Osteoporosis: Prevention and Treatment
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- Опубліковано 16 кві 2023
- Osteoporosis is a condition in which bones lose mass and become weak and brittle. It affects 10 million people and causes two million fractures in the U.S. per year. Joy Wu, MD, Chief, Division of Endocrinology, discusses the testing, diagnosing, and treatment of osteoporosis. She describes the condition’s risk factors, who should get a bone density test (DXA), and what steps you can take to decrease your risk. Dr. Wu covers common medications such as Fosamax (Alendronate), Boniva (Ibandronate) and other osteoporosis medications, including the pros and cons of each. Finally, Dr. Wu answers many questions from the audience.
Joy Wu, MD, PhD, is a board-certified endocrinologist who specializes in treating osteoporosis and other bone and mineral diseases. Dr. Wu is Chief of the Division of Endocrinology, Gerontology and Metabolism and Vice Chair of Basic Science in the Department of Medicine at Stanford.
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The confusion starts by using the term “falls” and “accidents” with the assumption that it means the same thing as fractures. “50 % of people over 50 years experience falls” does Not mean that it translates into fractures.
The actual statistics show only one in a hundred people will get a fracture, and that that one person may be helped by a “bone health” medication only half the time. That is, of 200 people, only two may have a fracture, and only one of them might be helped with medication. That’s one in 200, That’s .05% improvement at best, with quite possibly a pharmaceutical company funded bias. (Often relative statistics are quoted instead of absolute results, which confuses doctors as well as their patients.)
Necrosis of the jaw is Not “rare.” The whole action of a drug such as Fosamax, the bisphosphonates, is to Stop all osteoclasts from continually breaking down old or damaged bone cells while osteoblasts are Stopped from rebuilding it. The result is the old and damaged material that’s not removed builds up, thus making the bone Appear thicker or “denser.” This increase is the result of blocking the osteoclasts from taking out the bone trash, while rebuilding bone naturally is blocked.
With medication, the bone is more dense, but not stronger. It’s actually more porous. For bone under more heavy use in body action, such as the jaw or femur, the blocking of bone building causes eventual disintegration of the bone. This is why patients are put on a drug “holiday”, usually after about three years. The drug is removed before damage is so severe that it will be a problem for every patient. It’s not a rare “if” problem, it’s a matter of when it becomes so damaging that it’s noticed as an eventual “side effect.”
Because bone building is halted, if a break does occur, healing is difficult or impossible. This may be temporary if taken off the medication, or it will have so damaged the ability of osteoblasts to build bone, that trouble building bone and repairing breaks is permanent.
Finally, a break doesn’t necessarily mean a patient has unusually fragile bones. They may be fragile because of a sedentary lifestyle, they broke a wrist or thumb while skiing, or slipped on black ice. These are behavioral issues, not issues that need to be medicated.
Bravo, you hit the bone, er, nail on the head! There has been an incredible coverup of the horrible class of drugs, the bisphosphonates. What a scam, what a racket. This is "science?"
Thanks
What is difference between t-score and z-score? Which one is more powerful marker of osteoporosis?
What about EchoLight? It’s supposed to be much more accurate than DEXA.
I’m confused . If my bone density is -2.7 and I’m 58. 7 stone . 4ft 9 in . Do I need medical advise ?
Also if you get osteonecrosis what can they do medically?
please see your gp immedialtly if u have op u will be prescribed many possible treatments depinging on your own circumstances. fist things first get a dexa scan immediatley
@@davidakin3840 thank you
What about osteoporosis I before menopause in younger age about 36?
Forget calcium ! Do research on minerals, K7 !
Lift weights 🏋️♀️ 3 x a week
What if my doctor won’t listen to me?
The how much milk question is ludicrous. There are so
many other sources of calcium. The calcium in milk is poorly absorbed.
The calcium from milk is well absorbed by the body. Stop spreading misinformation with your inadequate knowledge.
Lots of negative reports about Prolia.
My dr just prescribed prolia but I'm hoping to be seen at stanfird soon I already have a referral and holding out for my appt there before I start prolia
Typical Doctor pushing drugs!
Thanks so much. I won’t bother watching.
OMG, it's so PATHETIC how these doctors treat osteoporosis and other diseases, they don't have a fucking clue what they're doing, its shocking to me how unscientific the medical community is sometimes.
38:52 Being a physician myself. I found that the speaker was not pushing meds, but just giving the facts. Unfortunately there are lazy people out there that do not care to exercise..ever, and will end up on medication. Those that are on meds unfortunately as steroid will be at more risk, or those confined to bed or wheelchair. Physical therapy will be helpful. In general, if you walk and use moderate weights, you will increase the mechanical load on your bones, and reduce your risks. I also appreciate the fact that she gave tips like having night lights in hallways and bedrooms at home, especially for older individuals. People with Parkinson's as well should be extra careful to avoid falls.
@@patriciawarmoth661Dismissing that bone loss doesn't cause pain is disingenuous and dismissive. Many are in severe pain, yet this is all too often dismissed, or blamed on other causes. To dismiss patients as 'lazy' is not helpful, and is a reason so many look to other sources of care, and may either give up from frustration, and/or look to alternative treatments (for better or for worse), become victims of whatever is being sold on the market, including painkillers (OTC, Rx & street drugs).
While there may be a small percentage of people who are lazy, this is generally not the case.
I hope, for the sake of your patients, you re-think your view of your patients.
So many people feel they have to go outside the medical industry for true Healthcare as a direct result of such dismissive attitudes.
Additionally, the statement about bone loss not causing pain (in this presentation) is, in many cases, simply not true.
Pain is far too often dismissed. Patients who have been in chronic pain often don't bother bringing it up, yet when asked in a genuinely concerning manner, will tell you that they are in fact in pain. If you don't ask, they will generally not tell you.
In addition, irritability can be a sign of pain that doesn't necessarily register as such, yet when acknowledged and properly addressed, there are better patient outcomes.
So many don't think to mention that they have been taking OTC ibuprofen, Tylenol and other painkillers, using CBD or other drugs, and may not make the connection between this and osteopenia or osteoporosis.
I would hope this subject would be considered in future presentations.
One can look online for the numerous persons looking for help with their pain outside the confines of the medical industry, and the many offering diets, supplements, or even street drugs, to discover that this is a very real problem.
As James Campbell, M.D. of the American Pain Society says, "Pain is the 5th vital sign".
When we ignore pain, or dismiss it, our patients are not treated properly, and sadly, often look outside of medical guidance for relief, which unfortunately doesn't treat the underlying cause, and can lead to disastrous outcomes for patients.
He goes onto say,"Quality care means that pain is measured and treated."
I hope you, and others who may not have considered this, take this into account with your patients in the future.
Bruh just do strength training.