cause heart attacks in post-menopausal women” o One study of 1500 women with a mean age of 74 taking calcium supplements has a 50% chance of having either a heart attack or stroke compared with those taking a placebo It has been determined that calcium uptake is better when vitamin D is enhanced (present) More studies are needed to capture the best relationship with vitamin D and calcium Osteoporosis Therapy o Vitamin D + calcium ( vitamin D increases calcium uptake ) – very cheap; 1,000 IU’s of calcium for roughly 2 cents Adolf Windaus - In winter, we need sun to get vitamin D process going eventually worked out Vitamin D3 Vitamin D helps maintain Ca+2 in summer, and we need UV-B rays (500 IU/day), but harder to get in the Winter snowbirds are Canadians who go south during the Winter i.e. to get more Vitamin D o Exercise stimulates bone density, and bone mass increases o Estrogen Estrogen receptors found in bone cells For many years, the conclusion was the estrogen helps prevent osteoporosis and may even help prevent heart disease However, it increases the risk of uterine cancer and may increase the risk of breast cancer Estrogen + progestin = Prempro (progestin helps osteoporosis & reduces risk of uterine cancer BUT may further increase risk of
breast cancer and may not be as effective against heart disease as originally thought) “In 10 yr period, 3.5% of post-menopausal women will develop breast cancer – with estrogen, this increases to 5% BUT, an alternate interpretation is just as meaningful: a woman who takes estrogen reduces her chance of remaining cancer from 96.5% to 95%.” 162,000 women were studied for estrogen + progestin but the trial was stopped because researchers found that the risks of long term estrogen + progestin therapy outweigh its protective benefits (heart attack, stroke, breast cancer, blood clot) – only helped for 2 (deaths, endometrial cancer – but barely) But some people still argue the benefits of estrogen; it is not clear-cut. Osteoporosis Summary o Adequate calcium intake early in life definitely reduces risk o Calcium supplements can be part of this intake o Estrogen supplements after menopause reduce the risk & o Calcium supplements can reduce the dose of estrogen required, BUT o Estrogen is associated with uterine cancer and may cause breast cancer – and maybe not o But absolute risk of estrogen is fairly low Final Notes: o Key reason for using estrogen to treat osteoporosis is that estrogen levels decrease after menopause
o Progestins are added to estrogen supplements in order to reduce the risk of uterine cancer
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- Spring '11
- Sodium, Sodium chloride