Osteoporosis treatment guidelines by US Endocrinology groups – Sept 2016

AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY CLINICAL PRACTICE GUIDELINES FOR THE DIAGNOSIS AND TREATMENT OF POSTMENOPAUSAL OSTEOPOROSIS — 2016--EXECUTIVE SUMMARY

Endocrine Practice: September 2016, Vol. 22, No. 9, pp. 1111-1118.
doi: http://dx.doi.org/10.4158/EP161435.ESGL

VitaminDWiki Comment

Overview Osteoporosis and vitamin D contains the following summary

  • FACT: Bones need Calcium (this has been known for a very long time)
  • FACT: Vitamin D improves Calcium bioavailability (3X ?)
  • FACT: Should not take > 750 mg of Calcium if taking lots of vitamin D (Calcium becomes too bio-available)
  • FACT: Adding vitamin D via Sun, UV, or supplements increased vitamin D in the blood
  • FACT: Vitamin D supplements are very low cost
  • FACT: Many trials, studies. reviews, and meta-analysis agree: adding vitamin D reduces osteoporosis
  • FACT: Toxic level of vitamin D is about 4X higher than the amount needed to reduce osteoporosis
  • FACT: Co-factors help build bones.
  • FACT: Vitamin D Receptor can restrict Vitamin D from getting to many tissues, such as bones
  • It appears that to TREAT Osteoporosis:
  •        Calcium OR vitamin D is ok
  •        Calcium + vitamin D is good
  •        Calcium + vitamin D + other co-factors is great
  •        Low-cost Vitamin D Receptor activators sometimes may be helpful
  • CONCLUSION: To PREVENT many diseases, including Osteoporosis, as well as TREAT Osteoporosis
  • Category Osteoporosis has 219 items
  • Category Bone Health has 312 items

Note: Osteoporosis causes bones to become fragile and prone to fracture
  Osteoarthritis is a disease where damage occurs to the joints at the end of the bones
Osteoporosis category includes the following

An Osteoporosis Vitamin D letter behind a $40 paywall
Further major uncorrected errors in National Osteoporosis Foundation meta-analyses of calcium and vitamin D supplementation in fracture prevention


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Pauline M. Camacho, MD, FACE1; Steven M. Petak, MD, MACE, FACP, FCLM, JD2; Neil Binkley, MD3; Bart L. Clarke, MD, FACP, FACE4; Steven T. Harris, MD, FACP5; Daniel L. Hurley, MD, FACE6; Michael Kleerekoper, MBBS, MACE7; E. Michael Lewiecki, MD, FACP, FACE8; Paul D. Miller, MD9; Harmeet S. Narula, MD, FACP, FACE10; Rachel Pessah-Pollack, MD, FACE11; Vin Tangpricha, MD, PhD, FACE12; Sunil J. Wimalawansa, MD, PhD, MBA, FCCP, FACP, FRCP, DSc, FACE13; Nelson B. Watts, MD, FACP, MACE14
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Questions discussed

• Q1. How is fracture risk assessed and osteoporosis diagnosed?
• Q2. When osteoporosis is diagnosed, what is an appropriate evaluation?
• Q3. What are the fundamental measures for bone health?
• Q4. Who needs pharmacologic therapy?
• Q5. What medication should be used to treat osteoporosis?
• Q6. How is treatment monitored?
• Q7. What is successful treatment of osteoporosis?
• Q8. How long should patients be treated?
• Q9. Is combination therapy better than treatment with a single agent?
• Q10. Should sequential use of therapeutic agents be considered?
• Q11. Should vertebral augmentation be considered for compression fractures?
• Q12. When should referral to a clinical endocrinologist or osteoporosis specialist be considered?

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