:
! Don’t Forget…
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