Posts Tagged ‘alendronate’

Bone Health: Is a Fracture in Your Future?

Osteoporosis is a condition of weak bones, which makes them more likely to break. Ten million Americans have osteoporosis and 44 million have thinning bones, according to the National Osteoporosis Foundation (NOF), a health organization dedicated to preventing osteoporosis and broken bones though awareness, education and research.

In the United States, one out of every two women and one in four men over age 50 will have an osteoporosis-related fracture in their lifetime. Twenty-four percent of seniors who suffer a hip fracture will die within one year of the event. If you are female your risk of having a bone break from osteoporosis is equal to your risks of breast, uterine and ovarian cancer COMBINED.

My mother died of complications from osteoporosis. She broke her left wrist when she was 74 years old, tripping in downtown Seattle when trying to catch a bus. Four years later she fell onto her right when getting out of bed in the middle of the night. Her right knee swelled up and she insisted it was “just my knee”, refusing to go to the doctor. Nearly 2 weeks later when the pain hadn’t gone away she finally agreed to get it checked but by that time the ends of her broken bones had slipped down and were already knitting back together. She suffered from the discomfort and inconvenience of her right leg one inch shorter than her left one for the rest of her life.

Although its complications show up in old age, osteoporosis starts in childhood. Nearly 90 percent of our peak bone mass is built before we turn 20 years old. At middle age that begins to reverse and we lose 1% of our bone mass per year, doubling to 2% per year for women after menopause. The thinner your bones are to start with, the more likely you’ll eventually experience a fracture.

Here are 5 tips to help keep your bones healthy and strong:

  1. Get the calcium and vitamin D you need every day. Eating a variety of foods rich in calcium is a critical step to building and maintaining strong bones. Green leafy vegetables like broccoli, Brussels sprouts and kale are good sources of calcium, as are dairy products like milk and yoghurt. Calcium and Vitamin D supplements are also helpful.
  1. Do regular weight bearing and muscle-strengthening exercises. Getting up and moving is one of the best things you can do for your bones. Weight-bearing activities like walking, cycling or dancing help signal your body to keep your bones strong.
  1. Don’t smoke.My mother smoked since she was 18 years old. Quitting smoking could have helped her avoid the fractures that plagued her final years.
  1. Talk to your doctor about your chances of osteoporosis and ask about bone density testing.If you have passed menopause or have taken certain drugs, especially prednisone or corticosteroids, you may have thin bones without knowing it. Testing your bone density helps determine how likely you are to have a bone break in the future and if you are at risk, your bone loss can be slowed with medicine and other strategies. My mother never realized she had thin bones until she broke her wrist. With screening and the bone-building drugs available today she may have avoided the hip fracture that shortened her life.
  1. Try eating prunes every day. A recent study showed that eating prunes every day could make your bones stronger. The study participants ate 100 grams (about 10 prunes) every day for a year. Luckily,   you don’t have to eat quite that many to benefit your bones. I suggest taking it slowly and building up to what you can manage, as prunes are a natural stool softener. I weighed out 100 gm of dried plums (prunes) and found that 100 grams is 9 of the Mariani® brand of dried plums sold by Costco. With my family history, I decided to eat at least 5 prunes a day, and see if I could work up from there.

Is there a fracture in your future? Keeping your bones strong and healthy includes getting enough calcium and Vitamin D, doing some weight bearing exercise every day, quitting smoking and asking your doctor or medical provider about bone density testing. If you do have osteoporosis, there are bone building drugs available, from tablets you take every week or every month like alendronate (Fosamax®), Actonel® or Boniva®, to injections given daily, every 6 months or even once a year. And even prunes!

To find out more about osteoporosis and how you can prevent it, check out the National Osteoporosis Foundation website at www.nof.org.

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How To Take Thyroid Medicine

Q: On the bottle of my thyroid medicine it says to take it in the morning on an empty stomach. But sometimes I forget and don’t realize it’s still there until after I’ve eaten my breakfast. Is it safe to take it then?

My mother took the thyroid medicine levothyroxine, and her prescription bottle said to take it 30 minutes before breakfast. Every day she worried about what might happen if she didn’t take it “correctly”. If she took her first bite of breakfast and noticed that her yellow levothyroxine tablet was still sitting on the counter, she’d skip her dose for that day rather than risk getting an upset stomach or worse.

“Louise, what if it CAN’T be safely mixed with food? What if taking thyroid medicine with food in my stomach starts a deadly chain reaction and my stomach ruptures?”

“It’s okay, Mom. Your stomach won’t rupture if you accidently take your thyroid medicine at the same time as your breakfast. If you take it with breakfast what happens is your body might not get all of the medicine in that pill. That’s because food can change how much of the levothyroxine your body absorbs.”

“But the label on the bottle says to take it BEFORE breakfast. Are you SURE it’s safe if I take it later than that? I don’t want to get into trouble.”

“You might get less of your thyroid medicine if you take it with your breakfast, but skipping it completely guarantees you’ll get NONE of the dose. ZERO medicine. That can affect you even more than if you messed up and took it with breakfast.”

Levothyroxine is one of the most commonly prescribed medicines in the United States, and it can be hard to remember to take it first thing in the morning.

Kate struggled to take her pills every day according to the directions on the labels. She’d even set her alarm for 6am just so she could take her levothyroxine in the morning before breakfast. Otherwise she’d forget it completely. She took her regular morning pills right after she finished breakfast, then took her blood thinner warfarin at 5pm and her cholesterol medicine simvastatin at bedtime. She had to remember to take her medicines 4 times a day every day and it felt overwhelming.

“I want to take my medicines like the doctor wants me to, but it’s so hard to remember to take all of them every day.”

I suggested she move her thyroid medicine and her blood thinner to bedtime, the same time she was taking her simvastatin. That way she only had to take her pills twice a day, which would be easier than 4 times a day.

When she started taking her thyroid medicine more consistently she felt more energetic and no longer worries about taking her medicine correctly. “It’s such a relief to have less to remember, and I love having more energy!”

Here are some tips on how to take this common medicine:

  1. There’s nothing that says you must take levothyroxine in the morning. It won’t hurt you if you take it at a different time, like at breakfast or bedtime.
  2. Although levothyroxine is absorbed better if you take it on an empty stomach (30 minutes to an hour before a meal or 4 hours afterward), as long as you take it the same way every time, you’ll get a consistent dose.
  3. Don’t just skip your dose if you forget to take it before you eat. Even some of your thyroid medicine is better than none.
  4. There are some medicines that should be taken 4 hours from levothyroxine: calcium pills, iron pills, or multivitamins with minerals containing calcium or iron. An easy way to do this is to take any multivitamins or supplements with calcium or iron at your lunch or dinner meal.
  5. If you take thyroid medicine, then if you also take medicine for building bones like alendronate (Fosamax®) take the alendronate FIRST, on an empty stomach and your thyroid medicine at least 30 minutes later.

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