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home:othertreatments:boneagents [09.14.2022] (current) – external edit 127.0.0.1
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 +====== Bone density conservation agents    ====== 
 +
 +
 +<relatedarticle> [[home:diseases:osteoporosis_osteopenia|Osteoporosis and osteopenia]] </article>
 +
 +A variety of medications including the bisphosphonates have been touted to conserve or increase bone mass. These drugs have a number of side effects and are known or suspected to interfere with proper immune function. 
 +===== Bisphosphonates =====
 +
 +Bone has constant turnover, and is kept in balance (homeostasis) by osteoblasts creating bone and osteoclasts digesting bone. Bisphosphonates inhibit the digesting of bone by osteoclasts. 
 +
 +The bisphosphonate has a variety of side effects:(({{pmid>long:19371818}}))
 +  * chronic musculoskeletal pain(({{pmid>long:17627083}}))
 +  * atrial fibrillation – Numerous studies have shown that the frequency of atrial fibrillation increases with increasing age in both men and women. Data from the Framingham Heart Study showed a greater biennial incidence of AF with increasing age, with the odds ratio rising by a factor of 2.2 for every additional 10 years of age.(({{pmid>long:8114238}})) 
 +  * calcium deposition in the soft tissues(({{pmid>long: 14523647}}))
 +  * osteonecrosis of the jaw, i.e. bone death
 +  * reduced organ function, e.g. renal dysfunction or failure
 +
 +Those patients with elevated 1,25-D – which is [[home:pathogenesis:vitamind:metabolism#evidence_for_high_1_25-d_in_patients_with_chronic_disease|very common]] among those suffering from Th1 disease – seem particularly predisposed to the adverse effects of dysregulated calcium metabolism.
 +
 +All these meds have some effect on the immune or endocrine system and are, therefore, to be avoided.
 +
 +==== Types of bisphopshonates ====
 +
 +  * alendronate (Fosamax)
 +  * etidronate (Didronel)
 +  * ibandronate (Boniva)
 +  * pamidronate (Aredia)
 +  * risedronate (Actonel)
 +  * tiludronate (Skelid)
 +  * zoledronic acid (Zometa, Zomera, Aclasta and Reclast)
 +
 +
 +
 +
 +===== Other types of bone density conservation agents =====
 +
 +  * **calcitonin (Miacalcin nasal spray)** – A synthetic hormone with unknown effects on the immune system
 +  * **raloxifene  (Evista)** – An oral selective estrogen receptor modulator (SERM) that has estrogenic actions on bone and anti-estrogenic actions on the uterus and breast. It is used in the prevention ofosteoporosis in postmenopausal women. In a 2006 study published in //New England Journal of Medicine//, raloxifene produced significantly more strokes and blood clots than the placebo.(({{pmid>long: 16837676}}))
 +  * **teriparatide (Forteo)** – A hormonal injection of parathyroid hormone, a hormone secreted by the parathyroid gland that regulates calcium in the body. Parathyroid hormone controls many other hormones, and may cause deposition of calcium into soft tissues.
 +
 +
 +{{tag>non-MP_therapies}}
 +<nodisp>
 +===== Notes and comments =====
 +
 +
 +FDA Alert - Oral Bisphosphonates: Ongoing Safety Review - https://bit.ly/9EfpXY
 +
 +===== References ===== </nodisp>
  
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