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Osteoporosis
- The Silent Epidemic Article Index
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| Osteoporosis
Prevention & Treatment - Drug and Hormone Therapies |
Estrogen
replacement therapy
One of the functions of estrogen is to slow down the bone resorbing
activity of the osteroclasts. It also stimulates the production
of active form of vitamin D metabolites, helps your kidney conserve
calcium and triggers your pituitary gland to release growth hormones
that stimulate the growth of bone. The difference in our center
is we only use bio-identical estrogen and progesterone replacement
using transdermal delivery methods. We evaluate all our female patients
for testosterone deficient and if indicated will include testosterone
replacement in low doses to increase bone formation. Also we use
only the natural form of progesterone due to that fact that synthetic
progestins e.g. provera or Depro-Provera have be indicated as cause
for osteoporosis. (see section on natural hormone replacement)
Selective
Estrogen Receptor Modulators (SERMS) sometimes
called designer estrogens these drugs have a few effects as estrogen
but they don't stimulate breast or uterine tissue like estrogen
does. The only FDA approved SERM for the treatment of osteoporosis
is raloxifene (Evista). The problem with the use of this drug is
the potential to worsen menopause symptoms in greater then 30% of
patients. Recent studies have shown it proving out to lower the
incidence of breast cancer final results pending results of the
ongoing star trial. Thus Evista is a excellent options for women
with history of breast cancer.
Calcitonin
Calcitonin is a naturally occurring hormone that acts directly on
osteoclasts (via receptors on the cell surface for calcitonin), and
bone biopsies from patients treated with the drug show no effects
on mineralization but reduction of vertebral fracture rates occur.
Parathyroid
Hormone
A new drug called Forteo (generic name,
teriparatide) may soon be the first FDA approved treatment for osteoporosis
that actually helps form new bone in patients. Forteo
significantly reduced the incidence of spinal and non-spinal fractures
and increased bone mineral density in post-menopausal women with osteoporosis.
Forteo is identical to a portion of the human parathyroid protein,
a hormone responsible for bone formation. Eli Lilly, is the maker
of Forteo, and approval for release should be within the next few
months. This represents the first anabolic agents to be approved that
will actual rebuild bone and represents a potential cure.
Statins
The
use of the class of drugs known as Statins (coenzyme A reductase inhibitors)
which are commonly used in the treatment of elevated cholesterol have
also been found to increase Bone mineral density and reduce fracture
rate. These drugs appear to hold some promise in the treatment of
osteoporosis.
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Disclaimer: The
information contained on this website has not been evaluated by
the FDA. This information is not intended to treat, diagnose,
cure or prevent any disease. All material provided in the Dr.
Brizel's web site is provided for educational purposes only. Always
seek the advice of your physician or other qualified health care
provider with any questions you have regarding a medical condition,
and before undertaking any diet, exercise or other health program.
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