Monday, April 25, 2016

Zolpidem (Ambien) Increases Fracture Risk In Men and Women with Osteoporosis

People break bones when they fall. In fact, falling is the number one cause of fractures especially in the elderly. It therefore makes sense that people with osteoporosis should avoid taking medications that increase their risk of falling. That is exactly what a recent study published in Osteoporosis International concluded. Park et al. conducted a large (1,092,925 participants) systematic review and meta-analysis and concluded that Zolpidem (Ambien), a medication often prescribed for insomnia, was associated with increased risk for fracture. The study noted that the increased fracture rate was especially pronounced for hip fractures.

This finding makes total sense when you realize that Ambien, a short-acting nonbenzodiazopine hypnotic, can cause ataxia, poor motor control, difficulty maintaining balance, dizziness, and sleepwalking. The last thing a person with fragile bones needs to be doing is dizzily walking around in their sleep . The kicker here is that a 2012 NIH study published in the British Medical Journal concluded that much of Zolpidem's effectiveness is psychological...in other words, a placebo effect. The study concluded that greater caution should be used when prescribing Ambien to individuals at risk for fracture and that "increased attention should be directed at psychological intervention of insomnia".

Park, S.M. et al.  2016. Zolpidem use and risk of fractures: a systematic review and meta-analysis. Osteoporosis International April 22.

Huedo-Medina, T.B. et al. 2012. Effectiveness of non-benzodiazopine hypnotics in treatment of adult insomnia: meta-analysis of data submitted to the Food and Drug Administration. BMJ (Clinical Research ed.) 345:e8343.

Thursday, April 21, 2016

Do Calcium Supplements Contribute to Clogged Arteries?


"Am I at risk for clogged arteries by taking calcium supplements?"
                   Woman age 65 living with osteoporosis

Excellent question.

The short answer:
Healthy bones DO need a sensible intake of supplemental calcium, along with adequate vitamin D and K, and magnesium for proper absorption. They also need ingredients that (1) promote balanced bone remodeling and (2) help prevent blood vessel calcification. OsteoNaturals products fit all these requirements.

The long answer:
In a recent study published in Climacteric, C.E. Lampropoulos, et al. assessed the correlation between osteoporosis and vascular calcification in postmenopausal women. The goal was to determine not only if there was a correlation (there have been numerous studies linking these as comorbidities) but also to determine if low dose calcium supplementation plus vitamin D contributed to calcification of arteries.

The study concluded that "Calcified plaques were significantly correlated with osteoporosis."  Osteoporotic women were "16 times more likely" to develop calcification of the abdominal aorta and "seven times more likely" to develop plaques and thickening of blood vessels compared to normal individuals. It also concluded that "low doses of supplements do not appear to cause any increase in vascular calcification in osteoporotic women." In other words, although bone loss and calcification of arteries go hand in hand their connection is NOT due to taking calcium supplements. And this is key! We need calcium for our bones to be healthy. Taking supplemental calcium is safe when used in moderation. Taking huge amounts of any supplement, including calcium, is never advisable. But a sensible intake of 600 to 1,000 mg/day of supplemental calcium (plus another 500 or so from the diet) is important for getting your 1,200 to 1,500 mg calcium/day as recommended by most bone-health experts. Making sure you get adequate vitamins D and K, and magnesium is also a vital part of the equation. You NEED these to ensure that the calcium you take in goes to the right places in your body: muscles, nerves and bone...and NOT settle into the blood vessels!

So what is it that makes women with bone loss be more susceptible to calcification and hardening of the arteries? The answer is INFLAMATION. We at OsteoNaturals know that simply taking in adequate calcium is NOT the total answer to improving bone health. The MOST important thing you can do for better bone health is to reduce inflammation-driven, excessive osteoclastic bone resorption. Inflammation, not a lack of calcium, is usually what fuels excessive bone loss. And that is where OsteoStim comes to the rescue. OsteoNaturals' OsteoStim has ingredients designed to do exactly that: modulate the activity between the osteoclasts and the osteoblasts so that the bone remodeling process comes more into balance. A balanced bone remodeling system is important for the skeleton to renew itself periodically...important for keeping it young, supple, and strong. AND, not only does OsteoStim have ingredients that promote balanced bone remodeling but it also has 300 mg of a very important antioxidant that, yes, you guessed it...helps prevent blood vessel calcification!

And as Lampropoulos, et al. showed in their research, since osteoporotic women are 16 times more likely to develop calcifications it is EXTREMELY important to address this head on! Alpha lipoic acid is THE perfect antioxidant that can help prevent this calcification. Studies such as the one by Ying, et al. demonstrate this beneficial effect. In this 2010  research, published in Life Sciences, Ying, et al. showed that lipoic acid "reduced atherosclerotic plaques in the abdominal aorta".

The combined effect of supplemental calcium, magnesium and other minerals from OsteoSustain and OsteoMineralBoost, plus improved bone remodeling and lowered atherosclerotic risk from our OsteoStim makes OsteoNaturals products your first choice for improved skeletal health.  

Lampropoulos, C.E., et al. 2016. Osteoporosis and vascular calcification in postmenopausal women: a cross-sectional study. Climacteric April 5:1-5.

Ying, Z., et al. 2010. Lipoic acid effects on established atherosclerosis. Life Sciences 86(3-4):95-102.   

Saturday, April 9, 2016

Climbing Mt. Kilimanjaro

Success/failure...?...well, the course of this adventure was certainly not the way I had planned it... but I'm going to put it in the category of success none the less. I guess that is the way I will interpret my ascent up Mt. Kilimanjaro (19,341 feet) two days ago. My plan had been to take the Umbwe route up to the top in three days, going slowly to get used to the altitude. Then on day four head back down the mountain to the starting point at Umbwe gate (about 5,000 feet above sea level) and then do a speed ascent/descent on the fifth day. That all changed on the third day when snow and freezing rain made the going extremely dangerous. After camping at 17,000 feet at the Lava Tower we (my guides Julius, Jonas and myself) started our ascent up the dangerous Western Breach. We only made it approximately 2 kilometers when we hit an impasse on a ridge with 30 foot drop-offs to each side. It was just too treacherous to continue up and trying to make steps with the ice axe was of no help due to the loose shale rock beneath the snow. We

had no choice but to head back down the mountain. I knew at this point that a speed attempt would not happen. With rain and snow for five days straight this, the beginning of the rainy season in Tanzania, was not the optimal time to try a speed ascent.

After descending to about 14,000 feet we spent the night at Barranco camp. On day four we headed back up to 17,000 feet to Barafu where we camped and from where we would try again to reach Uhuru peak, the top of Mt. Kilimanjaro, on the morning of day five.

Julius and I started our ascent at 1 a.m. It was cold and the trail was snow covered the whole way. Not too long into the ascent I became extremely ill with altitude sickness throwing up numerous times. The nausea never let up and it was tough going. We reached Uhuru peak just before sunrise. Freezing cold at 20 degrees and with extreme nausea I couldn't enjoy the view and headed back down off the mountain after only 5
View from the top of Africa
minutes at the top of Africa. I just had to get down to a lower altitude and breath some air again.

I will certainly never forget this adventure up Mount Kilimanjaro. I would love to try for a speed attempt again someday but I'm still nauseous two days later so it is hard for me to make that commitment right now. I'm just happy to have made it to the top. My advice for anyone wanting to tackle this amazing mountain is to NOT try in the rainy season. The altitude is a problem no matter what season but by not having to deal with snow and ice your odds of success will improve greatly. So, what ever your next dream...dream big, I always do. Don't be afraid to try...and don't be afraid to fail. The more failures you rack up in your life just means the more things you have tried...and that is awesome in and of itself. Most of all, enjoy what ever you do. Onward!

Friday, April 1, 2016

Follow Your Dreams

In a week from now I'll be heading up the slopes of Mt. Kilimanjaro for an attempt at a speed ascent. I arrived in Nairobi three days ago and after logging a few miles at a slight altitude (between 5 and 8,000 feet), seeing some cool animals, and very unsuccessfully trying to shake off jet lag, I take off for Arusha, Tanzania later today. With this challenge just around the corner, I find myself reflecting on just why I get so excited by adventures such as this. What is it that makes me so excited about something that will hurt so much?

In Run or Die, super endurance athlete (and former record holder for the Mt. Kilimanjaro speed ascent) Kilian Jornet writes, "Winning isn’t about finishing in first place. It isn’t about beating the others. It is about overcoming yourself. Overcoming your body, your limitations, and your fears. Winning means surpassing yourself and turning your dreams into reality."

Limitations...fears...dreams...yes, these are all certainly part of why I love to challenge myself. No
matter if I am competing in a race or simply challenging myself in some cooked-up crazy scheme  like tackling Mt. Kilimanjaro in one day. I absolutely love pushing my body to its limit. And, probably equal to challenging myself, I love the feelings that are born with the blending of my surroundings with my own body, with my own struggles. The visual beauty of trees and sky, the sounds of wind and birds, the scents of flowers and shrubbery (Wow, the wild basil when running through the Ngong hills here in Nairobi was awesome!), and the constant impact of my feet with the earth and my body funneling through the air...this blending of my surroundings with "me" is a feeling that has always drawn me to running. It was like that when I was 5 years old and it's still like that today. I guess it's something like when multiple forces collide...new and refreshed energy emerges. It is this energy that fuels me, keeps me going forward. Not just physically but propelling me forward in life itself with all of its continual challenges.

As someone who has gone through the challenges of osteoporosis, I am constantly thankful that I can do crazy things like this attempt to run up (and down) Mt Kilimanjaro in a day. As people age, activities of daily living (ADLs) can become challenging especially for those who suffer from musculoskeletal disease (such as osteoarthritis and osteoporosis). Increased rates of depression are also part of what can be a spiraling downward cascade of ill-health in the elderly. Now I'm not saying I'm elderly at 61 and I'm not saying that running up Mt. Kilimanjaro is an ADL, but I'm just saying that I'm totally excited that I can still do things like Ironman triathlons and endurance runs and that I continue to follow my dreams. Continuing to engage in physical activity as we age has been shown to not only improve skeletal health but also improve brain function and dramatically reduce depression. So whether you love to exercise or don't even list it as a top 100 things you like to do, I hope that these benefits are enough to get you out there walking, running, lifting weights, or just moving and playing in the mountains.

Everyone has their struggles in life, both physical and emotional, and they will meet those challenges in different ways. But I hope that what ever your dreams are, and no matter how difficult things might seem at times, that you will always live each day and follow all your dreams. Having osteoporosis can certainly impose its own set of unique challenges the likes of which I happen to know a lot about. But whatever your challenge, what ever mountain it is you are trying to climb, don't just dream it...get out there and do it...today. Sometimes all it takes is just one step at a time...and don't give up on your dreams.

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