How To Increase Bone DensityOnly supplement the estimated amount you do not get through your diet. Bone density tests are. Foods Good For Bone DensityAsk the Osteoporosis Experts. Online Health Chat with Dr. Andrea Sikon and Dr. Johnny Su. May 4, 2. Introduction. Cleveland. Improving Bone Density through Diet and. Improving bone density through diet. A balanced diet. Calcium is an essential nutrient for bone health. A well-balanced diet. Where Can I Go for More.
Our experts will discuss how both men and women are affected by this metabolic bone disease. They will address early detection and prevention strategies that focus on balance and falls, vitamin D intake and the amount of calcium in your diet, along with the variety of osteoporosis medications available. Osteoporosis is a common, preventable, and treatable form of metabolic bone disease. Ten million Americans have this condition. Four- fifths of them are women. Early identification and treatment of low bone density is most effective in increasing bone mass and avoiding painful fractures. Andrea Sikon, MD, FACP, NCMP, CCD, is the Chair of the Department of Internal Medicine at Cleveland Clinic in Cleveland, Ohio. She is a National Certified Menopause Practitioner (NCMP) through the North American Menopause Society (NAMS) and a Certified Clinical Densitometrist (CCD) through the International Society of Clinical Densitometry (ISCD), practicing in both Internal Medicine and the Center for Specialized Women’s Health. Sikon’s clinical interests are in women’s health, osteoporosis, and menopause. She started the Primary Care Women’s Health program of the Medicine Institute at the Cleveland Clinic as its first director in 2. Johnny Su, MD, is a rheumatologist in the Orthopaedic & Rheumatologic Institute. He specializes in osteoporosis and general rheumatology. Su graduated from the University of Michigan Medical School and went on to complete a residency in Internal Medicine at University Hospitals of Cleveland. He also completed a fellowship in rheumatology at University Hospitals of Cleveland. He is a member of the American College of Rheumatology and the International Society of Clinical Densitometry. To make an appointment with Johnny Su, MD, or any of the other specialists in our Department of Rheumatic and Immunologic Diseases at Cleveland Clinic, please call toll- free at 8. You can also visit us online at clevelandclinic. To make an appointment with Andrea Sikon, MD, please call 2. You can also visit us online at clevelandclinic. Cleveland. Andrea Sikon and Dr. We are thrilled to have them here today for this chat. Let’s begin with some of your questions. TREATMENTSJean. B: Are there alternatives for those of us who would prefer not to take drugs ? My doctor is very adamant that I take Fosamax. She says I am at high risk because I am white and thin (1. I have been diagnosed with osteoporosis of the spine; my hips are okay. I am 6. 8 years old and have no history of osteoporosis on my maternal side; one aunt on my paternal side had osteoporosis. I have been on/off Fosamax for over a year and have experienced side effects. Prior to that, I took Actonel for several years. I exercise daily and take calcium and Vitamin D. My general practitioner told me that taking calcium does no good. I feel I'm being pro- active for my health, but what else can I do aside from take drugs? I have been struggling with this question for a few years. In terms of whether you need osteoporosis drugs at this point in time, it depends on whether your bone density test is stable and how long total that you have been on either Actonel or Fosamax. A urine test, called urine NTX, can be used to determine if previous medications are effective. An appointment is recommended in order to be more specific with regard to individualized recommendations. My father had Paget's disease. My mother had osteoporosis and celiac disease. I was on Fosamax for 1. Miacalcin. Recent DEXA testing showed osteoporosis in spine, osteopenia in hips. What should I be doing now for the osteoporosis? If the bone density is stable, and you were on Fosamax for 1. NTX shows that you are losing the effects from previous Fosamax use. I would need to know results for your bone density tests and other medical history to see if you should continue it. Metaphor: My question relates to conflicting medications and supplements: Is it safe to take omeprazole (Prilosec? Does having had a zoledronic acid (Reclast? How does a family history of severe osteoporosis contribute? Is Citracal? My bone density numbers are slowly going down, and I have had two stress fractures in the last 3 to 4 years. I also had cortisone shots in my back for osteoarthritis over several years. No doctor seems to have a comprehensive answer. Products like Prilosec, Nexium, famotidine (Pepcid. To be safest, you can either ingest your calcium in your diet by eating/drinking food that is high in calcium, like skim milk and dark green leafy vegetables, or you can take a calcium citrate supplement instead of calcium carbonate. Calcium citrate does not need an acidic environment to be absorbed and thus should not interfere with Prilosec, Nexium, etc. Reclast should not change this. Family history dramatically increases a person's own risk of osteoporosis and bone breaks/fractures, but does not necessarily weigh in on the calcium absorption issue above. I recommend doing a calcium calculator, of which many can be found online by searching . Postmenopausal women need 1. If you are taking enough calcium, taking enough vitamin D and getting Reclast, and you are still breaking bones, you should likely be checked for other causes of osteoporosis, called secondary causes, which may be missed. Doctors who specialize in bone health, such as women's health doctors, rheumatologists, and endocrinologists, can all help to guide such an evaluation and next best treatment steps. I am off the Nexium that had an impact on my back (curving), but I am taking 2. Also, taking large doses of calcium really aggravates my stomach. First, will taking the 2 doses of Pepcid a day have the same effect as the Nexium? Is it the reduction of acid or the medication that causes the mal- absorption? What medication do you recommend for patients with both conditions? I feel like I have to choose between my stomach and my bones! Please tell us how you treat people with severe acid reflux and osteoporosis. Is taking two 2. 0mg doses of Pepcid every day the same as taking a proton- pump inhibitor (PPI)? Dr. I recommend that patients try to get their calcium preferably from their diet, rather than supplements, when possible. For some, it is too hard to do, especially those with lactose intolerance, as dairy products have the most calcium concentrations. If a supplement is needed, calcium citrate is a type of calcium supplement that does not need an acidic environment in the stomach to be absorbed and can be used when antacids are necessary. DJOHNSON: I have been advised by my physician to get a Reclast IV treatment or denosumab injection (Prolia. I am researching the side effects. I would like information about these from you. I was found to have holes in the L1- L2- L3 (vertebrae). They told me that if I fell, these would collapse, and I would be in very bad pain. I do have acid reflux and years ago tried Actonel and Fosamax, which really messed with the reflux. What does this Reclast do? My insurance will pay for it, but I have to find out about the Prolia. I am taking calcium with vitamin D x. Please help me decide what I need to do. Thank you in advance. Prolia is stronger than Reclast and may actually help you make more bone. Both of these medications are better alternatives than the pills due to the reflux. Websites for the two drugs are www. I recommend an appointment to better assess which medication is more suitable for you individually. Goferbroker: Please comment on medications appropriate for restoring bone density. I have very low testosterone levels that have been causing loss of bone density. I am using testosterone gel (Testim. In addition to treating low testosterone level, medications such as Reclast, Boniva, Actonel, or Fosamax may be needed to treat low bone density. But if you already had fractures related to bone density, medications such as teriparatide (r. DNA origin) (Forteo. Choice also depends on other concurrent medical conditions that you are being treated for. What drug do you think is the most effective? Dr. Generally, as aging is one of the most significant risk factors for aging and that Prolia can be used even if kidney function is reduced, which is also common in the elderly, it is generally a very nice option. There have not been head to head studies to date that I know of between Prolia and bisphosphonates to be able to answer which is . In general, all of the therapies for bone are safe, especially so if tailored based off of an individual's risk profile. Marvin: I have several spinal fractures which are causing pain. Would a testosterone patch applied to the fracture site on my back be likely to ease pain and help the condition? I understand of course that I would need a prescription for the patch. I have received zoledronic acid (Zometa. When one vertebra breaks, it causes a change in the positioning of the spine and can put stress on the vertebra above and below, causing more pain and increasing the risk of breaks in other vertebra as well. Testosterone therapy is not used to treat the pain from osteoporosis but rather if there is low testosterone levels as a cause from OP. You should, if you have not already, have a full secondary evaluation to find out if there is a specific condition that is causing your low bone density and breaks. My recent bone density test indicated that I have a T Score = 0. Should I take a ? I have never had a problem with the medications. My MD says we can discuss this, but has not come up with a conservative solution. I have never broken any bones and am somewhat concerned to go off this since all is going well for me. Thank you. Dr. Whether you need to be on another medication instead depends on the trend of your bone density test results. What is more important on your recent bone density is change from last bone density rather than T- score.
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