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EVISTA - (Raloxifene) in the news. June 2006
Evista is one of a class of drugs known as selective estrogen receptor modulators or SERMs that includes the drug Tamoxifen given to women at high risk for breast cancer. As often happens in modern medicine, a drug prescribed for a certain purpose shows risks and benefits in unexpected ways. In the late 1980s researchers noticed that women taking Tamoxifen had increased bone density.
Since then the SERM raloxifene (Evista) has been developed as a treatment for osteoporosis and has been found to reduce the risk of vertebral but not hip fractures in high risk women. Tamoxifen increases risks for clotting and uterine cancer and Evista carries a threefold increased risk for clotting – similar to that found with HRT. More...
Strontium – A novel bone building treatment
The mineral strontium is attracting a great deal of interest as a new treatment for osteoporosis. It is now approved for use in the UK as an alternative to bisphosphonates, but has not yet had FDA approval in the US.
Strontium lies directly below calcium on the periodic table of elements. Calcium, strontium and magnesium all belong to the same chemical family so strontium is an element with properties similar to calcium. In the 1940s it was discovered that the body contains significant amounts of the mineral and that 99 percent of it is in the skeleton. Strontium appears to play a crucial role in bone remodeling as it tends to migrate to sites in bone where active remodeling is taking place. More...
BONE HEALTH
Women are regularly asking where they can
go to get advice for non-medical approaches to bone health. Dr
Susan Brown author of
Better Bones, Better Body: Beyond Estrogen
and Calcium directs
the Osteoporosis Education Project and the Nutrition Education
and Consulting Service in Syracuse New York . She conducts research,
lectures widely on osteoporosis prevention and reversal, and teaches
the use of a holistic, natural program for the regeneration of
bone health. The service offers telephone consultations with individuals
the world over. Find out more at www.susanbrownphd.com or www.betterbones.com
Perpetuating the Hype: The U.S. Surgeon General
Report on Osteoporosis 2004
The October 2004 report released with great fanfare
and media attention has created a new wave of fear among populations
of well men and women. But claims that by the year 2020 half of
all American citizens older than 50 will suffer osteoporosis-related
fractures are unsubstantiated, and alarming hip fracture mortality
rates misleading. When osteoporosis is characterised by fragile
bones that break easily it is linked most often to serious chronic
conditions afflicting a small percentage of the population. A close
examination of the evidence reveals that the great majority of
the population need not be concerned about the disease. In fact
for most people a good diet, healthy lifestyle and regular exercise
are sufficient protection against future fracture. In the words
of Californian Osteoporosis expert Dr Bruce Ettinger, "the osteoporosis
that causes pain and disability is a very rare disease". More...
The Osteoporosis Treatment
Paradox
Once defined as the relatively rare disease of fragile or porous bones, osteoporosis
was re-defined in 1994 as a condition characterised by low bone mineral density.
Overnight, normal age-related decrease in bone mineral density became categorised
as abnormal and postmenopausal women were warned that they had a 50 percent chance
of developing osteoporosis.
Frightening images of the bent older woman, and
the wheelchair bound elderly hooked healthy women into repeat
BMD screening and long-term drug therapy.
Hormone replacement therapy was the gold-standard treatment for osteoporosis for over twenty years. But evidence for fracture benefit from HRT remains minimal, and following the damning evidence of breast cancer, heart disease, clotting, and stroke risk from the WHI trial in 2002 it is no longer considered safe to be used long term. As vast numbers of women come off HRT, doctors are being urged to identify at-risk patients and proceed with alternative bone sparing treatments.
IMaking the decision to embark on osteoporosis treatment is complex and difficult. Ultimately, the decision to undergo treatment must involve a careful weighing up of your risk for fracture against the risk of embarking on a treatment that cannot guarantee prevention of fracture and carries unknown long term side-effects. When examining current osteoporosis treatments, a paradox emerges. Although they may influence bone density, they do not benefit the majority of people taking them. It is even possible that they may worsen a patient’s condition. Most of the current treatments do not build new bone or stimulate the growth of new bone. They are classified as ‘anti-resorptive’ treatments because they slow down bone resorption or bone loss.In most cases low bone density alone is not a disease requiring treatment. A genuine diagnosis of established osteoporosis (fragile bones) is most often linked to other factors such as corticosteroid use, Celiac disease or Crohn’s disease, hormone disorders such as hyperthyroidism, low blood levels of Vitamin D and high levels of calcium excretion. These conditions require individualized treatment.. More...
Pregnancy Related Osteoporosis
This is a rare condition where bones become fragile
and break easily either during pregnancy or after pregnancy. Painful
fractures can occur in the spine or occasionally the hip. It is
a condition which probably goes undiagnosed in many cases. Women
with the condition can find it very difficult to find information.
There is good news. Much is still not understood
about the condition, but it is known that these broken bones heal
normally, that most women make a full recovery, and that the condition
does not recur with subsequent pregnancies. The
National Osteoporosis Society in the UK have produced helpful
literature. More...
The
Myth of Osteoporosis: Blowing the Whistle on the Epidemic
When my friend Ann turned 45 she went for a bone densitometry
scan. She is one of the healthiest women I know, but because
she is small-framed and has avoided dairy products all her life
her doctor recommended it as a responsible thing to do. |
As she slid off the radiology table after the test, the technician warned her that by the time she is 80 she ‘could be in big trouble’. Later, the specialist informed her that she had ‘decreased bone density’ and advised a calcium supplement programme and a repeat scan in two years to monitor a potentially serious problem. Until that point, Ann had thought osteoporosis was a rare disease suffered by stooped elderly women who hadn’t had enough calcium and vitamin D when they were children. Suddenly she was worrying about falling and splintering and wondering if she should take more care when she exercised. It never occurred to Ann to question the diagnosis or to wonder why osteoporosis now afflicts half of all women over the age of 50, making it more widespread than breast cancer, AIDS and heart disease combined. More...
Bad Break: Homocysteine may weaken bones
by Nathan Seppa, Science News On Line May 15 2004
In the 1960s, scientists discovered that people with a gene mutation that leads to extremely high concentrations of the amino acid homocysteine in their blood are prone to heart problems and bone deformities. Since then, physicians have found that even moderately elevated homocysteine readings increase people's risk of heart disease.
Now, two groups of researchers poring over medical data find that elderly people with excess homocysteine fracture their bones more readily than do those with low amounts of the compound in their blood More...
Bone Diagnosis Gives New Data But No Answers
By Gina Kolata, New York Times September 28, 2003
The disease, if it is a disease, afflicts most middle-aged and elderly women, and a large segment of men. But it has no symptoms, it is not clear what patients should do about it and it is being diagnosed more and more often.
The condition is osteopenia, or low bone density. It is considered by many doctors to be a first step along the path to osteoporosis, a serious condition in which bone density is extremely low and bones are porous and prone to shatter. But researchers say that while bone density predicts fracture risk, more is involved, including age, family history and a poorly understood factor known as bone quality. More...
The Calcium/Dairy Myth
Although calcium intake is essential, bones are
complex and dynamic and have a wide range of nutritional needs.
Taking a calcium pill does not guarantee that it will end up in
your bones and it does not appear to prevent fractures. Too much
supplemental calcium can even be harmful.
So what about the instructions to drink lots of milk, particularly while young?
More...
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