Fluoride and bone - quantity versus quality

Article Abstract:

Osteoporosis, a disease involving loss of bone that is especially prevalent among aging women, can be treated either by preventing bone loss or by effectively managing patients with fractures resulting from their bones' weakened condition. Sodium fluoride is an agent that increases bone density and clinicians have hoped it could repair damaged bone in postmenopausal patients. Two unfortunate consequences of this treatment, however, are its unpleasant side effects, including gastric disturbances, and the fact that the bone formed in people taking it is abnormal. A study in the March 22, 1990, issue of The New England Journal of Medicine reported increases in bone density of the spine with no decrease in the fracture rate, and increases in bone density in other bones with an increased number of fractures. These findings strongly imply that bone formed while taking sodium fluoride is inadequate and suggest that this is not an effective treatment for postmenopausal osteoporosis, although further investigation using this compound at different doses and in combination with other drugs is warranted. It is possible that increases in bone mass will always be inadequate once the basic framework of the bone has been destroyed by disease. The standard remedy is treatment with estrogen and calcitonin - the earlier, the better; but controlled studies showing reductions of fracture rates among patients receiving these drugs have not been done. It is possible that the improvement noted after treatment with estrogen and calcitonin is due to their effect on other systems in the body. Potentially promising approaches are briefly discussed. As the population as a whole ages, osteoporosis could grow to epidemic proportions, so stepping up the pace of research now could yield major benefits for our future older generations. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Fluorides, Age factors in disease, Disease age factors, editorial

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Estrogen treatment of patients with established postmenopausal osteoporosis

Article Abstract:

Oral estrogen has been used in the postmenopausal phase of life for the prevention of osteoporosis; however, few studies have documented its effectiveness for the treatment of established osteoporosis. Postmenopausal women with established osteoporosis were studied to determine if estrogen given in addition to calcium supplementation was more effective than calcium supplementation alone to prevent further bone loss. Calcium supplementation equalled approximately 1,500 mg per day and the dose of conjugated estrogen administered was 0.625 mg per day. Additionally, the two major fracture sites, spine and hip, were studied to determine if there was a difference in treatment effectiveness. The age of the patients and the condition of the skeleton were also examined to determine any differences in treatment effectiveness. A total of 40 women were studied for two years. There was a significant increase in bone mass during treatment with estrogen and calcium, while calcium alone was associated with a slow but gradual loss of bone from the lumbar spine. The results were quite evident in the lumbar spine; however, a trend was also seen in the femoral neck. The goal of treatment of patients with established osteoporosis is to prevent recurrent fractures; however, this issue was not specifically addressed in this study. Estrogen given along with calcium supplementation seems better than calcium alone. It would be useful to see the results of additional studies using larger groups of patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Calcium, Calcium (Chemical element)

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Daily and cycle parathyroid hormone in women receiving alendronate

Article Abstract:

An attempt is made to evaluate whether patients with osteoporosis treated with long-term alendronate have a response to parathyroid hormone treatment and whether short, three-month cycles of parathyroid hormone therapy could be as effective as daily administration. Results indicate that in patients with persistent osteoporosis after prior alendronate treatment, both daily treatment and cyclic treatment with parathyroid hormone increase spinal bone mineral density.

New England States, Women, Parathyroid hormone, Parathyroid hormones, Women's health, New England, Alendronate

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