Osteoporosis, Metabolic Bone & Mineral Disorders Archive Questions

Below are Dr. Streeten’s answers to Osteoporosis, Metabolic Bone & Mineral Disorders questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.



Now displaying records 1 to 15 of 29.

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Q : 1 04/13/2010	The New England Journal of Medicine stated that fosamax is not necessary with parathyroid hormone injections to get "bone benefits." Do you prescribe just PTH? Also, would the risk of bone cancer and other side effects be lessened? Not only is fosamax not necessary for the benefits of parathyroid hormone (Forteo) but they shouldn't be used together because they blunt each others' effects. There is no risk of bone cancer from Forteo in humans, only rats given a huge dose of it.
Q : 2 03/14/2010	The FOX News health report 3-14-10 on Fosamax & Boniva concerns me. The report said that if someone takes these medications for 4 or more years, they could have the reverse effect. Is this true? I have been using Fosamax and am experiencing severe fracturing. Is there something that could help? The news media has been irresponsible, in my opinion, on it's reporting of the possible side effects of bisphosphonates (Fosamax, Actonel, Boniva, Reclast) by not giving balanced information. Information you hear on the news media about medications is often incorrect or incomplete. The risk of osteonecrosis of the jaw is 1/140,000 for those on these drugs. The risk of mid-femur fractures has been estimated at 1/10,000 on bisphosphonates. A recent New England Journal of Medicine article found NO difference in the incidence of mid-femur fractures in those on bisphosphonates compared to those NOT on them. The news media reported on this issue without having all the facts, it's that simple. If I understand your last question, it is "if a fracture occurs while taking Fosamax" then what should you do. The answer depends on all of your health information. When a doctor wants to change from bisphosphonates to something else, the only drug that is effective, when bisphosphonates are not, is Forteo.
Q : 3 03/02/2010	I have Osteoporosis with Kidney Stones and no parathyroid problems. I am taking vitamin D and my general practitioner has suggested I take a calcium supplement. My urologist believes that I shouldn't take calcium and my endocrinologist says that I don't have parathyroid problems. What do I do? Some kidney stones are related to calcium and some are not. The way to determine if your kidney stones have anything to do with calcium is to do a 24 hour urine test (called a kidney stone diagnostic panel). I suspect that you have not done this but everyone with kidney stones should have this done. Perhaps your endocrinologist would be willing to do this for you. If you are losing calcium through the kidneys excessively (true in some people with kidney stones but not all), then you should not take calcium supplements until this is corrected (hydrochlorothiazide corrects this very well usually). If your 24 hour urine calcium is normal, then your kidney stones are not related to calcium and calcium supplements are not contraindicated. I hope this helps.
Q : 4 02/09/2010	I'm having a lot of pain in my hands the joints sometimes they fall asleep at night my hands. They hurt very much. Does this have anything to do with Osteoporosis? I already have Osteoporosis. Osteoporosis only hurts if there is a fracture. It sounds like you may have arthritis, which is a disorder of cartilage, not bone. I recommend that you see a rheumatologist, a medical joint specialist.
Q : 5 02/03/2010	I have been told in the past that bad knees can cause hip pain, and vice versa. Is this indeed true? Yes, although I would say that it is more common for knee problems to lead to hip pain than the other way around. Knee problems can cause one leg bone to be shorter than the other and can cause limping. Both of these can lead to hip pain. I hope this helps
Q : 6 12/26/2009	Can you overdose on Vitamin C? Not really. Whatever your body doesn't need is excreted in the urine. However, over 1 g of vit C at once can cause stomach upset.
Q : 7 12/04/2009	Does calcium in kidneys draw calcium out of bones? Calcium is excreted out the urine in all of us, but the amount that is excreted varies from person to person. Most of the calcium that is excreted out the urine comes from calcium taken in by mouth (both by food and supplements) and a small amount comes from calcium released from the bone by normal bone turnover (the process by which old bone is broken down and new bone is formed, occurring in all of us all the time). Several hormones control how much of the calcium we take in by mouth is excreted out the urine and how much is retained in the bones (eg. parathyroid hormone, estrogen in women and testosterone in men, vitamin D, thyroid hormone to name the key players).
Q : 8 10/26/2009	I was told that the weight-bearing nature of many yoga poses,(standing on one leg, or balancing entire body weight on one hand-one foot) is good for building bone density. Now I read that no it's not, you MUST be jumping or running. What's the official scoop? All exercises which involve bearing your weight, including standing in a yoga pose, are good for the bones. High impact (eg. jogging, jumping jacks, jump rope), however, is the best for stimulating bone formation.
Q : 9 09/18/2009	Taking 1,500 mg of calcium caplets daily makes me nauseous. Are there any alternative calcium products? Calcium can be obtained from food. Postmenopausal women and men over 65 need 1200-1500 mg of calcium total, including diet and supplements. Most people get some calcium in their diets and do not need to take 1500 mg as supplements. No more than 500-600 mg of calcium should be taken at one time or it is not absorbed.
Q : 10 08/17/2009	Is long term use of fosomax (over 10 years) recommended to prevent osteoporosis in osteopenia patients? The answer to this depends on the person's entire medical history and how bad the osteopenia is. The thinking on treatment of osteopenia has also changed over the past 10 years. Currently, many physicians (including myself) are using an online tool called "FRAX" to help decide which patients with osteopenia need medication. The FRAX tool calculates your 10 year absolute fracture risk. If this risk is 3% or higher for hip or 20% or higher for spine, medication is usually recommended.
Q : 11 07/25/2009	Can celiac disaese cause rickets? Where is vitamin D absorbed in the intestine? Could you tell a bit more about heriditary hypophasphatemia causing rickets and its treatment? Celiac disease can cause rickets in a child, by causing vitamin D deficiency. Vitamin D is absorbed the best in the small intestine, although it is absorbed in the large intestine also. There are several types of hypophosphatemic rickets, all of which lead to excessive loss of phosphorus in the urine. The low phosphorus causes rickets in children and osteomalacia in adults. The treatment for most types of hypophosphatemic rickets includes phosphorus pills taken usually 3 times a day and a prescription form of activated vitamin D called calcitriol. The treatment is best done by an endocrinologist.
Q : 12 06/03/2009	Can Osteoporosis cause pain in your back? Osteoporosis only causes pain if there has been a fracture (compression fracture of the spine).
Q : 13 05/02/2009	I am 37 1/2 weeks pregnant, and my baby has two fractured femurs. Is it possible for any of my movement to be the cause of his bone fractures? I have not fallen or anything severe, but I am overly concerned that if I bend the wrong way and his leg is in my ribs or something, that I could harm him. In your opinion, is this possible? Babies who have fractures while still in the uterus generally have some form of reduced bone strength (there are many possible causes). Generally this does not happen from the mother's movement.
Q : 14 04/26/2009	Do you have an opinion on Strontium as a supplement for Osteoporosis? The studies with Strontium have been encouraging but it is not available in the US.
Q : 15 03/29/2009	More and more good health benefits are being attributed to drinking green tea. Can women with beginning osteoporosis drink tea? I've heard tea absorbs calcium. I am not aware of any studies showing that tea helps to absorb calcium. Most people absorb calcium very well, particularly if it is taken after a meal. Generally, calcium (green tea or not) is not enough to treat osteoporosis.

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