Spine Osteoporosis

[annapurna]

You were wondering if cortisone or prednisone are aggravating agents for osteoporosis, right?!

Slightly off topic for this discussion but it is well known that cortisone does damage cartilage, which would suggest that repeated injections into the facets or disk would temporarily decrease pain but lead to an expectation of increasing damage. I don't see too much problems with expanding upon that and assuming even more repeated use would be expected to damage the underlying bone.

[2cool4U]

Originally Posted by hey_look_its_dave

I note that the "lumbar" DEXA scans only look at L1 to L4. By looking at the images, I understand that to be the case because below L4 the pelvic bone gets into the image and overstates the density, while above L1 the ribs get into the image and again, overstate the density.

My disc trouble level is L5-S1, so I can't get a measurement of that exact level.

Does this jive with everyone's understanding?

Dave

In this case, L5 was excluded b/c there is an ADR at that level. Getting the proper exposure and therefore density measurements is not possible when metal is included in the index images b/c of its high density. That level was therefore excluded. You can see the very top edge of the L5 metal endplate at the edge of the image. L5 can be measured if carefully done avoiding the iliac problem you describe.

-tc-

[hey_look_its_dave]

Interesting, what you say. I was wondering if it were possible to adjust the area the machine is averaging density over. I can see on my report pages (Harrison attached some in a previous post of this thread) the area over which the density is averaged. It struck me that the technician could easily use their mouse and adjust the polygon of area being selected.

Anyway, for me they only did L1-L4 and I don't have any ADR. I guess they don't adjust the scan areas except under special circumstances. Perhaps they need to be specifically asked.

Dave

[hey_look_its_dave]

Sorry for the Back to the Future quote. Just thought of it.

Anyway, I went for my 3rd and last epidural and set of facet injections for at least 6 months.

When there, I brought a copy of my DEXA results and asked the pain guy to give his opinion on whether I should get this shot or not.

He said he could not discount the possibility that the shots are causing some bone density loss.

I went ahead anyway, figuring this'll be it.

I started myself on calcium and vitamin D supplements while await an appt with my GP for his recommendation.

Dave

[Harrison]

I noticed a particularly informative article and wanted to share the link with you all:

Christiane Northrup, MD: A Diet That Protects Against Osteoporosiss

It’s a good complement to this multipage topic, particularly my post from March 25 which referenced Phyliss Balch’s nutritional regime for osteoporosis. Here’s an excerpt from Dr. Northrop’s article:

“…The bottom line: For healthy bones, your blood needs to maintain a slightly alkaline pH level (a measure of relative acidity or alkalinity), which you can achieve by eating at least five servings of fruits and vegetables for every one serving of red meat, chicken or fish. Another good idea is to eat vegan--no meat or dairy--one day a week, which is very easy given the wide availability of beans, tofu and other protein these days…”

She then provides a checklist of things to do including important dietary considerations – very helpful indeed. As to how this might help with localized osteoporosis – that’s a tough nut to crack!

[Harrison]

Study suggests link between metabolic disease, bone mass in mice
July 22, 2010

A new study by Johns Hopkins researchers has found that insulin, the sugar-regulating hormone, is required for normal bone development and that it may provide a link between bone health and metabolic disease, such as diabetes.

Study suggests link between metabolic disease, bone mass in mice

[Harrison]

This paper was published in 2004. It’s relevant to this topic and I’ll expand on it more on the weeks again. Bottom line: proper nutrition is crucial for not just bones, but overall well-being!
__________________________________________________ ______

Cognitive function in relation with bone mass and nutrition: cross-sectional association in postmenopausal women

Conclusions: It appears mild degree of cognitive impairment may be a marker for lower bone mineral density as well as for a diet lower in carbohydrate and potassium intake, and higher in saturated fat. Consequently, older women with cognitive impairment may benefit of being screened for potential bone loss and poor nutrition.

Full article here: Cognitive function in relation with bone mass and nutrition: cross-sectional association in postmenopausal women
__________________________________________________ ______

As you read the full article, think about your diet. Then think about the “average American" diet. Bear in mind that potassium intake from natural foods is what’s being implied as a best practice by the study results. Most of us don’t get enough veggies as we know. That’s why I started juicing...

That said, playing with your electrolyte balance might actually cause you harm, so talk to your doctor about any concerns. It is known that many medications can affect the sodium-potassium balance and this article touches on this:

http://www.umm.edu/altmed/articles/potassium-000320.htm

I thought many popular OTC and prescription meds cause loss of potassium, a condition that can lead to hypokalemia; but this article confused me to think the contrary. If anyone can shed light on this, please do!

[Harrison]

Well, I answered most of my own question here by delving into books. I didn't have to look to far, as I found a good reference table in my favorite book (Prescription for Nutritional Healing) which I patiently transcribed into the attached document: substances that rob the body of nutrients. It addresses part of my question above...not all of it.

[Harrison]

As I mentioned here and in other topics, supplementation with the prohormone/secosteroid/vitamin D is tricky for many reasons.

Vitamin D No Magic Bullet for Osteoarthritis
It didn't reduce pain or delay disease progression, researchers found

By Steven Reinberg, HealthDay Reporter

SUNDAY, Nov. 7 (HealthDay News) -- People suffering from osteoarthritis of the knee appear to receive no relief from taking vitamin D supplements, U.S. researchers report.

"I've never heard of vitamin D as an intervention strategy," said Dr. Kevin Dalal, an assistant professor of rehabilitation medicine at the University of Miami Miller School of Medicine. "I am not surprised it didn't work. It's a tough process to try to change after it's been going on for years."

And:

After two years, there were no substantial differences between those people taking vitamin D and those taking placebo, the researchers found.

"This study tested whether vitamin D supplementation, given over a two-year period, could influence the rate of progression of joint damage in people with knee osteoarthritis," McAlindon said in a statement. "The study found no difference compared to a placebo treatment."

Full story here: Vitamin D No Magic Bullet for Osteoarthritis

What's depressing about this story is that it's a dead end. Like many other studies, it fails to offer other alternatives for patients seeking wellness. But it wasn't intended to find answers for patients -- only eliminate natural, off-the-shelf ones.

To be fair, one needs to differentiate between the quality, dose and type of D, as there are many. Research the tricky differences between D2 and D3 and you will quickly become confused and for good reason. Also, what you take with D matters greatly in terms of how it CAN be absorbed by your body.

One diagnostic rarely mentioned regard the blood testing biomarkers D25 and D1,25. Some docs say that the difference in the two is indicative of a metabolic disorder which may stem from sub-clinical infection. I think we are years away from establishing this as fact; but this may be point of interest or discovery for any spine patient.

Note: If this is your first time reading this thread, this is a multi-page topic, so look at the first few pages from the beginning. Or see the printer-friendly tab in "thread tools."

[Harrison]

After speaking to a patient who had contraindications for ADR because of his T Scores, I wanted to refresh this topic.