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Jan 27, 2018 03:41PM
Jan 27, 2018 06:44PM
Anyone with osteoporosis, rare exceptions,(e.g., patients with active renal stones) needs to get adequate calcium and vitamin D as part of their OP management, either from diet or from supplements, per all reputable western organizations that have expertise in OP. However, though calcium and D are necessary, they are not sufficient to rx the OP. Think of calcium as a building block for bone, and vitamin D a means to absorb it so it can get to your bone. But you also need more,
The bisphosphonates and prolia (denosumab) are antiresorptives that prevent bone breakdown and all can, very rarely, especially with prolonged use and with extractions or implants (well under 1 per cent of people) cause ONJ, but note even if someone has ONJ in early stages, i.e., it is monitored, all that is done is to smear a cream on the area! If the risk of OP fx is big enough, docs may even continue the treatment, as they balance risk vs. benefit, if there are no good alternatives! The horror stories of ONJ are from people who were not monitored and advanced to higher stages, and of course they make the news, The vast majority of people on OP doses of bisphosphonates and prolia in doses used for OP do not get dental side effects or serious other side effects
Higher doses, used to treat metastatic cancer to bone (e.g., monthly or every three months) increase the risk of ONJ
Here is one overview of OP for lay people extracted from National Osteoporosis Foundation recommendations which talks about calcium, D, and agents available.
After a decade of autoimmune problems, Dx 10/2017 at age 63, IDC, Left, 9mm, Oncotype 13, Stage IA, Grade 1, 0/5 nodes, ER+/PR+, HER2-, 11/22/2017 Lumpectomy, Arimidex. Declined radiation.