Talk:Osteoporosis/Archive 2

{talk archive}} {==New guideline for disease in men== [1] Doc James (talk · contribs · email) 06:05, 20 June 2012 (UTC)

How does aging increase the risk of osteoporosis?

I've heard some explanations—“By decreasing bone density,” which itself, I've heard, results from disruption of calcium metabolism, which in its own turn occurs with the broader disruption of metabolism triggered by senescence. Alright, but what mechanisms underlie the disruption of calcium metabolism? Do we even know? EIN (talk) 14:11, 29 October 2012 (UTC)

Additional section on evolutionary considerations

I am a biology student at Case Western Reserve University and as part of a project for my Darwinian Medicine course I am adding a section on this page about the evolutionary considerations of Osteoporosis and it's relationship to bipedalism. I would love to get feedback on the section before I post it. It will be in my sandbox (Cpb45). — Preceding unsigned comment added by Cpb45 (talk • contribs) 02:01, 24 October 2013 (UTC)

Such a section (perhaps within "Epidemiology") can only be sustained by very high-quality secondary sources (e.g. widely recognised textbooks or reviews). We can't really do a randomised controlled trial of bipedalism, so any evolutionary consideration is highly speculative. JFW | T@lk 16:43, 27 October 2013 (UTC)

I understand your concerns regarding the types of sources and the kinds of data available regarding evolution. As far as evolution being highly speculative, this is not the case. Evolution is widely accepted as a theory with high validity and extreme relevance. Articles by Stephen Stearns (Evolutionary Medicine: it's scope, interest and potential), Understanding Evolution (a site by Berkley, "Why Evolution is True" (article or video by Coyne), or Evmedreview.com are all good resources that emphasize the support for evolution and it's relevance to medicine. As far as data is concerned, there cannot be randomized controlled experiments of bipedalism or evolution. This is a comparative and historical science and the need for data should be mindful of the sorts of data that can appropriately for this field. Lastly, I am doing this project as a collaboration with other students and professors from various universities around the country. This group is striving to increase the public understanding of evolution and the possible influences in medicine through understanding the vulnerabilities humans have to certain diseases and where those originate. I hope this helps to ease some of your concerns. Please let me know if you still have any reservations or questions regarding my section. — Preceding unsigned comment added by Cpb45 (talk • contribs) 23:53, 3 November 2013 (UTC)

I am aware of the methodological limitations on evolutionary research, and I agree that observational studies (e.g. association between species posture and bone health) can inform this debate. I do not need to persuaded that evolution exists (not here anyway), nor that certain health conditions have their roots in human evolution, but I want to avoid content that cannot be solidly supported by high-quality sources. JFW | T@lk 21:06, 4 December 2013 (UTC)

Incidentally, I hope it is very clear that your edits are attributable to you alone, and not on behalf of a group of students or professors. This is expressly against Wikipedia policy. JFW | T@lk 21:08, 4 December 2013 (UTC)

Loss of Height

I can find no medical description of this syndrome. The only discussion you ever see cites spinal compression, and does not mention decrease in length of the long bones. I can tell you, it's not welcome! Apart from stoop, personally I discovered that by the age of 70, I now needed trousers (pants in the USA) with 27 inch inside leg, rather than the 29 inch I'd been since adulthood.

But that's not all, I suspect every bone is affected, e.g. my hands are now smaller. Yes, like I said, it's not welcome! I think it's not uncommon, and might affect women more than men, but then they live longer.

A very noticeable example is Queen Elizabeth of the UK. Her well older husband the Duke of Edinburgh has not been affected, which draws attention really. I guess her height at her marriage and now could be deduced from photos and newsreel clips, but how many more examples exist in the ranks of ageing notables?

So, is their some scope for research here, leading to a new syndrome description? L0ngpar1sh (talk) 16:10, 28 January 2014 (UTC)

L0ngpar1sh I don't know if there are any WP:MEDRS sources that might support such a claim. The loss of height is the result of gravity and vertebral collapse, but the cortical and non-weight bearing bones are not thought to change size. New syndromes belong in the medical literature and not really here, per WP:NOR etc etc. JFW | T@lk 22:38, 28 January 2014 (UTC)

Most people lose height from age 40 onwards. It does seem to be connected at least somewhat with osteoporosis. But regardless of whether there is any direct medical connection, it at least deserves a see-also link.-71.174.175.150 (talk) 21:04, 12 November 2014 (UTC)

Yes we need a ref. Doc James (talk · contribs · email) 21:49, 12 November 2014 (UTC)

It is very strange that there seems to be no generic medical term for Loss of Height -- and no corresponding WP article!.-71.174.175.150 (talk) 22:34, 12 November 2014 (UTC)

Water fluoridation a cause?

I live in a country town in which the drinking water is very low on fluoride. Our local government organisation is considering fluoridating the water. In response, anti-fluoriders from all over the country have suddenly moved in. They are claiming that one of the "problems" that fluoridation creates is an increased occurrence of osteoporosis. Googling the two together produces a number of web sites that support this link. Is there any truth in it? — Preceding unsigned comment added by 124.187.135.252 (talk) 05:01, 6 July 2014 (UTC)

Hi there 124, we're not allowed to provide medical advice here on Wikipedia, but I will refer you to the Water fluoridation article. I think it will answer your question. I am not aware of any high-quality studies suggesting that water fluoridation plays a major role in osteoporosis though if such studies exist I would be interested to know about them. TylerDurden8823 (talk) 05:22, 6 July 2014 (UTC)

Effectiveness of treatment

doi:10.7326/M14-0317 is a very thorough review of treatments for fracture prevention. It compares vertebral, non-vertebral and other fractures in the different agents. Worth including, perhaps even with the NNT. JFW | T@lk 20:09, 9 September 2014 (UTC)

Yeah, here it is. I finally got to it on paper. As far as I can see on my first reading, they didn't change any conclusions significantly, but did support them with a larger evidence base. And they had more on the atypical femur fracture. The accompanying editorial argues that the evidence is weakest where fractures are most prevalent and dangerous, in the older age groups in their 70s and 80s.

Crandall CJ, Newberry SJ, Diamant A, et al.

Reviews: Comparative Effectiveness of Pharmacologic Treatments to Prevent Fractures: An Updated Systematic Review

http://annals.org/article.aspx?articleID=1902273

Annals of Internal Medicine. 2014;161(10):711-723. doi:10.7326/M14-0317 18 November 2014

Bischoff-Ferrari HA, Meyer O

Editorial: Comparative Effectiveness of Pharmacologic Treatments to Prevent Fractures: Is This All We Need to Know?

http://annals.org/article.aspx?articleid=1902274

Annals of Internal Medicine. 2014;161(10):755-756. doi:10.7326/M14-1942 18 November 2014

--Nbauman (talk) 01:23, 23 November 2014 (UTC)

Dated primary source

Sequoiahealth, could you please explain why you are adding text from a 2002 primary source, relative to WP:MEDRS? The source is more than a decade old; if the findings are relevant, they will have been mentioned in a secondary review. Also, please have a look at WP:3RR and discuss your edits on talk rather than reverting. SandyGeorgia (Talk) 14:18, 9 April 2015 (UTC)

Epidemiology

Before my edit on Aug 19, the Epidemiology section began: "Osteoporosis affects 55% of Americans aged 50 and above." This doesn't pass the sniff test and would mean over 50 million people in the US have it. The reference given was a 2002 National Osteoporosis Foundation publication. When I looked at that publication, it said "Osteoporosis and low bone mass" pose a threat to 55% of Americans over age 50. Low bone mass is a different thing and much more common than clinical osteoporosis. I rewrote the beginning of this section to include more realistic numbers and more current references. The American Association of Orthopaedic Surgeons website says 10 million Americans have osteoporosis. http://www.aaos.org/about/papers/position/1113.asp The International Osteoporosis Foundation says the number worldwide is 200 million. http://www.iofbonehealth.org/epidemiology Carax (talk) 02:24, 20 August 2015 (UTC) — Preceding unsigned comment added by Carax (talk • contribs) 02:19, 20 August 2015 (UTC)

Should have been 15%. Corrected it. Doc James (talk · contribs · email) 04:33, 21 August 2015 (UTC)

Some proposed changes

Kindly add the below sentence and reference to this section "Prognosis-->Vertebral fractures" Recent advances in computer vision techniques have helped to quantify the extent of these vertebral fractures. https://www.ncbi.nlm.nih.gov/pubmed/20172792 Hidasri (talk) 08:51, 14 August 2017 (UTC)

As before, content about health needs to be sourced per WP:MEDRS. Please do read that. thanks. Jytdog (talk) 20:10, 14 August 2017 (UTC)

My name is German Guerrero, MD, and I am Senior Medical Director, Global Medical Affairs at Radius Health, Inc., a biopharmaceutical company based out of Waltham, MA. I'm here to contribute content on the Osteoporosis page, specifically to the first line of the fourth paragraph under the “Medications” section (under “Management”).

I am aware of Wikipedia's policies and guidelines, including those on WP:COI, WP:RS, WP:V and WP:NPOV, and I will abide by them. My edit suggestions will be restricted to Talk pages, and I will not engage in directly editing any teriparatide-related article. On any pages where I may suggest changes, I will be sure to disclose my relationship to Radius Health in the interest of transparency.

If you have any questions about my editing activities, please leave me a message on my User Talk page.

Revisions to Osteoporosis page

Current:

Teriparatide ( a recombinant parathyroid hormone ) has been shown to be effective in treatment of women with postmenopausal osteoporosis.[110] Some evidence also indicates strontium ranelate is effective in decreasing the risk of vertebral and nonvertebral fractures in postmenopausal women with osteoporosis.[111] Hormone replacement therapy, while effective for osteoporosis, is only recommended in women who also have menopausal symptoms.[87] It is not recommended for osteoporosis by itself.[105] Raloxifene, while effective in decreasing vertebral fractures, does not affect the risk of nonvertebral fracture.[87] And while it reduces the risk of breast cancer, it increases the risk of blood clots and strokes.[87] Denosumab is also effective for preventing osteoporotic fractures but not in males.[87][107] In hypogonadal men, testosterone has been shown to improve bone quantity and quality, but, as of 2008, no studies evaluated its effect on fracture risk or in men with a normal testosterone levels.[56] Calcitonin while once recommended is no longer due to the associated risk of cancer and questionable effect on fracture risk.[112]

Revised:

• Updating the first sentence of the fourth paragraph under the “Medications” section (under “Management”) to add a recently approved medication

Teriparatide ( a recombinant parathyroid hormone ) and abaloparatide (a human parathyroid hormone related peptide [PTHrP(1-34)] analog) have been shown to be effective in treatment of women with postmenopausal osteoporosis at high risk for fracture.[110] Some evidence also indicates strontium ranelate is effective in decreasing the risk of vertebral and nonvertebral fractures in postmenopausal women with osteoporosis.[111] Hormone replacement therapy, while effective for osteoporosis, is only recommended in women who also have menopausal symptoms.[87] It is not recommended for osteoporosis by itself.[105] Raloxifene, while effective in decreasing vertebral fractures, does not affect the risk of nonvertebral fracture.[87] And while it reduces the risk of breast cancer, it increases the risk of blood clots and strokes.[87] Denosumab is also effective for preventing osteoporotic fractures but not in males.[87][107] In hypogonadal men, testosterone has been shown to improve bone quantity and quality, but, as of 2008, no studies evaluated its effect on fracture risk or in men with a normal testosterone levels.[56] Calcitonin while once recommended is no longer due to the associated risk of cancer and questionable effect on fracture risk.[112]

References