<?xml version="1.0" encoding="UTF-8"?><rss version="2.0" xmlns:content="http://purl.org/rss/1.0/modules/content/" xmlns:wfw="http://wellformedweb.org/CommentAPI/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:atom="http://www.w3.org/2005/Atom" xmlns:sy="http://purl.org/rss/1.0/modules/syndication/" xmlns:slash="http://purl.org/rss/1.0/modules/slash/" > <channel> <title>Bone Health Archives - goldsteinmd</title> <atom:link href="https://www.goldsteinmd.com/category/bone-health/feed/" rel="self" type="application/rss+xml" /> <link>https://www.goldsteinmd.com/category/bone-health/</link> <description></description> <lastBuildDate>Wed, 22 Jan 2025 12:53:58 +0000</lastBuildDate> <language>en-US</language> <sy:updatePeriod> hourly </sy:updatePeriod> <sy:updateFrequency> 1 </sy:updateFrequency> <image> <url>https://www.goldsteinmd.com/wp-content/uploads/2017/12/cropped-header-logo-2-1-32x32.png</url> <title>Bone Health Archives - goldsteinmd</title> <link>https://www.goldsteinmd.com/category/bone-health/</link> <width>32</width> <height>32</height> </image> <item> <title>The Burden of Osteoporosis, Poor Bone Health, and Fragility Fractures – Dr Steven R. Goldstein</title> <link>https://www.goldsteinmd.com/blog/osteoporosis-poor-bone-health-and-fragility-fractures</link> <comments>https://www.goldsteinmd.com/blog/osteoporosis-poor-bone-health-and-fragility-fractures#respond</comments> <dc:creator><![CDATA[GoldsteinMD]]></dc:creator> <pubDate>Wed, 21 Dec 2022 21:40:39 +0000</pubDate> <category><![CDATA[Breast Health]]></category> <category><![CDATA[Bone Health]]></category> <category><![CDATA[Menopause/Perimenopause]]></category> <guid isPermaLink="false">https://www.goldsteinmd.com/?p=5493</guid> <description><![CDATA[<p>Bone Health is more than just Osteoporosis In my office almost all women are cognizant of breast health, have a great fear of breast cancer, and for the most part are attuned to the importance of competent periodic breast imaging… the key to earliest detection. The goal is not to have a better bone density … <a href="https://www.goldsteinmd.com/blog/osteoporosis-poor-bone-health-and-fragility-fractures" class="more-link">Continue reading<span class="screen-reader-text"> "The Burden of Osteoporosis, Poor Bone Health, and Fragility Fractures – Dr Steven R. Goldstein"</span></a></p> <p>The post <a href="https://www.goldsteinmd.com/blog/osteoporosis-poor-bone-health-and-fragility-fractures">The Burden of Osteoporosis, Poor Bone Health, and Fragility Fractures – Dr Steven R. Goldstein</a> appeared first on <a href="https://www.goldsteinmd.com">goldsteinmd</a>.</p> ]]></description> <content:encoded><![CDATA[<h1><strong>Bone Health is more than just Osteoporosis<br /> </strong></h1> <p>In my office almost all women are cognizant of breast health, have a great fear of breast cancer, and for the most part are attuned to the importance of competent periodic breast imaging… the key to earliest detection.</p> <p>The goal is not to have a better bone density score on a Dexa test at age 82, the goal is to not break a hip at age 82</p> <p><a href="https://www.goldsteinmd.com/conditions/osteoporosis-specialist-nyc-menopause-bone-loss/" target="_blank" rel="noopener">Bone health IS more than just osteoporosis</a>. My hope is to get these same patients to be just as concerned about their bone health as they are concerned about their breast health, so I compiled some statistics which I hope will help you to understand how important bone health, osteoporosis and fragility fractures are to you as you pursue HEALTHY aging!</p> <p> </p> <p> </p> <h2><img fetchpriority="high" decoding="async" class="aligncenter wp-image-5647" src="https://www.goldsteinmd.com/wp-content/uploads/2022/12/MenopauseBoneLoss_1080x1080Artboard-1-1024x1024.png" alt="" width="482" height="482" srcset="https://www.goldsteinmd.com/wp-content/uploads/2022/12/MenopauseBoneLoss_1080x1080Artboard-1-1024x1024.png 1024w, https://www.goldsteinmd.com/wp-content/uploads/2022/12/MenopauseBoneLoss_1080x1080Artboard-1-300x300.png 300w, https://www.goldsteinmd.com/wp-content/uploads/2022/12/MenopauseBoneLoss_1080x1080Artboard-1-150x150.png 150w, https://www.goldsteinmd.com/wp-content/uploads/2022/12/MenopauseBoneLoss_1080x1080Artboard-1-768x768.png 768w, https://www.goldsteinmd.com/wp-content/uploads/2022/12/MenopauseBoneLoss_1080x1080Artboard-1.png 1080w" sizes="(max-width: 482px) 85vw, 482px" /></h2> <h2>Why pay attention to bone health, osteoporosis and fragility fractures?</h2> <p>First, worldwide, osteoporosis causes more than 8.9 million fractures annually, resulting in an osteoporotic fracture every three seconds.<a href="#_edn1" name="_ednref1">[i]</a></p> <p>Second, it is estimated that osteoporosis effects 200 million women worldwide. One-tenth of women aged 60, one-fifth of women aged 70, two-fifths of women aged 80 and, actually two-thirds of women aged 90 carry this diagnosis.<a href="#_edn2" name="_ednref2">[ii]</a></p> <p>Third, worldwide, one in three women after the age 50 will experience an osteoporotic fracture.<a href="#_edn3" name="_ednref3">[iii]</a></p> <p>Fourth, at <a href="https://www.goldsteinmd.com/services/menopause-and-perimenopause/" target="_blank" rel="noopener">menopause</a>, the removal of estrogen has much greater effects in women than men of similar age. The female-to-male ratio of osteoporotic fractures is approximately 1.6, such that 80% of forearm fractures, 75% of humerus fractures, 70% of hip fractures, and 58% of spine fractures occur in women.<a href="#_edn4" name="_ednref4">[iv]</a></p> <p>Fifth, A prior fracture is associated with an 86% increased risk of any subsequent fracture.<a href="#_edn5" name="_ednref5">[v]</a></p> <p>Sixth, Fragility fractures are a leading cause of chronic disease morbidity. For instance, in Europe, fragility fractures are the fourth leading cause, after ischemic heart disease, dementia, and lung cancer; however, they surpass chronic obstructive pulmonary disease and ischemic stroke.<a href="#_edn6" name="_ednref6">[vi]</a></p> <p>Seventh, After sustaining a hip fracture, 10-20% of formerly community-dwelling patients require long-term nursing care.<a href="#_edn7" name="_ednref7">[vii]</a></p> <p>Overall, hip fractures cause the most morbidity, and reported mortality rates are up to 20-24% in the first year after a hip fracture.<a href="#_edn8" name="_ednref8">[viii]</a></p> <p>Loss of function and independence among survivors is profound, with 40% unable to walk independently, and 60% require assistance a year later.<a href="#_edn9" name="_ednref9">[ix]</a></p> <h2> </h2> <h2><strong>Is monitoring bone health just as important as the early detection of breast cancer?<br /> </strong></h2> <p>In localized breast cancer where there is no sign that the cancer has spread outside the breast, the 5-year survival in the US is 99%!</p> <p>(American Cancer Society. Survival Rates for Breast Cancer. Available at: <a href="https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/breast-cancer-survival-rates.html">https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/breast-cancer-survival-rates.html</a> )</p> <p>Even regional breast cancer, defined as spread outside the breast to nearby structures or lymph nodes, has an 86% five-year survival.</p> <p>(American Cancer Society. Survival Rates for Breast Cancer. Available at: <a href="https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/breast-cancer-survival-rates.html">https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/breast-cancer-survival-rates.html</a> )</p> <p>In developed countries where women have access to periodic competent breast screening by imaging techniques, for many the diagnosis of localized breast cancer and the psychological ramifications may actually exceed the physical manifestations.</p> <p style="text-align: center;"><strong>You only have to contrast the statistics above vis a vis breast cancer versus the statistics cited about the incidence, morbidity and even mortality associated with osteoporosis and fragility fractures (ESPECIALLY of the hip) to see the importance of <a href="https://www.goldsteinmd.com/conditions/osteoporosis-specialist-nyc-menopause-bone-loss/" target="_blank" rel="noopener">bone health and osteoporosis</a></strong></p> <p> </p> <h2>Promoting Bone Health</h2> <p>There are several things you can do to improve your bone health.</p> <p>Be sure you are getting enough calcium in your diet and that you supplement with Vitamin D. Here is an article from Dr. Goldstein with more information on calcium and vitamin D. Click <a href="https://www.goldsteinmd.com/calcium-vitamin-d/">HERE</a></p> <p>Be sure to exercise. Walking is a good exercise, especially when you practice “mindful walking”, which includes being aware of your steps and that the surface is safe. Be aware of black ice and use non-skid rugs in the bathroom. Ensure that your eyesight is good and there is sufficient illumination. It is also essential to maintain muscle strength which can be done, depending on your condition and advice from your doctor, by using light weights. You want to avoid sarcopenia which is “muscle wasting,” and atrophy of your muscles.</p> <p>Balance exercises are also recommended. For more information on this, check out this article from the <a href="https://www.heart.org/en/healthy-living/fitness/fitness-basics/balance-exercise">American Heart Association</a><u>.</u></p> <p>As usual if you have any questions, schedule a consultation with Dr Goldstein, a <a href="https://www.goldsteinmd.com/services/menopause-and-perimenopause/" target="_blank" rel="noopener">Menopause Specialist in NYC</a> </p> <p> </p> <p>Footnotes:</p> <p><a href="#_ednref1" name="_edn1">[i]</a> Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporosis Int. 2006;17:1726–1733.</p> <p><a href="#_ednref2" name="_edn2">[ii]</a> Kanis, JA, Odén A, McCloskey EV, et al. A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporosis Int. 2012;23:2239–2256.</p> <p><a href="#_ednref3" name="_edn3">[iii]</a> Adult Official Positions of the ISCD as updated in 2019. www.iscd.org. Last accessed July 2021</p> <p><a href="#_ednref4" name="_edn4">[iv]</a> Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporosis Int. 2006;17:1726–1733.</p> <p><a href="#_ednref5" name="_edn5">[v]</a> Kanis JA, Johansson H, Harvey NC, et al. A brief history of FRAX. Arch Osteoporos. 2018;13(1):118</p> <p><a href="#_ednref6" name="_edn6">[vi]</a> Kanis JA, Johansson H, Strom O, et al. The National Osteoporosis Guideline Group. Case finding for the management of osteoporosis with FRAX<sup>®</sup> – assessment and intervention thresholds for the UK. Osteoporos Int. 2008;19:1395–1408.</p> <p><a href="#_ednref7" name="_edn7">[vii]</a> Bone HG, Wagman RG, Brandi ML, et al. 10 years of denosumab treatment in postmenopausal women with osteoporosis: results from the phase 3 randomised FREEDOM trial and open-label extension. Lancet Diabetes Endocrinol. 2017;5:513–523.</p> <p><a href="#_ednref8" name="_edn8">[viii]</a> Goodpaster BH, Park SW, Harris TB, et al. The loss of skeletal muscle strength, mass, and quality in older adults: The health, aging and body composition study. J Gerontol A Biol Sci Med Sci. 2006;61:1059–1064.</p> <p><a href="#_ednref9" name="_edn9">[ix]</a> Anker SD, Morley JE, von Haehling S, et al. Welcome to the ICD-10 code for sarcopenia. J Cachexia Sarcopenia Muscle. 2026;7(5):512–514.</p> <p>The post <a href="https://www.goldsteinmd.com/blog/osteoporosis-poor-bone-health-and-fragility-fractures">The Burden of Osteoporosis, Poor Bone Health, and Fragility Fractures – Dr Steven R. Goldstein</a> appeared first on <a href="https://www.goldsteinmd.com">goldsteinmd</a>.</p> ]]></content:encoded> <wfw:commentRss>https://www.goldsteinmd.com/blog/osteoporosis-poor-bone-health-and-fragility-fractures/feed/</wfw:commentRss> <slash:comments>0</slash:comments> </item> <item> <title>Update from World Congress of the International Menopause Society</title> <link>https://www.goldsteinmd.com/blog/update-from-world-congress-of-the-international-menopause-society</link> <comments>https://www.goldsteinmd.com/blog/update-from-world-congress-of-the-international-menopause-society#respond</comments> <dc:creator><![CDATA[GoldsteinMD]]></dc:creator> <pubDate>Thu, 03 Nov 2022 19:15:27 +0000</pubDate> <category><![CDATA[Bone Health]]></category> <category><![CDATA[Menopause/Perimenopause]]></category> <guid isPermaLink="false">https://www.goldsteinmd.com/?p=5438</guid> <description><![CDATA[<p>To my patients, I am writing this email blast from Lisbon, Portugal where the 18th World Congress of the International Menopause Society has just concluded. As many of you know, I have been the president of this society for the last two years and this meeting was the culmination of that term. There were over … <a href="https://www.goldsteinmd.com/blog/update-from-world-congress-of-the-international-menopause-society" class="more-link">Continue reading<span class="screen-reader-text"> "Update from World Congress of the International Menopause Society"</span></a></p> <p>The post <a href="https://www.goldsteinmd.com/blog/update-from-world-congress-of-the-international-menopause-society">Update from World Congress of the International Menopause Society</a> appeared first on <a href="https://www.goldsteinmd.com">goldsteinmd</a>.</p> ]]></description> <content:encoded><![CDATA[<p>To my patients,</p> <p>I am writing this email blast from Lisbon, Portugal where the 18th World Congress of the <a href="https://www.imsociety.org/" target="_blank" rel="noopener">International Menopause Society</a> has just concluded. As many of you know, I have been the president of this society for the last two years and this meeting was the culmination of that term. There were over 1,700 healthcare providers from 76 countries, 183 invited speakers with dozens of scientific sessions, debates, “meet the expert” sessions, and over 200 oral or poster communications. I was honored to deliver the Presidential Lecture. I highlighted the history of the role of vaginal ultrasound in menopausal and perimenopausal patients of which I was the first to suggest its utility, for instance, in measuring the lining of the uterus in patients with abnormal bleeding, sonohysterograms, that is putting fluid into the uterus to see the lining better, and using ultrasound and color Doppler blood flow to allow us to leave benign ovarian cysts alone without surgery, just to name a few. I also delivered a “meet the expert” session on SERMs (selective estrogen receptor modulators) something I have spoken to many of you about.</p> <p>The presentations involved all aspects of midlife women’s health before, during, and after <a href="https://www.goldsteinmd.com/services/menopause-and-perimenopause/">menopause</a>. There are important new areas a few of which I share here: Duavee, the combination of estrogen and a SERM will be shipping again January 1. Although the FDA is allowed to take up to six months to reapprove it, all efforts are being made to expedite this. Secondly, the role of <a href="https://www.goldsteinmd.com/conditions/osteoporosis-specialist-nyc-menopause-bone-loss/">muscle and bone health</a> – preventing the muscle wasting of sarcopenia, something I have talked to so many of you about, has finally made its way into these scientific sessions; and, finally, a new drug to treat hot flashes known as an NK3 receptor antagonist is likely to gain approval in February. While this will not offer the benefits of HRT to bone or vagina, it is an important addition especially for breast cancer survivors and patients who have experienced blood clots and cannot take estrogen regardless of the severity of their hot flashes or night sweats.</p> <p>Hearing all the science from all over the globe was stimulating and exciting. Also exhausting, especially as the president with all the ceremonious responsibilities that went along with it. I learned being asked to pose for a “selfie” is the 2022 equivalent of being asked for an autograph! I am ready to use all that I know as well as all that I learned to benefit all of you.</p> <p>Yours in Health,</p> <p>Dr Goldstein</p> <p> </p> <p>The post <a href="https://www.goldsteinmd.com/blog/update-from-world-congress-of-the-international-menopause-society">Update from World Congress of the International Menopause Society</a> appeared first on <a href="https://www.goldsteinmd.com">goldsteinmd</a>.</p> ]]></content:encoded> <wfw:commentRss>https://www.goldsteinmd.com/blog/update-from-world-congress-of-the-international-menopause-society/feed/</wfw:commentRss> <slash:comments>0</slash:comments> </item> <item> <title>Dr Goldstein comments on NY Times article on preventing breast cancer</title> <link>https://www.goldsteinmd.com/blog/dr-goldstein-comments-on-ny-times-article-on-preventing-breast-cancer</link> <comments>https://www.goldsteinmd.com/blog/dr-goldstein-comments-on-ny-times-article-on-preventing-breast-cancer#respond</comments> <dc:creator><![CDATA[GoldsteinMD]]></dc:creator> <pubDate>Fri, 22 Nov 2019 19:10:42 +0000</pubDate> <category><![CDATA[Breast Health]]></category> <category><![CDATA[Bone Health]]></category> <category><![CDATA[Screenings]]></category> <guid isPermaLink="false">https://www.goldsteinmd.com/?p=2784</guid> <description><![CDATA[<p>To my patients, In last week’s Science Times, the weekly column on personal health by Jane Brody was entitled, “A New Focus Turns to Preventing Breast Cancer.” I have tremendous respect for Jane Brody and almost always agree with what she writes and the thoroughness with which she presents information. There are, however, some points … <a href="https://www.goldsteinmd.com/blog/dr-goldstein-comments-on-ny-times-article-on-preventing-breast-cancer" class="more-link">Continue reading<span class="screen-reader-text"> "Dr Goldstein comments on NY Times article on preventing breast cancer"</span></a></p> <p>The post <a href="https://www.goldsteinmd.com/blog/dr-goldstein-comments-on-ny-times-article-on-preventing-breast-cancer">Dr Goldstein comments on NY Times article on preventing breast cancer</a> appeared first on <a href="https://www.goldsteinmd.com">goldsteinmd</a>.</p> ]]></description> <content:encoded><![CDATA[ <p>To my patients,</p> <p>In last week’s Science Times, the weekly column on personal health by Jane Brody was entitled, “A New Focus Turns to Preventing Breast Cancer.” I have tremendous respect for Jane Brody and almost always agree with what she writes and the thoroughness with which she presents information. There are, however, some points in that article that I feel I must comment on. </p> <p>She does mention, and rightly so, that if breast cancer is confined to the breast with no spread to regional lymph nodes, five-year survival rates are as high as 99%. Many of you have heard me extol the virtues of quality breast cancer surveillance with imaging (3D mammograms with ultrasound as well). Even with spread to regional lymph nodes, the five-year survival is still 85%. Clearly, breast cancer is not the same disease it was one or two generations ago. When caught early, it need not be lethal.</p> <p>There are and have been, however, a number of medications that are approved for breast cancer risk reduction. In her article, Jane Brody, in fact, quotes the United States Preventative Services Task Force, whose recommendations are that women who have more than a 3% chance of developing invasive breast cancer within the next five years be offered such risk reducing drugs. My concern with her article is that she mentions tamoxifen, raloxifene (also known as Evista) and the category of drugs known as aromatase inhibitors. Although all these drugs have been shown to reduce breast cancer risk, they’re very different in their side effect profile, in terms of both serious adverse events as well as nuisance side effects.</p> <p>The only one approved for use in premenopausal women is tamoxifen. Many of you are aware, however, that it results in formation of benign uterine polyps in 10-17% of women as well as a small but real number of uterine cancers in postmenopausal women. Evista, which is now generically available as raloxifene, has similar breast cancer prevention results as tamoxifen but does not have cancer or polyp producing potential in the uterus. In addition, however, both tamoxifen and raloxifene prevent bone loss because of their selectivity in which they act like estrogen in bone, while being estrogen blockers in breast. Both of these drugs may exacerbate hot flashes and night sweats making their use in younger, more recently menopausal women less desirable.</p> <p>The aromatase inhibitors are pure anti-estrogens (unlike the first two drugs, which are selective for the breast but not in all aspects of the body) these drugs contribute to osteoporosis, joint pain, vaginal atrophy, etc. Thus, in my opinion, while the aromatase inhibitors are excellent drugs for women with advanced breast cancers and can be lifesaving in such cases, their use for prevention of breast cancer, in women who don’t already have that disease, is inappropriate and unnecessary, especially in light of the high treatability when breast cancers are detected early.</p> <p>Furthermore, <a href="https://www.goldsteinmd.com/conditions/osteoporosis-specialist-nyc-menopause-bone-loss/">bone health</a>, in my opinion, is as, if not more, important of an issue for long term healthy aging and quality of life as breast health. Allow me to expand on this: since early detection of breast cancer will almost always result in a favorable outcome, and since women are routinely living much longer lives than previous generations, a fracture, especially of the hip, of a woman can be a much more life threatening and devastating event than an early breast cancer. A woman who suffers a hip fracture has a 20-30% chance of being dead within one year, and a 25% chance of never living independently again. Thus, drugs to prevent breast cancer that actually cause <a href="https://www.goldsteinmd.com/conditions/osteoporosis-specialist-nyc-menopause-bone-loss/">bone loss</a>, like the aromatase inhibitors, in my opinion, make no sense for this purpose. Since its introduction in 1997, many of my patients have been excellent candidates for Evista (raloxifene) because of its dual effect of reducing breast cancer risk and preventing and treating osteoporosis. Thus, for certain patients, it is an excellent choice and remains thus so. </p> <p>If you think this is of value to you or any of your family or friends, feel free to pass this information along. Dr Steven R. Goldstein is a <a href="https://www.goldsteinmd.com/services/menopause-and-perimenopause/" target="_blank" rel="noopener">Menopause Specialist in NYC</a> working with women on healthy aging, including their bone health. </p> <p> </p> <p>The post <a href="https://www.goldsteinmd.com/blog/dr-goldstein-comments-on-ny-times-article-on-preventing-breast-cancer">Dr Goldstein comments on NY Times article on preventing breast cancer</a> appeared first on <a href="https://www.goldsteinmd.com">goldsteinmd</a>.</p> ]]></content:encoded> <wfw:commentRss>https://www.goldsteinmd.com/blog/dr-goldstein-comments-on-ny-times-article-on-preventing-breast-cancer/feed/</wfw:commentRss> <slash:comments>0</slash:comments> </item> <item> <title>More Medical News – Calcium and Cardiovascular health</title> <link>https://www.goldsteinmd.com/blog/more-medical-news-calcium-and-cardiovascular-health</link> <comments>https://www.goldsteinmd.com/blog/more-medical-news-calcium-and-cardiovascular-health#respond</comments> <dc:creator><![CDATA[GoldsteinMD]]></dc:creator> <pubDate>Tue, 23 Jul 2019 14:32:41 +0000</pubDate> <category><![CDATA[Bone Health]]></category> <category><![CDATA[Other]]></category> <guid isPermaLink="false">https://www.goldsteinmd.com/?p=2664</guid> <description><![CDATA[<p>An article in the Science Section of last week’s New York Times mandates sending this out. The article was entitled, “Popular but not very effective.” The subtitle was, “Cardiovascular supplements and diets do little for hearts.” It was a relatively extensive article about a number of popular supplements and different diets based on research published … <a href="https://www.goldsteinmd.com/blog/more-medical-news-calcium-and-cardiovascular-health" class="more-link">Continue reading<span class="screen-reader-text"> "More Medical News – Calcium and Cardiovascular health"</span></a></p> <p>The post <a href="https://www.goldsteinmd.com/blog/more-medical-news-calcium-and-cardiovascular-health">More Medical News – Calcium and Cardiovascular health</a> appeared first on <a href="https://www.goldsteinmd.com">goldsteinmd</a>.</p> ]]></description> <content:encoded><![CDATA[ <p>An article in the Science Section of last week’s New York Times mandates sending this out. The article was entitled, “Popular but not very effective.” The subtitle was, “Cardiovascular supplements and diets do little for hearts.” It was a relatively extensive article about a number of popular supplements and different diets based on research published in the Annals of Internal Medicine, which reviewed data from hundreds of clinical trials involving almost one million people. </p> <p>Obviously, I am not a cardiovascular specialist and I am not going to comment on most aspects of that article. However, it did mention that taking calcium, “increased the risk of stroke, perhaps because of increases in blood clotting and hardening of the arteries.” THIS IS NOT NEW NEWS! In January of 2017, I sent an email blast based on a cover story in the journal OBG Management that I had written entitled, “Calcium and atherosclerosis?” At that time, I described the fact that in 2001, the National Institutes of Health (NIH) had a consensus panel on osteoporosis that concluded that calcium intake was crucial to maintain bone mass and should be maintained at 1,000-1,500 milligrams per day in older adults. That panel felt that the majority of older adults were not meeting recommended intake from dietary sources and recommended calcium supplements.</p> <p>However, even at that time in 2017, large randomized, placebo-controlled trials, which, as you know, are the gold standard of clinical research, that involved calcium supplements had demonstrated concerns about their safety as well as their efficacy in possible fracture prevention. Studies show that calcium supplements increase the risk of kidney stones, as well as cardiovascular events in healthy older women. In addition, I reviewed the fact that calcium supplements are actually bound as a “salt” and, when they are broken down in the blood stream to elemental calcium, they only yield 40% of what was on the label. Thus, a 500 milligram Oscal® will give you, at best, 200 milligrams of elemental calcium.</p> <p>Since that time, I have advised so many of you to make sure that your diet has adequate calcium intake (approximately 1,200 milligrams per day). Click here for a <a href="http://r20.rs6.net/tn.jsp?f=001uCAUCTOBx18m1SW78i5Wts9-Ef4FSNFJavLpFY3EMzE2EA1w_YEb5JHmVI5JFFaE1dG4oVkgmsqvlXZBqg6iZKQjTTv80wBknDI65J0byEhKjw_sBYiN6JWiP8bHnYEGR_AUx1AlEnpC3xXDLR9lApKYOGuesIM8ZSN0cBQqrNHBGLWstAqEebzb3mgYE2m0PaGp7n4pckSO8JNxIwNDKhLc0gI5SXcDSg_SWKsSMDE=&c=-ZYoCJCNp0N46Hw-bzg7FEt1zW1q73emzgHrg17Beq4zXnLltwLbPQ==&ch=sKeckxugsJ3kXsbzEjEqAubE8DEPMHfbonXe-emDB43j_EgLEAe_iQ==" target="_blank" rel="noreferrer noopener">list of foods</a> and how much calcium they contain. Vitamin D supplementation is important and should be in the range of 1-2,000 IU/day. Next time you have blood drawn, either by me or your primary care doctor, ask them to check your vitamin D level. The optimal range is 30-50 picograms/milliliter. </p> <p>Dr Steven R. Goldstein is a <a href="https://www.goldsteinmd.com/services/menopause-and-perimenopause/" target="_blank" rel="noopener">Menopause Specialist in NYC</a> with concern for the bone health of women and Osteoporosis as they age and go through Menopause.</p> <p>The post <a href="https://www.goldsteinmd.com/blog/more-medical-news-calcium-and-cardiovascular-health">More Medical News – Calcium and Cardiovascular health</a> appeared first on <a href="https://www.goldsteinmd.com">goldsteinmd</a>.</p> ]]></content:encoded> <wfw:commentRss>https://www.goldsteinmd.com/blog/more-medical-news-calcium-and-cardiovascular-health/feed/</wfw:commentRss> <slash:comments>0</slash:comments> </item> <item> <title>Dr. Goldstein comments on NY Times article on new Osteoporosis drug</title> <link>https://www.goldsteinmd.com/blog/dr-goldstein-comments-on-ny-times-article-on-new-osteoporosis-drug</link> <comments>https://www.goldsteinmd.com/blog/dr-goldstein-comments-on-ny-times-article-on-new-osteoporosis-drug#respond</comments> <dc:creator><![CDATA[GoldsteinMD]]></dc:creator> <pubDate>Thu, 11 Apr 2019 14:25:45 +0000</pubDate> <category><![CDATA[Bone Health]]></category> <guid isPermaLink="false">https://www.goldsteinmd.com/?p=2648</guid> <description><![CDATA[<p>In yesterday‘s New York Times, a teaser on the front page was entitled “Treatment for brittle bones”. The article itself was entitled “Osteoporosis drug deploys genetic tool to build bone”. On Tuesday the FDA approved a new drug known as Evenity (generic is romosozumab-aqqg). The article talks significantly about the fact that this is the … <a href="https://www.goldsteinmd.com/blog/dr-goldstein-comments-on-ny-times-article-on-new-osteoporosis-drug" class="more-link">Continue reading<span class="screen-reader-text"> "Dr. Goldstein comments on NY Times article on new Osteoporosis drug"</span></a></p> <p>The post <a href="https://www.goldsteinmd.com/blog/dr-goldstein-comments-on-ny-times-article-on-new-osteoporosis-drug">Dr. Goldstein comments on NY Times article on new Osteoporosis drug</a> appeared first on <a href="https://www.goldsteinmd.com">goldsteinmd</a>.</p> ]]></description> <content:encoded><![CDATA[ <p>In yesterday‘s New York Times, a teaser on the front page was entitled “Treatment for brittle bones”. The article itself was entitled “Osteoporosis drug deploys genetic tool to build bone”. On Tuesday the FDA approved a new drug known as Evenity (generic is romosozumab-aqqg). The article talks significantly about the fact that this is the first drug that restores bone without breaking it down. Understand that bone is a dynamic organ. It is constantly being laid down and taken away until the day you die. Estrogen is a potent inhibitor of taking bone away. This is why when women at menopause stop making estrogen they lose bone rapidly. Most of the commonly employed medications to prevent and treat osteoporosis are such “anti-resorptives” (they inhibit the taking away of bone like estrogen did yielding a net positive balance). There are some injectables that are anabolic bone drugs (like Forteo or Tymlos) that actually build bone but do not inhibit some of it’s taking away. Previously these have been reserved for the most severe cases and are limited to 18 months of use because of some bone cancers observed in rodents. This new drug, Evenity, actually uses genetically engineered blocking antibodies to restore bone without breaking it down.</p> <p> To some of you who may have read the article, this may sound like a wonderful breakthrough and something you might in fact be interested in. Understand, this was a clinical trial of close to 8,000 women. <strong>All </strong>of them had osteoporosis <strong>and</strong> at least one pre-existing osteoporotic fracture of the vertebral column. In other words all these women were <strong>extremel</strong>y high risk. <a href="https://www.goldsteinmd.com/conditions/osteoporosis-specialist-nyc-menopause-bone-loss/">Bone health</a> is increasingly one of the most important issues for my patients. As longevity has increased dramatically over the last generation or two, so many women are living into their early 90s. Suffering a hip fracture will result in 25% of women never living independently again and 20 to 30% will be dead within one year. My patients should be as concerned about their bone health as any other aspect of their lives as they pursue “healthy aging.”</p> <p> My take-home point, however, is that this drug is an excellent “arrow in the quiver” of clinicians who take care of women with severe osteoporosis <strong>and</strong> previous fracture. It is a monthly injectable. It is not for patients with average <a href="https://www.goldsteinmd.com/conditions/osteoporosis-specialist-nyc-menopause-bone-loss/">bone loss or early osteoporosis</a>. It should be reserved for the most severely affected patients. It is not without potentially serious side effects. The most serious ones, as pointed out in the article, were a statistically significant increase in heart attacks, strokes, and even sudden death among women who used this medication. That is why, obviously, it should only be reserved for severely affected women with osteoporosis and pre-existing fracture. </p> <p> As usual, I hope you find this commentary on articles in the news Media helpful.</p> <p>The post <a href="https://www.goldsteinmd.com/blog/dr-goldstein-comments-on-ny-times-article-on-new-osteoporosis-drug">Dr. Goldstein comments on NY Times article on new Osteoporosis drug</a> appeared first on <a href="https://www.goldsteinmd.com">goldsteinmd</a>.</p> ]]></content:encoded> <wfw:commentRss>https://www.goldsteinmd.com/blog/dr-goldstein-comments-on-ny-times-article-on-new-osteoporosis-drug/feed/</wfw:commentRss> <slash:comments>0</slash:comments> </item> <item> <title>You know about osteoporosis but are you aware of muscle wasting</title> <link>https://www.goldsteinmd.com/blog/you-know-about-osteoporosis-but-are-you-aware-of-muscle-wasting</link> <comments>https://www.goldsteinmd.com/blog/you-know-about-osteoporosis-but-are-you-aware-of-muscle-wasting#respond</comments> <dc:creator><![CDATA[GoldsteinMD]]></dc:creator> <pubDate>Tue, 18 Sep 2018 14:08:07 +0000</pubDate> <category><![CDATA[Bone Health]]></category> <guid isPermaLink="false">https://www.goldsteinmd.com/?p=2528</guid> <description><![CDATA[<p>You know about osteoporosis but are you aware of muscle wasting In the Science Times of September 4th, the weekly column called, “Personal Health,” by Jane Brody talked about an entity called “sarcopenia”. This is the wasting of muscle that is seen in elderly patients. It can begin as early as age 40. It can … <a href="https://www.goldsteinmd.com/blog/you-know-about-osteoporosis-but-are-you-aware-of-muscle-wasting" class="more-link">Continue reading<span class="screen-reader-text"> "You know about osteoporosis but are you aware of muscle wasting"</span></a></p> <p>The post <a href="https://www.goldsteinmd.com/blog/you-know-about-osteoporosis-but-are-you-aware-of-muscle-wasting">You know about osteoporosis but are you aware of muscle wasting</a> appeared first on <a href="https://www.goldsteinmd.com">goldsteinmd</a>.</p> ]]></description> <content:encoded><![CDATA[<p>You know about <a href="https://www.goldsteinmd.com/conditions/osteoporosis-specialist-nyc-menopause-bone-loss/">osteoporosis</a> but are you aware of muscle wasting</p> <p>In the Science Times of September 4th, the weekly column called, “Personal Health,” by Jane Brody talked about an entity called “sarcopenia”. This is the wasting of muscle that is seen in elderly patients. It can begin as early as age 40. It can become extremely pronounced in women in their 60’s. And as women approach their 80’s and beyond, it is increasingly recognized as a major impediment to continued health and well-being. It is a major component of “frailty.” Why is this so important? A 50-year-old women, who does not already have cancer or heart disease, has a life expectancy of 91! Thus, concerns about “healthy aging” are an extremely important part of what I am helping my patients accomplish. Many of you know that I have had a particular interest in bone health, preventing osteoporosis, diagnosing bone mass with bone density testing and talking to many of you about fall prevention and balance exercise. Sarcopenia and its loss of muscle can be just as devastating to the elderly as loss of bone. Resistive exercises are important. Walking, biking and cardiovascular machines are good for you but do not build muscle mass. Only resistive exercises and strength training can do so.</p> <p>Adequate protein in one’s diet is crucial. An adult female who weighs 150 pounds should be eating approximately 81 grams of protein per day. Foods that are relatively high in protein include (believe it or not) peanut butter, for which two table spoons have 8 grams of protein; one cup of non-fat milk, 8.8 grams; two medium eggs, 11.4 grams; one chicken drum stick, 12.2 grams; one half cup of cottage cheese, 15 grams; and 3 ounces of flounder or turkey, 25 grams.</p> <p>Again, if you have any concerns about this or any other aspects of your overall health, please do not hesitate to contact us.</p> <p>Dr Steven R. Goldstein is a <a href="https://www.goldsteinmd.com/conditions/osteoporosis-specialist-nyc-menopause-bone-loss/" target="_blank" rel="noopener">specialist for osteoporosis in NYC</a> and frequently works with Menopausal women to ensure bone health during Menopause.</p> <p>The post <a href="https://www.goldsteinmd.com/blog/you-know-about-osteoporosis-but-are-you-aware-of-muscle-wasting">You know about osteoporosis but are you aware of muscle wasting</a> appeared first on <a href="https://www.goldsteinmd.com">goldsteinmd</a>.</p> ]]></content:encoded> <wfw:commentRss>https://www.goldsteinmd.com/blog/you-know-about-osteoporosis-but-are-you-aware-of-muscle-wasting/feed/</wfw:commentRss> <slash:comments>0</slash:comments> </item> </channel> </rss>