Question/Comment:

can you please explain the difference between osteoarthritis and osteoporosis and what should be done for each. can a person have both also what is degenerative disk disease
please advise and anything I should be doing for any or all of the above.
Thank you
58 year old female

Question/Comment:

How often should you have your vitamin D and bone density levels checked?

Answer/Reply from iGuard:

There are different answers for the vitamin D and Bone Density tests. For vitamin D, most people in the general population probably don’t need a vitamin D level check ever, they just need to take the right amount of vitamin D, which for adults many experts believe is about 1,000 units a day. If you have reasons why you do not absorb vitamin D or are taking certain medications known to interfere with absorption, then you should have your vitamin D measured. If you are tested and you establish that your vitamin D level is fine, it would be unusual for you to have to keep rechecking that level. How often you should have your bone density checked is a tough question because there is not a single answer that fits every situation. In general, Medicare will cover one Bone Density test every 2 years. There are, however, situations where more frequent measurements are clinically warranted. One would be a patient on steroids (e.g., prednisone). People who are in a situation where they are likely to be losing rapidly should have their Bone Density tested every year. There’s little point in getting your Bone Density tested more frequently than once per year, because bone doesn’t change that fast.

Question/Comment:

I am unable to get dental implants due to having taken bisphosphonates. Is this condition reversible such that I would eventually be able to get dental implants?

Answer/Reply from iGuard:

The circumstances surrounding the occurrence of osteonecrosis of the jaw are several fold: 1) the trauma of a tooth extraction, 2) the trauma to the jaw of an ill-fitting denture putting too much loading on a particular area of the jaw, and 3) an invasive procedure such as a dental implant. Patients on steroids, receiving chemotherapy, or taking an immunosuppressant are at higher risk. Length of time on a bisphosphonate and use of high, high bisphosphonate doses also increase risk. The bisphosphonate Reclast has been available for years under the brand name Zometa; Zometa is used to prevent the spread of cancer in bone. Its in those cancer patients who received several-fold higher doses of bisphosponate that this connection was originally made. Osteonecrosis is so rare for bisphosphonate doses in the osteoporosis dosage range that I’ve only seen two cases of it and that’s in a huge practice. Do we know whether if you stopped the bisphosphonate it lowers your chance of having a problem should you need a dental extraction or implant down the road? we have no data on that. However, if you want to make an educated guess, you would stop it and allow the bone regeneration capacity to resume. And that time interval is going to depend on which drug you’re taking. If you’re on Actonel you can escape from that suppression in a year, but if you’re on Fosamax it’s going to take several years. If you’re on Reclast, I don’t know how long, but a long time. So that’s a lot of talk without giving you a single specific answer because we don’t yet have the information needed to make that call.

Question/Comment:

What is the affect of taking fosamax d on a patient who has sarcoidosis and is taking prednisone to prevent recurrence of brain tumors? Is there an increased danger of taking calcium and vitamin d on patients with autoimmune disease(s)?

Question/Comment:

What affect does taking bone density medications such as Fosamax D for patients with Sarcoidosis when taking steroids for the conditions?