CLINICAL
OSTEOPOROSIS CPD
THE RIGHT VITAMINS FOR
OSTEOPOROSIS
Osteoporosis, defined by porous bones, is a common problem in Western countries. It is especially common among elderly women
and strongly raises the risk of fractures.
Osteoporosis is a common
disease characterised by low
bone strength that results in an
increased risk of fracture. In SA,
one in three women and one in five men
will develop osteoporosis.
PREVENT FRACTURES
Fractures are associated with serious
clinical consequences, including
long-term disability, increased risk
of death, and high healthcare costs.
Early identification and intervention
with patients at high risk for fracture
is needed to reduce the burden of
osteoporotic fractures.
The management of a patient with
a confirmed diagnosis of osteoporosis
or low bone mass (osteopenia) includes
assessment of fracture risk, evaluation
for secondary causes of skeletal
fragility, making decisions on initiation
of treatment, and identification of
all relevant clinical factors that may
influence patient management.
A three-year trial in 244
postmenopausal women found that
those taking vitamin K2 supplements
had much slower decreases in age-
related bone mineral density.
Lengthy studies on Japanese
women have shown similar benefits,
although they used very high doses.
Out of 13 trials, only one failed to show
significant improvement.
Seven of those trials also reported
fractures and found that vitamin K2
reduced spinal fractures by 60%, hip
fractures by 77% and all non-spinal
fractures by 81%.
VITAMIN K
Vitamin K2 is rare in the Western diet
and hasn’t received much mainstream
attention. However, this powerful
nutrient plays an essential role in many
aspects of health.
It has been postulated that vitamin
K2 may just be the ‘missing link’
between diet and several diseases.
Vitamin K was discovered in
1929 as an essential nutrient
for blood coagulation. The initial
discovery was reported in a German
scientific journal, where it was called
Koagulationsvitamin. That’s where the
‘K’ comes from.
The three types of vitamin K are:
1. Vitamin K1, or phylloquinone, is
CONDITIONS, DISEASES AND MEDICATIONS THAT CAUSE OR CONTRIBUTE TO
OSTEOPOROSIS AND FRACTURES
LIFESTYLE FACTORS
Low calcium intake
Vitamin D insufficiency
Excess vitamin A
High caffeine intake
High salt intake
Aluminum (in antacids)
Alcohol (three or more drinks/d)
Inadequate physical activity
Immobilisation
Smoking (active or passive)
Falling
Thinness
GENETIC FACTORS
Cystic fibrosis
Homocystinuria
Osteogenesis imperfecta
Ehlers-Danlos syndrome
Hypophosphatasia
Parental history of hip fracture
Gaucher’s disease
Idiopathic hypercalciuria
Porphyria
Glycogen storage diseases
Marfan syndrome
Riley-Day syndrome
Hemochromatosis
Menkes steely hair syndrome
Hypogonadal states
Androgen insensitivity
Hyperprolactinemia
Turner’s and Klinefelter’s syndromes
Anorexia nervosa and bulimia
Panhypopituitarism
Athletic amenorrhea
Premature ovarian failure
ENDOCRINE DISORDERS
Adrenal insufficiency
Diabetes mellitus
Thyrotoxicosis
Cushing’s syndrome
Hyperparathyroidism
GASTROINTESTINAL
DISORDERS
Celiac disease
Inflammatory bowel disease
Primary biliary cirrhosis
YOUR BONES
AND HEART WILL
LOVE YOU **
Gastric bypass
Malabsorption
GI surgery
Pancreatic disease
HAEMATOLOGIC DISORDERS
Haemophilia
Multiple myeloma
Systemic mastocytosis
Leukemia and lymphomas
Sickle cell disease
Thalassemia
RHEUMATIC AND
AUTOIMMUNE DISEASES
Ankylosing spondylitis
Lupus
Rheumatoid arthritis
MISCELLANEOUS
CONDITIONS AND DISEASES
Alcoholism
Emphysema
Muscular dystrophy
Amyloidosis
End stage renal disease
Parenteral nutrition
Chronic metabolic acidosis
Epilepsy
Post-transplant bone disease
Congestive heart failure
Idiopathic scoliosis
Prior fracture as an adult
Depression
Multiple sclerosis
Sarcoidosis
MEDICATIONS
Anticoagulants (heparin)
Cancer chemotherapeutic drugs
Gonadotropin releasing hormone
agonists
Anticonvulsants
Cyclosporine A and tacrolimus
Lithium
Aromatase inhibitors
Depo-medroxyprogesterone
Barbiturates
Glucocorticoids (≥5mg/d of
prednisone or equivalent for ≥3 mo)
#1
SA’S
SCRIPTED
CALCIUM SUPPLEMENT*
*Ref. Impact Rx, May 2016
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MEDICAL CHRONICLE | MAY 2017 31