Osteoporosis and Bone Quality - Dr. Lani Interviews Dr. Didier Hans
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- čas přidán 29. 08. 2019
- The Trabecular Bone Score (TBS) is a way to help determine bone quality. Bone density testing is an important piece of the bone health picture, but not the whole story. Bone quality helps explain why some people can have the same exact bone density, while one person fractures easily, and the other does not.
Just found you and thrilled to have done so. This was a great interview between two very learned people that I deeply appreciate. I am at the start of my journey having been diagnosed 3 weeks ago. I don’t believe my TBS was taken during my BDS. My parathyroid scan came back fine despite the blood tests indicating there could be an issue. I have a rheumatologist app next week and starting an “Onero” weight programme with an exercise physiologist today... I have been eating a mostly whole food plant based diet for 8 years and all my general blood work came back fine. I am physically fit and very active and of good weight. Don’t drink smoke. Never have. And never fractured despite many hard falls in my life time of sports. It came as a shock to me at 58. I refused my GP’s suggestion to start on prolia due to all these facts. Key feels to me to be to discover if I’m actively losing bone...hence the specialist appointment. Look forward to seeing more of your work. Thank you!
I think there is a 99.8% chance that you are low in Progesterone and probably testosterone (testosterone is not just a male hormone...women have it but lose most of it after age 50). You can eat great and exercise and do all those other things.....but your OSTEOBLASTS in your blood are looking for progesterone and testosterone to help build good bones. Without enough of these 2 hormones....you can chase diet and exercise and vitamins and minerals all you want and still not build good bones without progesterone and testosterone. Will your doctor ever tell you this ? (Probably not)
Thank You so much for all this info.
Quality and quantity yes a big difference!
I'm late to the party but continuing to learn. This was really great. Thank you Dr. Lani and Dr. Hans
This is so great thanks
Does not make sense the picture: 10% risk if osteopenia with good TBS and 5% if osteoporosis also with good TBS. It is a mistake, right?
so informative! thanks!
Excellent presentation thank you both. How do we get insurance to approve anabolics if one has a “good” dxa but very degraded bone micro architecture on TBS measurement? Because insurance only looks at dxa and previous fractures? Thanks
Very interesting! My internist only took a dxa scan. I’m seeing an endocrinologist in a few months. I’ll be asking about tbs and hope to learn more about my situation.
same here. My endocrinologist said the TBS test is not necessary since I took dxa scan. Strange isn't?
Id like to ask a question if I may. Whats the best treatment for Osteoporosis/ Osteopenia for Gastric Bypass ppl?
Hi Dr Lani. Its been suggested by MD to go on an anabolic for my degraded Tbs score ( structure) and -3.6 BMD . But since I have to go on a bisphosphonate type drug after, I am concerned because those INCREASE the risk of fracture and increase the brittleness of the bone which is counter productive so I have not wanted to go on medication. Do you have any advice on this. Please.
general understanding. Doctors in America won't order a TBS . Was put on Evista years ago as preventative for Breast Cancer and I will not take the osteoporosis medications. Doctors will not take me off of Evista. So I feel hand cuffed. Taking Algae Cal and Strontium Boost. What physician do you know in Tampa Bay Area to correctly assess my bone status?
Hello Dr. Lani I being diagnose with osteoporosis maybe about two years ago or less, my primary care doctor p😊un me right away first on Ibandronate Sodium 150 mg Oral tablets one once a month, so when I take my first I got so sick Belice me did I thought I was dying, so I called at urgent care and because I also was taking antibiotics for flu, he told me did the Ibandronate don’t do that kind or reaction to stop the antibiotics and eat only clear food and liquids for 24 hrs and I will be ok, so that’s w😊hat I did so I wait to the next month and take the Ibandronate again as I supposed to take it by the instructs doctor give me, and again I got so so sick did I was so scare it was the same reaction I called then m😊y primary care doctor to let him know so he give an appointment t😊o see me, and the. He prescribed me Prolia, and he told me because my system it’s very sensitive that’s the best for me, b😊it I already being in my second one and since I get the second one I be😊I guess with a lot of bone pain, I told him I don’t want to continue with that because all the bad side effect and he told did I need to keep taking it, honestly I’m not gonna do it, I’m not taking something did instead of healing me it’s getting me worse, my reads supposedly are this In my Spine I’m T-score is L2-L4 is 3.7 and BMD is 0.756 g/cm2
My Left Hip Total T-score is -1.8 and BMD is 0:784 g/cm2. Femoral neck T-score is - 1.o Ana BMD 0:893 g/cm2 (for FRAX calculation) and I’m really frustrated because I don’t know where else go and when you are retired and on Medicare looks like you are old and it’s nothing to help you you have to deal your own which whatever happens to you, I don’t know what else to do but I’m sure of one thing I’m. It going to continue with that Killing Prolia b😊y the way I’m 68, he also told me I need to do exercise, Thank you so much Dr. Lani for your I
Valuable information and hope you can read my message more like letter God Bless You
One additional question if I may. Would combining an anabolic with an anti resorptive med increase bone quality further than just taking an anabolic? Thanks
Why combine?. That is recommended in some cases when there is severe osteoporosis with significant high bone turnover. Typically you follow an anabolic with an anti-resorptive to shore up the gains you have and not lose.
@@DoctorLani thank you. Dr Schwartz mentioned in one of the presentations that combining an anti resorptive with an anabolic would produce greater effects on bone health gains. However I am not aware of any studies done proving this.
Good, would have been better if you had mentioned what are the actual bone markers you recommend. What do you really mean? calcium, magnesium , Vitamin D, what else? It's a big part of it. 😊
this is hard to understand , kind confusion