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Episode 68: Dr Priya Bone Endocrinologist - Part Two: Medications
Stronger Bones Lifestyle Podcast: Take Control of Your Bone Health
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[1:12] Medications: Dr. Priya’s thoughts and how she uses them for her patients
[9:54] Are all meds bad?
[11:04] Sequential therapy and who needs this.
[15:20] Lifestyle Recommendations
Hormone Replacement Therapy: A Key to Better Bone Health for Women
Welcome to the Stronger Bones Lifestyle Podcast. In Episode 68, Debi Robinson welcomes back esteemed endocrinologist Dr. Priya Krishnamurthy to discuss the pivotal role of hormone replacement therapy (HRT) in bone health, particularly for menopausal women.
Dr. Priya is an endocrinologist with a rich background in internal medicine, preventative medicine, and public health. Dr. Priya aims to shift the healthcare paradigm by focusing on lifestyle modifications and nutrition alongside traditional medical approaches. Today she shares her wisdom on bone health, addressing the appropriate timing and methodology for medications, particularly focusing on sequential therapy in osteoporosis management.
Join Debi and Dr. Priya as they delve into understanding risk categories for osteoporosis, the role of anabolic therapy, and the nuanced approach to HRT and anti-resorptive drugs. This episode is packed with actionable insights, particularly for those navigating bone health challenges in menopause or seeking to understand the best intervention strategies.
"This bone loss is not going to stop by you taking minerals and vitamin D." [6:32]
"There are so many aspects that affect the final decision that is made. And sometimes its not about being wrong or being right its about what is appropriate at this point in time." [10:40]
"You cant do algorithmic medicine, you’ve got to look at the patient, you’ve gotta look at what’s going on, you’ve got to asses them." [12:49]
"I love yoga, so to me yoqa is the answer to all of this.” [16:51]
Listen to more episodes on Bone Health and Osteoporosis
Frequently Asked Questions (FAQs)
Estrogen is critical for maintaining bone density. During menopause, the drop in estrogen levels can lead to accelerated bone loss. Hormone Replacement Therapy (HRT) can be an effective treatment to mitigate this bone loss and help maintain bone health.
Doctors evaluate a comprehensive range of factors, including symptoms, medical history, other ongoing medications, previous fractures, family history of fractures, lifestyle factors like smoking and alcohol consumption, and even balance issues. These factors help determine the patient’s risk level for fractures and inform the medication strategy.
Sequential therapy involves using different treatments in a specific order to maximize their effectiveness. For osteoporosis, this might start with hormone replacement therapy (HRT) or other medications like Fosamax to stop bone loss and then move to additional treatments depending on the patient’s response.
Yes, recent studies, such as one published in JAMA by the NIH, suggest that even women in their early, mid, or late 60s can benefit from HRT for bone health.
Bone turnover markers are biochemical markers that reflect the rate of bone formation and bone resorption. An example is the CTX (C-telopeptide) value, which helps in assessing how quickly bone is being broken down. These markers are essential for diagnosing the stage of osteoporosis and tailoring the treatment accordingly.