Conditions, diseases and medications that cause or contribute to osteoporosis and fractures:
Lifestyle factors
Low calcium intake Vitamin D insufficiency Excess vitamin A High caffeine intake High salt intake Aluminum( in antacids) Alcohol( 3 or more drinks per day) Inadequate physical activity Immobilisation Smoking( active or passive) Falling Thinness
CPD- SUPPLEMENTATION
GO TURQUOISE FOR THE ELDERLY
15 MAY – 15 JUNE
Genetic factors
Endocrine disorders
Gastrointestinal disorders
Haematologic disorders
Rheumatic and autoimmune diseases
Miscellaneous conditions and diseases
Medications
Cystic fibrosis Homocystinuria Osteogenesis imperfecta Ehlers-Danlos syndrome Hypophosphatasia Parental history of hip fracture Gaucher’ s disease Idiopathic hypercalciuria Porphyria Glycogen storage diseases Marfan syndrome Riley-Day syndrome Hemochromatosis Menkes steely hair syndrome Hypogonadal states Androgen insensitivity Hyperprolactinemia Turner’ s and Klinefelter’ s syndromes Anorexia nervosa and bulimia Panhypopituitarism Athletic amenorrhea Premature ovarian failure
Adrenal insufficiency Diabetes mellitus Thyrotoxicosis Cushing’ s syndrome Hyperparathyroidism
Celiac disease Inflammatory bowel disease Primary biliary cirrhosis Gastric bypass Malabsorption GI surgery Pancreatic disease
Haemophilia Multiple myeloma Systemic mastocytosis Leukaemia and lymphomas Sickle cell disease Thalassemia
Ankylosing spondylitis Lupus Rheumatoid arthritis
Alcoholism Emphysema Muscular dystrophy Amyloidosis End stage renal disease Parenteral nutrition Chronic metabolic acidosis Epilepsy Post-transplant bone disease Congestive heart failure Idiopathic scoliosis Prior fracture as an adult Depression Multiple sclerosis Sarcoidosis
Anticoagulants( heparin) Cancer chemotherapeutic drugs Gonadotropin releasing hormone agonists Anticonvulsants Cyclosporine A and tacrolimus Lithium Aromatase inhibitors Depo-medroxyprogesterone Barbiturates Glucocorticoids( ≥5mg / d of prednisone or equivalent for ≥3mo)
When lacking vitamin K2, patients are at much greater risk for osteoporosis.
Researchers are also looking into other health benefits. For example, one recent study published in the journal Modern Rheumatology found that vitamin K2 has the potential to improve disease activity besides osteoporosis in those with rheumatoid arthritis( RA). Another, published in the journal Science, found that vitamin K2 serves as a mitochondrial electron carrier, thereby helping maintain normal ATP production in mitochondrial dysfunction, such as that found in Parkinson’ s disease.
VITAMIN K2 DEFICIENCY There’ s no way to test for vitamin K2 deficiency. But by assessing diet and lifestyle, one can get an idea of whether or not patients may be lacking in this critical nutrient. If patients have any of the following health conditions, they’ re likely deficient in vitamin K2 as they are all connected to K2:
· Osteoporosis
· Heart disease
· Diabetes.
If patients do not have any of those health conditions, but do not regularly eat high amounts of the following foods, then the likelihood of being vitamin K2 deficient is still very high:
· Grass-fed organic animal products( i. e. eggs, butter, dairy)
· Certain fermented foods such as natto, or vegetables fermented using a starter culture of vitamin K2-producing bacteria. Please note that most fermented vegetables are not really high in vitamin K2 and come in at about 50mcg per serving. However, if specific starter cultures are used they can have ten times as much, or 500mcg per serving
· Certain cheeses such as Brie and Gouda( these two are particularly high in K2)
Note that not every strain of bacteria makes K2. For example, most yoghurts have almost no vitamin K2. Certain types of cheeses are very high in K2, and others are not. It really depends on the specific bacteria.
This SAMA accredited article first appeared in the Medical Chronicle in May 2017. CPD points cannot be guaranteed as they are awarded at the South African Pharmacy’ s discretion.
TO COMPLETE THE CPD QUESTIONS VISIT WWW. MEDICALCHRONICLE. CO. ZA
INSTRUCTIONS: 1. Go to www. medicalchronicle. co. za 2. Click the tab labelled‘ CPD Portal’ on the far right tab near the top of the page. 3. Select the relevant questionnaire from the list and complete the form.
Pharmacy Magazine MAY 2017 | 39