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New Osteoporosis Guidelines

From eNewsletter 4/29/2019

DID YOU KNOW that according to a study in this month's Current Opinion in Gastroenterology, there is a significant overlap between Irritable Bowel Syndrome (IBS) and gluten intolerance? The authors state that a large subset of patients presenting with IBS actually have gluten intolerance. Moreover, they purport that individuals with IBS have symptoms triggered by gluten. It all comes back to gluten doesn't it?


Starting today and ending Wednesday, you can order sale items for April and May. See below for details.


Steve and Bonnie: New Endocrine Society guidelines on the treatment of osteoporosis in postmenopausal women appeared in the March issue of Journal of Clinical Endocrinology & Metabolism.

While light on details, at least they strongly recommend lifestyle and nutritional optimization for bone health, especially calcium and vitamin D supplementation. Once again, they are clueless on what calcium source and how much calcium and vitamin D should be prescribed. This is crucial information that needs to be individualized. Too much or too little calcium, as well as the wrong calcium source, can do more harm than good. Of course, they do not mention magnesium as being critical to bone health.

As in the past, bisphosphonates and denosumab medications are still advised as first-line drug therapies. While we continue to have a major problem with this, at least they now recommend a drug holiday in individuals who have been on a bisphosphonate for up to 3 years. This change stems from myriad adverse events, including osteonecrosis of the jaw.

The problem we have with medication is that it is recommended way too early in the process because the guidelines for whom is considered osteopenic or osteoporatic is not individualized. We've seen countless women misdiagnosed with bone disorders because of a DEXA scan that does not take into account their naturally small frame and/or bone structure.

The only bone medication we have found to be safe for short-term use is Forteo (teriparatide). We only recommend it as a last resort if a DEXA scan score is much higher than what conventional guidelines suggest.

Moreover, the guidelines don't include recommendations regarding use of Evenity (abaloparatide), which was approved by the FDA just prior to the release of these guidelines. We've had many clients ask us about this medication, and we stick to our steadfast rule: wait at least two to three years to try any new medication. We've seen it too many times where a new drug comes to market and a few years later severe side effects appear that were never recognized in premarket studies.

The latest research updates on osteoporosis and bone health are highlighted in this issue's "Wild Card" segment.


Steve: The way substance use and misuse are viewed in medicine has dramatically changed over recent years...this article is reserved for NCI Well Connect Members. You can get this article by signing up here. You can get our free eNewsletter by signing up at the top of our website.


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