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Belinda
Research Team
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Posted: Mon Jan 30th, 2006 04:20 |
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(filelink)
Osteoporosis, osteopenia and Th1 illness
Th1 Disease Causes Bone Loss
Osteoporosis literally means "porous bones." It is characterized by gradual loss of bone mass, causing the bones to become thinner, fragile and more likely to break. The risk of fracture is the major concern. Vertebral fractures due to osteoporosis can result in decreased height and cause the spine to curve as shown here. The most common sites of osteoporotic fractures are the hip, vertebra and wrist. You can see photographs of normal bone and osteoporotic bone at the bottom of this tutorial.
Osteopenia describes a lack of calcification in bones. It is the term used to describe bones that are losing mineralization, but not as significantly as in osteoporosis. You can read about how osteoporosis and osteopenia are defined by the World Health Organization here.
The abnormally high 1,25-D (above 42 pg/ml) we know is related to Th1 disease causes bone resorption (the gradual loss of bone) and, therefore, osteoporosis. This phenomenon is explained by Dr. Marshall in his paper A Review-Vitamin D and Calcium in Sarcoidosis. Elevated 1,25-D can also cause resorption of calcium from teeth, resulting in dental fractures. See DENTAL PROBLEMS.
The NIH connects several Th1 diseases with higher risk of osteoporosis, including rheumatoid arthritis, celiac disease, anorexia nervosa, inflammatory bowel disease and lupus.
Activity, Exercise and Weight
Lack of activity is another factor in loss of bone density in Th1 disease. That's because weight-bearing exercise, or any activity that causes muscles to pull against bones, provokes the formation of stronger, denser bones. People have their strongest bone density about age 25-35, when most are quite active and caring for (including lifting and carrying) young children.
It is a problem for those with chronic illness that inactivity and prolonged bedrest can lead to loss of bone density. The problem of decreased BMD is equally challenging for astronauts who experience weightlessness and lack of weight bearing challenges to muscle and bone.
Simple, carefully selected exercises can slow BMD loss and help build stronger bones. If you are not able to exercise now, you can look forward to recovering your stamina using the MP and then working up to exercises that will focus on building strong bones. Studies have shown that even postmenopausal women can improve bone density by adding weight bearing and muscle strenghtening exercises to their routine.
Risk factors you can influence
Other factors that can interfere with strong bone development, according to a nutritionist at Harvard University Health Services, are:
- inadequate intake of either calories or protein. "The body needs adequate nutrition to build strong bones." More people who become osteoporotic tend to be thin with less muscle mass.
- hormone disturbances such as low estrogen in women or low testosterone in men. Note: Some hormone disturbances may be associated with cytokine production as a result of Th1 disease. Dr. Marshall has created a diagram summarizing some of the key relationships between the body's hormones and 1,25-D. You can access it at this link.
- excessive consumption of sodium or caffeine.
- alcohol consumption or
- smoking.
Some Drugs Cause Bone Loss
According to the NIH, use of drugs such as corticosteroids, high-dose thyroid replacement therapy and some anti-seizure medications can lead to loss of bone mineral density. Use of immunosuppressants can lead to rapid bone loss. Methotrexate has been linked to increased urinary calcium output and bone loss. Women who use the injected contraceptive DepoProvera may lose significant bone mineral density.
Other Conditions Associated with Osteoporosis
Having too much parathyroid hormone - hyperparathyroidism - can result in osteoporosis. Too much thyroid hormone, hyperthyroidism, can cause bone loss and osteoporosis.
Minocycline Helps Strengthen Bones
Animal studies conducted by the National Institutes of Health over the past several years have shown that *minocycline* increases bone density, improves bone strength and slows bone resorption. This study showed that minocycline stimulated bone formation in rats.
Does bone pain mean I have osteoporosis?
Loss of bone density is usually painless - which is why many people do not know they have the problem until they suffer a fall or fracture (which can be painful). If you have back pain or bone pain, your doctor may evaluate you to see if you have a fracture. Th1 disease can cause bone pain and quite a few of our members have reported bone pain as a Herx symptom.
Fall Prevention
Osteoporotic fractures can occur without any trauma, but people who are at risk should take care to prevent falls. You can reduce the risk of injury and broken bones if you:
* Increase your activity level gradually (but avoid unusually high impact sports)
* Wear supportive shoes with low heels and non-slippery soles
* Use support for walking, such as a cane, if you need it
* Maintain a safe and uncluttered home to help prevent falls
* Avoid throw rugs on your floors at home
* Avoid icy, wet, or slippery surfaces, especially in the bathroom
* Use nonskid mats in the shower and bathtub
Related information on this website:
Don't I need Vitamin D to prevent bone loss?
What does my bone density test mean?
My 25-D is low. Should I be concerned about osteoporosis?
Don't I need to take a calcium supplement?
Calcium Fact Sheet
Why are so many doctors ordering Vitamin D supplementation?
Vitamin D-Basic Information
See also Medications to avoid on the MP:
Biphosphonates-When patients with an elevated level of 1,25-D are given Fosamax (or other biphosphanates), it can cause calcium deposition into the soft tissues, reduced organ function and possible osteonecrosis of the jaw (ONJ). All these meds have some effect on the immune or endocrine system and are, therefore, to be avoided.
Biphosphonates and inflammation 4/13/06 Fosamax causes osteonecrosis of the jaw lawsuit
http://tinyurl.com/qharu
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Belinda
Research Team
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Posted: Mon Jan 30th, 2006 12:08 |
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What does my bone density test mean?
(filelink)
DEXA: Dual Energy X-ray Absorptiometry
The most widely test used to screen for osteoporosis is a bone density test (densitometry) that uses an enhanced X-ray technology called dual-energy x-ray absorptiometry (DXA or DEXA). This is NOT the same as a bone scan, which relies on a radioactive injection to help detect areas of increased bone metabolism due to fracture, infection or tumors.
During a bone density test, a low energy source is passed over the body. Information evaluated by a computer allows an estimate of bone mass. This helps the doctor get an idea of bone strength, osteoporosis and risk of fracture.
The results of a DEXA bone density test are interpreted by a radiologist and and report is sent to the doctor who ordered the test. The results will have two scores or numbers.
Understanding the Scores (<--click here)
Your T-score compares you to a young adult of your gender with peak bone mass. Any T-score larger than -1 is considered normal.
The Z-score reflects the amount of bone you have compared to other people your same size, age and gender. This number is related to percentiles. Originally, only Z-scores were calculated, but when bone density machines became commercially available beginning in the 80's, T-scores were devised because different manufacturers could not agree on a standard measurement. You can read about calculating and interpreting both scores here.
Still confused about what DEXA scores mean - in simple terms? Read this from the NIH.
How to read DEXA reports
There are step-by step directions on how to read DEXA reports in this tutorial.
Problems With DEXA Scores
The reproducibility of DEXA scores is frequently reported at 1-2 percent. That 1-2 percent is the average, but the range of reproducibility can vary as much as 7 percent. Variations come from changes in machine reading (using the same machine), technologists who are doing the test, and slight changes and body positioning, all of which can affect the end results. The most frequent source of error in repeat tests is patient positioning. The technology is limited because BMD is a two-dimensional image of a three-dimensional object.
A few more issues related to DEXA scores are covered in this Wikipedia article which says, inter alia, "It is important for patients to get repeat BMD measurements done on the same machine each time, or at least a machine from the same manufacturer. Error between machines, or trying to convert measurments from one manufacturer's standard to another can introduce errors large enough to wipe out the sensitivity of the measurments."
This Medscape article (registration required, but it is free) reviews the uses and limitations of BMD measurements and the relationship between BMD and bone strength.
Other Techniques
Other tests that are used to evaluate bone health include bone ultrasound (usually of the heel) and quantitative computed tomography (QTC) of the spine.
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Meg Mangin R.N.
Research Team
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Posted: Wed Feb 1st, 2006 03:10 |
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Ways to increase bone density Increasebonedenslink
Animal studies conducted by the National Institutes of Health over the past several years have shown that *minocycline* increases bone density, improves bone strength and slows bone resorption. This study showed that minocycline stimulated bone formation in rats.
Beyond the elevated Hormone D that causes calcium to be pulled from bones, lack of activity is another factor in loss of bone density in Th1 disease. That's because weight-bearing exercise or any activity that causes muscles to pull against bones provokes the formation of stronger, denser bones. People have their strongest bone density about age 25-35, when most are quite active and parenting young children. Lifting and carrying young children is good exercise for building strong bones.
You can look forward to recovering your stamina using the MP and then working up to exercises that will focus on building strong bones. Studies have shown that even postmenopausal women can improve bone density by adding weight bearing and muscle stenghtening exercises to their routine.
Other factors that can interfere with strong bone development, according to a nutritionist at Harvard University Health Services, are:
- inadequate intake of either calories or protein. "The body needs adequate nutrition to build strong bones."
- hormone disturbances such as low estrogen in women or low testosterone in men.
- excessive consumption of sodium, protein (the key is enough protein, but not too much) or caffeine.
- alcohol consumption or
- smoking.
The NIH connects several Th1 diseases with higher risk of osteoporosis, including rheumatoid arthritis, celiac disease, anorexia nervosa, inflammatory bowel disease and lupus.
According to the NIH,
- Use of drugs such as corticosteroids and some antiseizure medications can lead to loss of bone mineral density.
- Loss of bone density is painless - which is why many people do not know they have the problem until they suffer a fall or fracture.
- Fractures can occur without any trauma, but people who have osteoporosis should take care to prevent falls.
Th1 disease, on the other hand, can cause bone pain. And quite a few of our members have reported bone pain as a Herx symptom.
Belinda Fenter
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Meg Mangin R.N.
Research Team
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Posted: Tue Mar 7th, 2006 01:19 |
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Scientific studies
Polymorphisms at the ligand binding site of the vitamin D receptor gene and osteomalacia.
Calcium, Vitamin D Won't Protect Older Women From Fracture
"At the same time, women taking calcium plus vitamin D experienced an increased risk for kidney stones, they added."
.....................................
Epidemiological study finds a strong association between high 1,25 D levels and osteoporosis.
Relationships between bone mineral density, serum vitamin D metabolites and calcium:phosphorus intake in healthy perimenopausal women.
Brot C, Jorgensen N, Madsen OR, Jensen LB, Sorensen OH.
The Danish epidemiologist Brot studied 500 healthy women ( that is they were not drawn from a population with particular health issues) aged 42 to 58 and concluded that in this group bone density was strongly inversely proportional to 1,25 D levels ( that is low bone density was strongly associated with high 1,25 D levels) and only rather weakly directly proportional to 25 D levels. The sample was chosen randomly - and was not done to test the impact of any particular treatment programme. Last edited on Sun Jan 14th, 2007 21:00 by Meg Mangin R.N.
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Belinda
Research Team
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Posted: Mon Jul 3rd, 2006 16:35 |
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Q: re Continued Bone Loss?
I've been on the MP for over 1 and 1/2 years. When I started my D was 9.3 and 1,25 was 70. Now it's D 6.2 and 1,25 = 20.9. My doctor is now concerned that the levels are too low (under the normal range for 1,25) but also that my alk phosphate level has gone from 56 in 2003 to 134 now. A recent bone density scan has revealed significant oseoporosis and I have frequent broken ribs (hairline fractures) from doing nothing at all (like turning in bed).
I know the recommendation is against products like Boniva and Fosomax. I'm concerned, however that after a significant time there's been no improvement, but, in fact, continued bone loss.
Reply: from Belinda: Did you have actual bone density test numbers from pre-MP to compare with your most recent results?
The normal range of ALP, according to Medline is 20 to 140 IU/L, so your ALP is still within the normal range at 134. see further detail in FAQ What do my lab tests mean?
When my 1,25-D finally dipped below normal, I reminded my doc that getting 1,25-D was simple: just add a little light now and then. You could experiment to see if you could tolerate a little light exposure, like popping outdoors to move the water sprinkler in the late evening, when light rays are less direct. Remember to wear your sunglasses. Be on the lookout for how your body reacts to any increased light exposure, however brief.
The best way for normal people to induce bone building is to engage in weight-bearing exercise such as walking. For folks with Th1 - and dysregulated vitamin D, the first step to stronger bones is getting the elevated 1,25-D under control. So you are on the right path.
Sometimes the best answers are in non-drug interventions. Have you talked with your doctor the feasibility of beginning simple weight-bearing exercises with only a few repetitions, maybe every other day?
P.Bear R.N. reply: Your disease process helped cause these T scores, and the MP is the best thing you could possibly do to halt bone loss. It may also set your mind at ease if you read the book
The Myth of Osteoporosis: What Every Women Should Know About Creating Bone Health
by Gillian Sanson An interview with her here:
http://www.womenshealthmatters.ca/resources/show_res.cfm?ID=42199
Although she does not have our new information on "vitamin" D and does not understand that a low 25-D is most frequently associated with a high 1,25-D; she is generally on the right track.
You can see that test scores are not a good predictor of fracture. I hope your doc will continue to help you with the MP. best, P.B.
Meg Mangin R.N.
Although you have lost bone density since your last bone scan, the rate of loss may have slowed. This was the case for me and my doctor was impressed. Check previous bone scans if possible and ask to be tested again after you've been on the MP longer.
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