Glucocorticoid-induced osteoporosis: mechanisms for bone loss; evaluation of strategies for prevention
Article Abstract:
Glucocorticoids (GCs), a type of steroid hormone, provide effective treatment for many conditions that affect the elderly, such as rheumatoid diseases, emphysema, and multiple myeloma. GCs are useful because of their anti-inflammatory, immunosuppressive, and anticancer effects. However, long-term GC use may cause detrimental side effects, including osteoporosis, immunosuppression, and glucose intolerance. Osteoporosis, a common disease in the elderly, is characterized by loss of bone mass. The effects of GCs on bone and mineral metabolism and its regulation are reviewed, and the management of patients at risk for osteoporosis is discussed. Bone cells continually remodel, or recycle, their mineral content, and GCs uncouple this remodeling cycle. Calcium levels in the body affect calcium deposition in bone. Intestinal absorption of calcium is regulated by vitamin D, parathyroid hormone, and by kidney excretion (of calcium); GCs alter the metabolism of each of these regulators. Strategies to minimize the osteoporotic effects of GCs have included lowering the dosage, which is ineffective, or using new synthetic forms of GCs, which may or may not worsen osteoporosis. Several agents have been used to counter the effects of bone resorption and hyperparathyroidism, but further study is needed for these as well. Treatment with calcium supplements, with or without vitamin D, sodium fluoride, and a progesterone-like drug have been somewhat effective. Better understanding of glucocorticoid effects on bone loss is needed before effective ways to prevent or treat this problem can be forthcoming. Meanwhile, the effect of GC treatment on osteoporosis should be recognized by physicians. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journals of Gerontology
Subject: Seniors
ISSN: 0022-1422
Year: 1990
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Influence of thiamin supplementation on the health and general well-being of an elderly Irish population with marginal thiamin deficiency
Article Abstract:
While severe deficiencies of thiamin (vitamin B-1) are rarely seen unless malnutrition or alcoholism is present, marginal (mild) deficiencies are common. Symptoms of a marginal deficiency are nonspecific and include anorexia (loss of appetite), weight loss, sleeplessness, irritability, and depression. Elderly people often complain of having such symptoms. This study examined the effects thiamin supplementation on a population of elderly Irish women with marginal thiamin deficiency. Eighty women who were otherwise healthy were treated with either a thiamin supplement or a placebo (inactive substance) for six weeks. Assessments of symptoms, activity, and biochemical indices were performed before and after treatment. Results showed that more than 90 percent of the women receiving the supplements increased their thiamine levels to the normal range, while no changes in thiamin levels were seen in the placebo group. Subjective assessment revealed significant improvements in appetite, fatigue, and general well-being for those women who received the supplement. No such changes occurred in the placebo group. The supplemented group also tended to sleep less during the day than the placebo group during the treatment period. These results indicate that thiamin deficiency may be partially responsible for some of the common symptoms that elderly people complain of, and that thiamine status should be examined when symptoms include anorexia, weight loss, fatigue, depression, and sleep disorders. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journals of Gerontology
Subject: Seniors
ISSN: 0022-1422
Year: 1991
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Calcium supplementation lowers serum parathyroid hormone levels in elderly subjects
Article Abstract:
Osteoporosis (OP) is a major health problem, particularly among elderly white women, and contributes to over one million fractures annually in the US. One type of OP is related to menopause, while the cause of the second type is unclear; it may be related to elevated levels of parathyroid hormone (PTH), a regulator of calcium metabolism, which occur with increasing age. To test the notion that elevated PTH levels may respond to increases in dietary calcium, the effect of dietary calcium supplementation was studied in 40 elderly subjects (75 percent female). Although serum calcium levels did not differ between subjects treated with calcium or placebo, PTH levels dropped significantly in the supplemented group. Half of the subjects experienced a 20 percent reduction in PTH, and subjects with the highest PTH levels showed the greatest response. Calcium supplementation also resulted in increased urinary excretion of calcium. The major side effect of calcium supplementation was constipation. Further research is needed to determine the long-term effects of calcium supplementation on kidney and other functions, and to determine the effectiveness of this treatment in preventing osteoporosis. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journals of Gerontology
Subject: Seniors
ISSN: 0022-1422
Year: 1990
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