Archive for the ‘Osteoporosis’ Category

Top 5 Recommendations for your Family Doctor

Posted on: May 31st, 2011 by doctor No Comments

According to the National Physicians Alliance, the 5 steps your family doctor can take to most likely improve the quality of care you and your family receive are:

  1. DON”T do x-ray, MRI, or CT imaging for low back pain within the first 6 weeks unless red flags exist for other serious conditions that present with low back pain.  Low back pain in the 5th most common reason for a visit to the doctor.
  2. DON’T prescribe antibiotics for most cases of sinusitis unless severe, and symptoms of colored nasal discharge, facial pain, or dental pain last 7 or more days.  Most cases of sinusitis seen in clinics are due to viral infections that will resolve on their own.  Still, antibiotics are prescribed for 80% of these patients.
  3. DON’T order electrocardiogram (also known as EKG or ECG) for patients without cardiac problems or at high risk of cardiac problems.  Without symptoms or being at high-risk, EKG testing is likely to cause more problems than it is likely to help.
  4. DON’T perform Pap tests for patients younger than 21 years (most abnormal results resolve on their own) or women with a hysterectomy without a medical history of cancer of the reproductive organs.
  5. DON’T use bone mineral density testing to screen for osteoporosis in women younger than 65 year or men younger than 70 years unless there is another medical condition that increases the risk of osteoporosis.  Bone mineral density results have surprisingly little ability to identify a patient’s risk of fractures if the patient does not have a history of fragility fracture.
Being an educated patient and discussing your concerns with your doctor is the best way to ensure you get the best quality care possible.  By avoiding unnecessary procedures and treatments you are less likely to experience adverse effects and help to keep health care costs down for everyone.
Be well,
Richard Malik, ND

Proton Pump Inhibitors and Fracture Risk

Posted on: May 14th, 2011 by doctor No Comments

A recent article in the New York Times reports on research that links long-term Proton Pump Inhibitors (PPIs) with a 30% increased risk of bone fractures.  According to the article, the long-term use of PPIs may decrease absorption of calcium in the intestines.

PPIs reduce the acidity in the stomach in order to reduce symptoms of heartburn.  While this is an effective approach for reducing the burning pain caused by the regurgitation of stomach acid into the esophagus, lowered acidity in the stomach decreases the absorption of some nutrients – including calcium – and increases the chances of getting several types of infection including infections of the digestive tract and lung.

Some forms of calcium do not require stomach acid in order to be absorbed.  These forms include calcium citrate and calcium citrate/malate.  When taking PPIs or other antacid medicines, it is a good idea to supplement calcium intake with these forms of calcium especially if you are at increased risk of osteoporosis or of fracture.

The only drawback of calcium citrate and calcium citrate/malate is that these forms of calcium are very bulky – capsules usually contain only 150mg of calcium.  This means that the usually recommended dosage is 5 to 10 capsules per day.

Ensuring healthy vitamin D status is also very important for calcium absorption.

For more information on addressing osteoporosis, read my previous blog post on osteoporosis.

Other nutrients whose absorption can be decreased by acid lowering medications include magnesium and vitamin B-12.

Be well,

Richard Malik, ND

Stomach Acid is Important

Posted on: September 7th, 2009 by doctor No Comments

The acid that is secreted by the parietal cells in the human stomach play a couple of very important roles.  First off, it helps to break down proteins so that nutrients are more available in the intestines and easily absorbed.  Stomach acid is important for calcium absorption, among other nutrients.

Stomach acid is also an important part of the immune system of the digestive tract.  Acid kills many of the organisms that we are commonly exposed to and helps to prevent infection.

Over the counter and prescription medications used to treat heartburn or GERD focus on reducing stomach acid production.  As I mentioned in the previous post, stomach acid is not the cause of heartburn – it is caused by a loose lower esophageal sphincter.

Consistent with the physiological importance of stomach acid, recent medical research indicates that medications that lower stomach acidity are associated with an increased risk of infection (gastrointestinal and pneumonia!) and osteoporosis.  Another of the known adverse effects of these medications is hair loss – treated naturopathically with specific nutrients.

The natural treatment of GERD involves identification and avoidance of aggravating foods and herbal and nutritional recommendations that soothe and protect the esophagus while improving gastrointestinal function.  Discontinuance of acid lowering medication and WITHOUT GERD symptoms is a real possibility for many patients.

Be Well,

Richard

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Vitamin D and Cardiovascular Disease

Posted on: September 2nd, 2009 by doctor No Comments

I just ran across a recent study that indicates that vitamin D deficiency might increase the risk for a cardiovascular event like a heart attack or stroke.  This is interesting information from the Framingham Heart Study that needs to be confirmed with more extensive medical research.

However future research pans out, testing for vitamin D status is important for many reasons including bone health, immune function, and possibly cancer prevention.  Vitamin D is a helpful therapy for osteoporosis, hypertension, mood disorders (especially seasonal), and other medical conditions.

The article can be found here

Be Well,
Richard

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More Vitamin D News

Posted on: March 3rd, 2009 by doctor No Comments

Published on February 23rd, 2009 in the Archives of Internal Medicine, a very large study with 18,000 participants found that the people with lowest serum vitamin D levels (based on 25-OH Vitamin D testing as mentioned in the last post) were 36% more likely to get an upper respiratory tract infection than people with the highest (but safe) levels of serum vitamin D.

Another similar study from August of 2008 published in the same journal showed a 26% reduced risk of death (all-cause mortality) in people with the highest (but safe) vitamin D levels when compared to people with the lowest vitamin D levels.

Vitamin D deficiency is epidemic in northern latitudes, with 50% of some populations being clinically deficient.

Vitamin D acts like a hormone in the body – it regulates calcium metabolism (addressing osteoporosis), affects blood pressure (lowering effect), improves mood (likely by increasing levels of important neurotransmitters), and affects immune function (useful for colds, prevention of allergies in newborns, and possibly auto-immune disease).

Click HERE to get the best available vitamin D or go to my Holistic Pharmacy to find the best nutrients, herbs and supplements available.

Be Well,

Richard

Vitamin D & Cancer Prevention

Posted on: March 3rd, 2009 by doctor No Comments

I just ran across an interesting study that, through statistical analysis, comes to the conclusion that the incidence of several types of cancers are lower when people have higher vitamin D blood levels.  Their recommendation is for people to maintain vitamin D levels between 55ng/ml and 90ng/ml.  These levels are between the standard mainstream medicine reference ranges of above 32ng/ml being optimal and above 100ng/ml being toxic.

These researchers are recommending vitamin D intakes between 2,000 and 10,000 IU per day.  Current recommendations are 400-600 IU per day.

Vitamin D levels are accurately assessed with a test called 25-OH Vitamin D.  If taking high doses of vitamin D, please have your vitamin D levels checked by your physician after 3 months of supplementation to ensure your safety.

Vitamin D3 5,000 IU

Vitamin D3 5,000 IU

If you are deficient in vitamin D, supplementation will likely improve bone health, blood pressure, and possibly mood and immune function.

Here is the highest qualtiy and most affordable Vitamin D supplement I have found; tested for identity, potency, purity, and label claim to expiration date.  Taking one capsule every third day ensures a daily dose below the Institute of Medicine’s conservative upper intake limit of 2,000 IU per day.  At this dose, one bottle lasts about 9 months!

Be Well,

Richard

Osteoporosis Fracture Risk Assessment Tool

Posted on: January 22nd, 2009 by doctor No Comments

As mentioned in the podcast, it is now possible to determine your 10 year fracture risk from osteoporosis.  This is a wonderful tool for clinicians and patients to help them understand the seriousness of their osteoporosis, the likely benefit of treatment, and to monitor the effectiveness of treatment.

All you need to know is: your age, sex, height, weight; if you have had a previous fracture in adulthood; if you have a parent that had a hip fracture; if you smoke; if you take steroids; if you have rheumatoid arthritis; if you have osteoporosis caused by other medical conditions (diabetes, hyperthyroidism, bone disease, premature menopause, hypogonadism, etc); how much alcohol you drink per day, and you most recent bone mineral density results.

Osteoporosis Fracture Risk Assessment Tool

Be Well,

Richard

Exercise & Adolescent Girls – Osteoporosis Prevention 40 Years in Advance

Posted on: January 18th, 2009 by doctor No Comments

Preventing osteoporosis begins at a young age.  Yet another study has found that when girls exercise, their risk of post-menopausal osteoporosis is reduced.  These results were identified with bone mineral density and magnetic resonance imaging (MRI) testing.

Bottom Line:

In addition to adequate calcium intake and adequate vitamin D status, lifelong exercise plays an important role in preventing osteoporosis.

Be Well,

Richard

Vitamin K, Osteoporosis & Liver Cancer

Posted on: November 2nd, 2008 by doctor No Comments


While several research studies (1, 2, 3) show that very high-dose supplementation with vitamin K2 can be very helpful for IMPROVING bone mineral density in women with osteoporosis, another recent study exploring the same treatment has found dramatic reduction in liver cancer in patients that are at high risk for liver cancer.  Other studies show improved outcomes in liver cancer patients taking vitamin 

Vitamin K2, unlike other forms of vitamin K, is non-toxic.

The possibility exists that vitamin K recommended daily allowances are adequate for preventing coagulation problems (one of vitamin K’s jobs is to support blood clotting) but not high enough for healthy bones.  I think it is interesting that the daily recommended allowance of vitamin K is only less than 120 micrograms per day while one cup of chopped kale has over 500 micrograms.

Kale, broccoli, swiss chard, and parsley are the best dietary sources of vitamin K and are also rich in calcium!

For more information on Vitamin K and Osteoporosis, please take a look at my articles and podcasts on the subjects.

Be well,

Richard

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