Cox® Technic
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Osteoporosis Management: Drug vs. Vitamin Therapy?

April 28, 2010 16:36 by juliecoxcid

OSTEOCLAST PREVENTION DRUGS CALLED BIPHOSPHONATES (FOSAMAX, ACTONEL, BONIVA, RECLAST) LINKED TO UNPROVOKED FRACTURE OF THE FEMUR...ALSO LINKED TO OSTEONECROSIS OF THE JAW.  

Biphosphonates act on osteoclasts to prevent bone breakdown and reabsorption. This causes disturbed osteoblast and osteoclast balance and bone becomes brittle and susceptible to fracture.  (source: Fort Wayne News Sentinel, April 26, 2010, page 1F) It is recommended, therefore, that women do the following to treat osteoporosis: 

  1. Take calcium.  Dr. Cox suggests Formula #2 which is calcium citrate (as opposed to calcium carbonates often sold in drugstores) in capsule form with hydrochloric acid for absorption, magnesium, manganese, vitamin D3 and an additional 5 000 units of vitamin D3 a day.  Click here for more information.
  2. Increase Vitamin D3 intake to 5000 units a day.
  3. Exercise regularly with walking and free weight.
  4. Minimize caffeine and alcohol intake.

Further, please consider...70% decrease in fracture using Vitamin D3 vs. placebo...

VITAMIN D-3 SUPPLEMENTATION SHOWED A 70% PROBABILITY OF BEING A BETTER TREATMENT THAN PLACEBO FOR THE PREVENTION OF NON-VERTEBRAL FRACTURES, HIP FRACTURES, AND NON-VERTEBRAL, NON-HIP FRACTURES

from Bergman, GJD; Fan, T; McFetridge, JT; Sen, SS: Efficacy of vitamin D-3 supplementation in preventing fractures in elderly women: A meta-analysis. CURRENT MEDICAL RESEARCH AND OPINION 2010; 26 (5):1193-1201 The efficacy of vitamin D-3 in preventing fractures and falls has been explored in a number of clinical trials. However, recent evidence revealed new questions about the adequate doses of vitamin D-3 supplementation and its efficacy in fracture prevention independent of calcium supplements for various types of fractures.

A meta-analysis to estimate the effectiveness of 800 IU daily vitamin D-3 supplementation for increasing bone mineral density (BMD) and preventing fractures in postmenopausal women was done on Medline and EMBASE for controlled trials comparing the effectiveness of cholecalciferol (vitamin D-3) against placebo with or without background calcium supplementation in the treatment of postmenopausal women.

Results: Eight controlled trials evaluating the effect of vitamin D-3 supplementation with or without calcium were assessed. Of 12 658 women included in a Bayesian meta-analysis, 6089 received vitamin D-3 (with or without calcium) and 6569 received placebo (with or without calcium). Compared to placebo, vitamin D3 with calcium supplementation showed beneficial effects on the incidence of non-vertebral and hip fractures, while the effects on non-vertebral-non-hip fractures were associated with more uncertainty. Vitamin D-3 supplementation showed a 70% probability of being a better treatment than placebo for the prevention of non-vertebral fractures, hip fractures, and non-vertebral, non-hip fractures. Compared to calcium supplementation, vitamin D-3 plus calcium reduced non-vertebral fractures (OR 0.68, 95% CL 0.43-1.01) and non-vertebral, non-hip fractures, but did not reduce hip fractures. Key limitations to this analysis include a small number of studies and heterogeneity in the study populations.

Conclusions: This meta-analysis supports the use of vitamin D3 of 800 IU daily to reduce the incidence of osteoporotic non-vertebral, hip, and non-vertebral-non-hip fractures in elderly women. Vitamin D-3 with calcium appears to achieve benefits above those attained with calcium supplementation alone for non-vertebral and non-vertebral-non-hip fractures.


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Cox® F/D Helpful Tool for Thoracic Kyphosis

April 22, 2010 10:51 by juliecoxcid
THORACIC KYPHOSIS SEVERITY INCREASES RISK OF VERTEBRAL FRACTURE. THORACIC KYPHOSIS INCREASES OVER A 3 YEAR PERIOD. 

comment from James M. Cox DC DACBR: If for no other condition than hyperkyphosis of the thoracic spine, f/d decompression is worth having in the doctor’s treatment bag. Posture control coupled with f/d is an excellent addition to thoracic kyphosis care when you consider the possible complications as described in the report by Roux et al.

(from Roux, C; Fechtenbaurn, J; Kolta, S; Said-Nahal, R; Briot, K; Benhamou, CL.  Prospective Assessment of Thoracic Kyphosis in Postmenopausal Women With Osteoporosis. JOURNAL OF BONE AND MINERAL RESEARCH 25 (2). FEB 2010.  p.362-368)

 The relation of thoracic kyphosis, its influence on incident fractures and quality of life over three years in postmenopausal women with osteoporosis and the effect of strontium ranelate on thoracic kyphosis progression was studied on women with postmenopausal osteoporosis.  Vertebral fractures were assessed on lateral thoracic radiographs performed at baseline and at three years according to standardized procedure. Kyphosis index (KI, %) was defined as the percentage ratio between the maximum depth of thoracic curvature and the height measured from the T4 to the T12 vertebrae. Baseline characteristics of the 3218 patients (1594 strontium ranelate, 1624 placebo) were mean age 73.3 years, spine bone mineral density (BMD) T-score (1-2-4)-3.1, femoral neck T-score -3.0, and KI 25.4%.   In the placebo group, patients with the highest baseline KI experienced significantly more vertebral fractures than those with medium KIs or the lowest KIs. There was no difference in the risk of nonvertebral fractures according to baseline KI. Three-year changes in quality-of-life physical scores reflected significantly better status for patients in the lowest tertile of KI compared with those in the highest at baseline. Over three years, the kyphosis index increased for all patients, indicating worsening of thoracic kyphosis, whatever the presence of prevalent or incident vertebral fractures. This KI progression was lower in the strontium ranelate group than in the placebo group. Thoracic kyphosis is a risk factor for vertebral fractures over three years and influences physical capacity changes in postmenopausal women with osteoporosis. Thoracic kyphosis progression over three years is lower in a subgroup of strontium ranelate-treated patients compared with placebo-treated patients. 


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Hydrochloric Acid Needed for Calcium Resorption

March 6, 2010 01:31 by juliecoxcid

Sipponen andHarkonen (in Hypochlorhydric stomach: a risk condition for calcium  malabsorption and osteoporosis? SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY 2010;45(2):133-138)  write about a cause of osteoporosis being malabsorption which can stem from lack of acid or any other risk conditions like atrophic gastritis, gastric surgery and high-dose, long-term use of antisecretroy drugs that markedly reduce acid secretions. The addition of HCl in a calcium product is recommended.

 

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Osteoporosis is Preventable with Nutrition

February 26, 2010 02:23 by juliecoxcid

Osteoporosis continues to get attention in the medical and public media. New drugs are advertised to address osteoporosis. Well, Stransky and Rysava (in article: Nutrition as Prevention and Treatment of Osteoporosis. PHYSIOLOGICAL RESEARCH vol 58, no SUPPL, pgsS7-S11) present their findings from a meta analysis of 29 studies regarding calcium and vitamin D3 supplementation as

  • reducing the risk of bone fractures by 24% and
  • significantly reducing loss of bone mass.
Mind you, a meta analysis in the research world is the top level research. It considers the outcomes and results of many similar studies to draw a conclusion. These studies are highly regarded. Now, as most know but Stransky and Rysava summarize quite nicely, "osteoporosis is a systemic disease of the skeleton, characterized by reduction of bone mass and concurrent deterioration of bone structure. Consequently, bones are more fragile, and there is increased risk of fractures. The potential for acquisition of maximum bone mass is influenced by a number of factors. Among those are heredity, sex, nutrition, endocrine factors, mechanical influences and some risk factors. The best documented nutrient for metabolism of bone is calcium." 

The bottom line is that osteoporosis can result from several underlying issues. Osteoporosis is one of diseases which are influenced by nutrition and life style. It is preventable by means of adequate nutrition which includes CALCIUM and VITAMIN D3 and sufficient physical activity.


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