Topic: Confusion at the Vitamin Counter-Folic Acid-Others

Good Morning all,

I just woke up and I'm already thinking again to this question. My DH just walked by and sighed when he saw me back on the computer (lol). We're packing and leave tomorrow for our trip! So this will be quick...

BBS- thanks for the link to Vit D source and the doctor's research.

Following my thought of RDA requirements for "healthy" bodies......I was wondering how much of this research for Vit D is of young "healthy" and how much of old "geriatric". Joan said rightly I think that cancer then HT (Arimidex, etal) has made 90 year old women of us all by estrogen depletion standards. So possibly our requirements for these vitamins and supplements certainly would be much different "than the average bear!"

Rosemary- your cadavers spawned the thought in me that if cancer cells (and probably other maladies) dine on b-12 and magnesium, then it is logical that we would be depleted of these? Look at the success they have treating sickle cell anemia with magnesium. The question follows then how to restore the balance without inviting the cancer cells to dinner? Or, even if balance is not possible to restore...supplements are then key to remaining a "sustainable resource" around here. Maybe I missed this somewhere here before .... I'll go back and read some more. Forgive me if I'm being repetitive.

A thought about the NIH .... I remember in my younger days typing research papers for the docs. I asked them about funding by the NIH and how it was decided. My thinking then that the NIH was a "wonderful" organization. However, several of my favorite docs commented that it was staffed with political appointments and that research funding was not based on medical priorities as much as personal priorities. I realize that sweeping statement may sound sour grapes....but I had much respect for these docs and expect that they were right.

OKy doky then ... gotta run.

Pat,

If I don't see an improvement over my last dexa, I'm going to find a Dr. that does bones for a living.  My Onc prescribed Actonel and he really doesn't do any follow-up.  I have to remind him it's time for another dexa.  I'm not sure how good your Gyn is but if we have an on-going problem that isn't getting any better, maybe we should find someone in the know.   I don't even know how long I should be taking a break from it to see if my vision improves.  I think the Dr.s would do us a big favor of giving us a referral to a specialist instead of writing a prescription right off the bat for a field they might not know anything about.   Are you going to try the 3 cups of green tea daily?  I saw where you wrote that you take fosamax but I must have had actonel on the brain. 

Oh, I wanted to add, the Dr.s office I go to for the dexa scan, he's a regular MD with a machine in a room, they don't even check my height.  I have to ask them to do it.  Losing height is a biggie with this disease.  Save us. 

I don't remember reading that only green tea is supposed to help with bone density.  I think I did read that herbal tea doesn't.  So, does black tea also help?

Pat, it is my understanding that an endocrinologist is the doctor one wants to see when one has osteoporosis.  Just have to find a good one.

Shirley

Rosemary-As soon as I restarted the Boniva I noticed problems with eye discomfort as well as a difference in my vision. 

Are you ladies taking magnesium at half the dose of calcium???

Tina

Rosemary, - I remember posting some info from Letters to the editor section of the New England Journal of Medicine by some Ophthalmologists (I think the same year your Eureka Alert is referring to), sounding the alarm about eye problems and bisphosphonates on some support forum started by some Doctor who briefly appeared on the BCO support groups years ago--Can't remember the name of the forum??? 

Don't know how much attention was paid to this because it was hidden in the letters to the editor section.

I know no one had a clue about Fosamax when I had Lasik done.  Lasik causes dryness and if you have dry eye they won't do the procedure. 

Here is a little more elaboration about the eye issues.

---------------------------------------------------------------------- 

DRUG-RELATED ADVERSE EFFECTS

OF CLINICAL IMPORTANCE

TO THE OPHTHALMOLOGIST

PART I & PART II
 
F. T. (Fritz) Fraunfelder, M.D.

Casey Eye Institute

Oregon Health & Science University
Bisphosphonates - Pamidronate disodium (Aredia®), Alendronic acid (Fosamax®), Ibandronate, Zolendronate (Zometa®), Risedronate sodium (Actonel®), Clodronate (Bonefos®), Etidronate disodium (Didrocal®), Olpadronate     

Primary Use:  Pamidronate disodium (3-amino-1-hydroxy propylidene, disodium salt pentahydrate) inhibits bone resorption in the management of hypercalcemia of malignancy, osteolytic bone metastases of both breast cancer and multiple myeloma, and Paget’s disease of the bone.

 

Clinical Importance/ Ocular Concerns: This class of medicine has been reported to cause anterior uveitis and nonspecific conjunctivitis.  There are case reports of episcleritis, nerve palsy, ptosis, retrobulbar neuritis, and yellow vision.  We previously reported a case of anterior scleritis and a case of posterior scleritis associated with pamidronate use, without rechallenge data.  The most studied drug in this class, pamidronate, has caused seventeen cases of unilateral scleritis and one case of bilateral scleritis usually within 6 to 48 hours after intravenous use.  Six patients had positive rechallenge testing with the scleritis occurring after a repeat drug exposure.  Other ocular side effects with positive rechallenge data, associated with pamidronate disodium use, include: blurred vision, nonspecific conjunctivitis, ocular pain, bilateral anterior uveitis and episcleritis.

WHO Classification:

Certain

Blurred Vision

Ocular Irritation

Nonspecific conjunctivitis

      Pain

      Epiphoria

      Photophobia

Anterior Uveitis (rare – posterior)

Anterior Scleritis (rare – posterior)

Episcleritis

Probable

Periocular, lid and/or orbital edema

Possible

Retrobulbar neuritis

Yellow vision

Diplopia

Cranial nerve palsy

Ptosis

Visual hallucinations

Guidelines/ Conclusions:  This is the only class of drug proven to cause scleritis.  Bisphosphonates can cause vision threatening diseases, which may require discontinuing the drug in some uveitis cases and, in this series, all cases of scleritis.  Further guidelines are as follows:

               1. If persistent decrease in vision or ocular pain occurs, the patient should see an ophthalmologist.
               2. Nonspecific conjunctivitis seldom requires treatment and usually decreases in intensity or may be absent on subsequent pamidronate injections.  In rare instances, a non-steroidal anti-inflammatory eye drop may be needed.
               3. Bilateral anterior uveitis or rarely posterior or bilateral uveitis may occur and can vary markedly in severity.  Many cases required intensive topical ocular or systemic medication.  In some instances, the drug may need to be discontinued for the uveitis to resolve.
               4. Episcleritis may require topical ocular medication, however pamidronate may be continued.
               5. In this series, for the scleritis to resolve, even on full medical therapy, the intravenous pamidronate had to be discontinued.

I know I've been remiss in having my eyes checked,  ---but one bisphosphonate issue at a time--I just finished with my oral surgery debacle. LOL

 
 
 

 

Back to the confusion issue over vitamins.  My sister called me to report that the Bottom Line, which is a newsletter, has a list of vitamins not to take, so she's going off some very needed vitamins.  I just got her talked into taking some of them and bingo, this happens.

My husband brought me a list from the dentist office as a hand-out and it listed 10 vitamins not to take, vitamin C was one of them.  What is going on out there?  Who's behind this sudden call-to-arms against vitamins? I'm suspicious.  Some I can see, such as folic acid, if they found something new, let's hear about it.  But this is almost an assault.  We'll have to use our own common sense about this.

I'm still taking my vitamin C!

Shirley