Expensive Dr. Roach: I’m a 78-year-old male who’s in fairly good well being. I maintain my blood strain beneath management and train 5 days every week at a fitness center, doing half-hour of cardio and lifting mild weights. Nonetheless, I’ve osteoporosis. As I’ve declined to take drugs resembling Fosamax on account of their potential unwanted effects, my physician has advised that I take 1,400 mg of calcium and 600 mg of vitamin Ok per day (500 mg of MK-4 and 100 mg of MK-7).
I additionally take 35 mcg of vitamin D3.
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Whereas I eat a fairly good eating regimen, it may very well be higher. Would it not be higher for me to go on a strict eating regimen of consuming meals that comprise excessive ranges of calcium, and if that’s the case, which meals (and at which portions) would I’ve to eat to correctly handle my osteoporosis? Are there dietary supplements or different methods to deal with this to cut back or get rid of my osteoporosis?
— O.H.
Expensive O.H.: Calcium and vitamin D are normal therapies for osteoporosis. Nonetheless, they’re usually insufficient to revive extreme bone loss, so I do not suggest them as the one remedy in individuals who have extreme osteoporosis.
Calcium is more practical and safer when obtained via the eating regimen in comparison with dietary supplements, so I do suggest a high-calcium eating regimen for many who are open to it. About 1,400 mg of calcium a day is an inexpensive dose, and you may cut back your dietary supplements with further dietary calcium resembling dairy and fish with bones (sardines and anchovies). Almonds, beans, and darkish, leafy inexperienced greens are additionally modest sources of calcium.
It is virtually inconceivable to get sufficient vitamin D via the eating regimen, so dietary supplements are the most secure solution to devour extra vitamin D. However solar publicity is an possibility, particularly for lighter-skinned individuals and people dwelling additional south (e.g., under the road of Los Angeles to Atlanta).
Vitamin K2 was discovered to be a helpful remedy in Japan, however no research in the USA discovered a major sufficient profit for me to suggest its use. Nonetheless, it’s secure. Prunes had been discovered to have a modest enchancment in bone density in ladies who consumed 4 ounces day by day.
For males of their 70s with osteoporosis, checking their testosterone blood ranges is obligatory as it is a widespread danger for the event of bone loss.
In case your osteoporosis is extreme, and you’ve got a excessive danger of fracture that was calculated by the FRAX rating, I like to recommend contemplating remedy resembling parathyroid hormone analogues.
Expensive Dr. Roach: I’ve suffered with an idiopathic peripheral neuropathy for over 20 years. I at the moment take duloxetine and gabapentin for the ache. They’re considerably useful, however their unwanted effects are problematic even at low doses.These days I’ve discovered articles on the web recommending vitamin B1 for nerve enchancment. Does your observe assist its use for neuropathy? Any ideas are appreciated.
— J.A.
Expensive J.A.: “Neuropathy” is a time period that pertains to any of numerous situations that trigger injury to the nerves. Peripheral nerves are the nerves outdoors the mind and spinal wire, and “idiopathic” simply signifies that we do not know the trigger.
I’ve additionally discovered articles recommending thiamine, or a drug that’s transformed to thiamine within the physique (benfotiamine), for a peripheral neuropathy from an unknown trigger. I did discover just a few small trials that confirmed a profit with thiamine and benfotiamine in neuropathy on account of diabetes or extra alcohol use.
Extreme thiamine deficiency may cause a neuropathy that may be particularly handled by thiamine, however thiamine deficiency is a really uncommon reason for long-lasting peripheral neuropathy. I did not discover any high-quality proof that confirmed a profit with an idiopathic peripheral neuropathy.
As a result of thiamine is so secure (and low-cost), I’ve usually tried utilizing it for my sufferers with numerous types of neuropathy. My medical expertise is that it isn’t efficient for many.Readers could electronic mail inquiries to ToYourGoodHealth@med.cornell.edu.
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