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LOW TURNOVER OSTEOPATHY and FOSAMAX

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LOW TURNOVER OSTEOPATHY Symptoms and Causes

What is primary ovarian insufficiency (POI)?

Primary ovarian insufficiency (POI), also known as premature ovarian failure, happens when a woman's ovaries stop working normally before she is 40.

Many women naturally experience reduced fertility when they are about 40 years old. They may start getting irregular menstrual periods as they transition to menopause. For women with POI, irregular periods and reduced fertility start before the age of 40. Sometimes it can start as early as the teenage years.

POI is different from premature menopause. With premature menopause, your periods stop before age 40. You can no longer get pregnant. The cause can be natural or it can be a disease, surgery, chemotherapy, or radiation. With POI, some women still have occasional periods. They may even get pregnant. In most cases of POI, the cause is unknown.

What are the risk factors for primary ovarian insufficiency (POI)?

Certain factors can raise a woman's risk of POI:

  • Family history. Women who have a mother or sister with POI are more likely to have it.
  • Genes. Some changes to genes and genetic conditions put women at higher risk for POI. For example, women Fragile X syndrome or Turner syndrome are at higher risk.
  • Certain diseases, such as autoimmune diseases and viral infections
  • Cancer treatments, such as chemotherapy and radiation therapy
  • Age. Younger women can get POI, but it becomes more common between the ages of 35-40.
What causes primary ovarian insufficiency (POI)?

In about 90 percent of cases, the exact cause of POI is unknown.

Research shows that POI is related to problems with the follicles. Follicles are small sacs in your ovaries. Your eggs grow and mature inside them. One type of follicle problem is that you run out of working follicles earlier than normal. Another is that the follicles are not working properly. In most cases, the cause of the follicle problem is unknown. But sometimes the cause may be

  • Genetic disorders such as Fragile X syndrome and Turner syndrome
  • A low number of follicles
  • Autoimmune diseases, including thyroiditis and Addison disease
  • Chemotherapy or radiation therapy
  • Metabolic disorders
  • Toxins, such as cigarette smoke, chemicals, and pesticides
What are the symptoms of primary ovarian insufficiency (POI)?

The first sign of POI is usually irregular or missed periods. Later symptoms may be similar to those of natural menopause:

  • Hot flashes
  • Night sweats
  • Irritability
  • Poor concentration
  • Decreased sex drive
  • Pain during sex
  • Vaginal dryness

For many women with POI, trouble getting pregnant or infertility is the reason they go to their health care provider.

What other problems can primary ovarian insufficiency (POI) cause?

Since POI causes you to have lower levels of certain hormones, you are at greater risk for other health conditions, including

  • Anxiety and depression. Hormonal changes caused by POI can contribute to anxiety or lead to depression.
  • Dry eye syndrome and eye surface disease. Some women with POI have one of these eye conditions. Both can cause discomfort and may lead to blurred vision. If not treated, these conditions can cause permanent eye damage.
  • Heart disease. Lower levels of estrogen can affect the muscles lining the arteries and can increase the buildup of cholesterol in the arteries. These factors increase your risk of atherosclerosis (hardening of the arteries).
  • Infertility.
  • Low thyroid function. This problem also is called hypothyroidism. The thyroid is a gland that makes hormones that control your body's metabolism and energy level. Low levels thyroid hormones can affect your metabolism and can cause very low energy, mental sluggishness, and other symptoms.
  • Osteoporosis. The hormone estrogen helps keep bones strong. Without enough estrogen, women with POI often develop osteoporosis. It is a bone disease that causes weak, brittle bones that are more likely to break.
How is primary ovarian insufficiency (POI) diagnosed?

To diagnose POI, your health care provider may do

  • A medical history, including asking whether you have relatives with POI
  • A pregnancy test, to make sure that you are not pregnant
  • A physical exam, to look for signs of other disorders which could be causing your symptoms
  • Blood tests, to check for certain hormone levels. You may also have a blood test to do a chromosome analysis. A chromosome is the part of a cell that contains genetic information.
  • A pelvic ultrasound, to see whether or not the ovaries are enlarged or have multiple follicles
How is primary ovarian insufficiency (POI) treated?

Currently, there is no proven treatment to restore normal function to a woman's ovaries. But there are treatments for some of the symptoms of POI. There are also ways to lower your health risks and treat the conditions that POI can cause:

  • Hormone replacement therapy (HRT).HRT is the most common treatment. It gives your body the estrogen and other hormones that your ovaries are not making. HRT improves sexual health and decreases the risks for heart disease and osteoporosis. You usually take it until about age 50; that's about the age when menopause usually begins.
  • Calcium and vitamin D supplements. Because women with POI are at higher risk for osteoporosis, you should take calcium and vitamin D every day.
  • In vitro fertilization (IVF). If you have POI and you wish to become pregnant, you may consider trying IVF.
  • Regular physical activity and a healthy body weight.Getting regular exercise and controlling your weight can lower your risk for osteoporosis and heart disease.
  • Treatments for associated conditions. If you have a condition that is related to POI, it is important to treat that as well. Treatments may involve medicines and hormones.

NIH: National Institute of Child Health and Human Development

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FOSAMAX Side Effects

Femur Fracture (5674)
Anxiety (3177)
Osteonecrosis (2820)
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Depression (2384)
Arthralgia (1887)
Dental Caries (1636)
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Anaemia (1283)
Osteomyelitis (1270)
Hypertension (1242)
Blood Cholesterol Increased (1236)
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Tooth Disorder (890)
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Headache (477)

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LOW TURNOVER OSTEOPATHY Clinical Trials and Studies

Treatments might be new drugs or new combinations of drugs, new surgical procedures or devices, or new ways to use existing treatments. The goal of clinical trials is to determine if a new test or treatment works and is safe. Clinical trials can also look at other aspects of care, such as improving the quality of life for people with chronic illnesses. People participate in clinical trials for a variety of reasons. Healthy volunteers say they participate to help others and to contribute to moving science forward. Participants with an illness or disease also participate to help others, but also to possibly receive the newest treatment and to have the additional care and attention from the clinical trial staff.
Rank Status Study
1 Not yet recruiting The Effect of Alendronate on the Immune Response to Hepatitis B Vaccine in Healthy Adults
Condition: Healthy Volunteers
Interventions: Drug: Alendronate;   Drug: Hepatitis B Vaccine;   Drug: Placebo
Outcome Measures: Safety/Adverse events;   Efficacy
2 Recruiting Testosterone and Alendronate in Hypogonadal Men
Conditions: Hypogonadism;   Osteopenia;   Osteoporosis
Interventions: Drug: Testosterone;   Drug: Alendronate;   Drug: Placebo Alendronate;   Drug: Placebo Testosterone
Outcome Measure: Spine Bone Mineral Density by DXA
3 Unknown  Alendronate for Vascular Calcification in Peritoneal Dialysis Patients?
Condition: Peritoneal Dialysis
Intervention: Drug: alendronate (Fosamax)
Outcome Measures: 1.Changes of calcification score of coronary arteries and aorta;   2.Changes of bone density;   changes of parathyroid hormone;   changes of serum calcium and phosphate level;   changes of C reactive protein;   changes of lipid profile;   adverse reactions
4 Unknown  Fosamax for Childhood Cancer Survivors
Condition: Osteoporosis
Interventions: Drug: Alendronate;   Drug: Placebo
Outcome Measures: The percent change in bone mineral density (BMD) at lumbar spine at 36-weeks in subjects who receive active and control treatments;   Changes in BMD at femoral neck;   Changes in biochemical markers of bone turnover;   Occurrence of clinical bone-related symptoms at 12-weeks and end of this study
5 Not yet recruiting RA Denosumab on Bone Microstructure Study
Condition: Rheumatoid Arthritis
Interventions: Drug: Denosumab;   Drug: Alendronate
Outcome Measures: Changes from baseline in bone volumetric density at distal radius at 6th month;   Changes from baseline in trabecular bone microarchitecture at distal radius at 6th month;   Changes from baseline in bone volumetric density at the 2nd metacarpal bone at 6th month;   Changes from baseline in trabecular bone microarchitecture at 2nd metacarpal bone at 6th month;   Changes from baseline in areal bone density at total hip at 6th month;   Changes from baseline in areal bone density at lumbar spine at 6th month;   Changes in areal bone density at distal radius at 6th month;   Changes from baseline in bone volumetric density at distal radius at 3rd month;   Changes from baseline in trabecular bone microarchitecture at distal radius at 3rd month;   Changes from baseline in bone volumetric density at the 2nd metacarpal bone at 3rd month;   Changes from baseline in trabecular bone microarchitecture at 2nd metacarpal bone at 3rd month;   Changes from baseline in areal bone density at total hip at 3rd month;   Changes from baseline in areal bone density at lumbar spine at 3rd month;   Changes in areal bone density at distal radius at 3rd month
6 Recruiting Study to Determine the Efficacy and Safety of Romosozumab in the Treatment of Postmenopausal Women With Osteoporosis
Condition: Postmenopausal Women With Osteoporosis
Interventions: Drug: Romosozumab;   Drug: Alendronate
Outcome Measures: Incidence of clinical fracture;   Incidence of new vertebral fracture;   Incidence of fracture;   Percent changes in DXA Bone Mineral Density from baseline to 12 months;   Percent changes in DXA Bone Mineral Density from baseline to 24 months;   Percent changes in DXA Bone Mineral Density from baseline to 36 months
7 Not yet recruiting Bone Antiresorptive Therapy With Antiretroviral Initiation (BATARI) Pilot Trial
Condition: HIV
Intervention: Drug: alendronate/vitamin D
Outcome Measures: Percentage changes in BMD at a) the lumbar spine and b) proximal femur;   Feasibility;   Acceptability;   Safety/Tolerability;   Adherence;   Bone Biomarkers
8 Not yet recruiting Study Investigating the Effect of Drugs Used to Treat Osteoporosis on the Progression of Calcific Aortic Stenosis.
Condition: Calcific Aortic Stenosis
Interventions: Drug: Denosumab;   Drug: Alendronic Acid;   Drug: Denosumab Placebo;   Drug: Alendronic Acid Placebo
Outcome Measures: Change in aortic valve calcium score;   Change in aortic valve 18F-NaF uptake;   Change in aortic-jet velocity;   Change in thoracic aortic and coronary artery calcium score;   Change in thoracic spine bone mineral density;   Change in quality of life determined by Short Form 36 Questionnaire
9 Recruiting Comparison of the Effect of an Ongoing Treatment With Alendronate or a Drug Holiday on the Fracture Risk in Osteoporotic Patients With Bisphosphonate Long Term Therapy
Condition: Osteoporosis
Interventions: Drug: Alendronate;   Drug: Placebo
Outcome Measures: Incidence of new osteoporotic fractures;   Equivalence of deaths with and without continued bisphosphonate therapy;   Incidence of the combination of fractures and deaths
10 Recruiting Bone Healing After Dental Extraction in Postmenopausal Osteoporotic Women Treated With Alendronate Per os Weekly
Condition: Alveolar Bone Healing After Dental Extraction
Intervention: Procedure: Dental extraction
Outcome Measures: Alveolar socket filled by new bone;   Mucosal injury
11 Unknown  The Study of the Early Administration of Alendronate on Prevention of Bone Loss After Hip Fracture.
Condition: Osteoporosis
Intervention: Drug: Alendronate
Outcome Measure:
12 Unknown  Osteoporosis and Dental Implant
Condition: Osteoporosis
Interventions: Drug: alendronate once weekly 70mg;   Drug: placebo
Outcome Measure: Dental CT
13 Unknown  Randomized Study of Alendronate in Adult Patients With Cystic Fibrosis Related Osteoporosis
Conditions: Osteoporosis;   Cystic Fibrosis
Interventions: Drug: alendronate sodium;   Drug: calcium carbonate;   Drug: cholecalciferol
Outcome Measure:
14 Unknown  Phase II Randomized Study of Alendronate Sodium for Osteopenia in Patients With Gaucher's Disease
Conditions: Gaucher's Disease;   Osteopenia
Interventions: Drug: alendronate sodium;   Drug: calcium carbonate;   Drug: cholecalciferol
Outcome Measure:
15 Unknown  Pharmacokinetics of Maxmarvil® in Healthy Postmenopausal Women
Condition: Osteoporosis
Intervention: Drug: Maxmarvil®
Outcome Measure: analysis of Alendronate concentrate
16 Recruiting Stem Cell Recruitment in Osteoporosis Therapy
Condition: Low Bone Density
Interventions: Drug: Teriparatide;   Drug: Alendronate;   Dietary Supplement: calcium and vitamin D
Outcome Measures: Number of Stro-1+ MSCs at bone resorption sites in bone biopsies of subjects treated with PTH or ALN.;   Number of p-Smad 2/3+ cells/mm2 at active resorption sites on bone biopsy specimens of subjects treated with PTH or ALN.;   The percent increase in Stro-1+/CD146+ cells in the blood before and after treatment with PTH or ALN.;   Number of human Stro-1+ MSCs at bone resorption sites in bone of Rag2-/- mice reconstituted with human bone marrow derived from subjects treated with PTH or ALN.
17 Recruiting Twenty Four Month Extension Study of BA058-05-003
Condition: Postmenopausal Osteoporosis
Intervention: Drug: Alendronate
Outcome Measures: Safety;   Vertebral Fracture Incidence;   Non-vertebral Fracture Incidence
18 Recruiting Bisphosphonate Biomarker Study
Conditions: Osteoporosis, With or Without Treatment;   Bisphosphonate Treatment;   Atypical Femur Fracture;   Bisphosphonate Related Osteonecrosis of the Jaws (BRONJ);   Healthy Volunteers
Intervention:
Outcome Measures: Absorption, Distribution, Metabolism, Excretion (ADME) Profiling of DNA from all sample types vs. normative data for the ADME panel and across study groups;   Differential expression of miRNA biomarkers across participant groups within the study
19 Recruiting Effectiveness of DiscontinuinG bisphosphonatEs Study: R21 Pilot Study
Condition: Osteoporosis
Intervention: Drug: Alendronate
Outcome Measures: Clinical site recruitment rate;   Participant recruitment rate;   Contracting and procedures;   Administrative procedures;   Osteonecrosis of the jaw;   Atypical femoral fracture;   Clinical fracture rate
20 Recruiting Acute Effect of Teriparatide With Bisphosphonate or Denosumab on Bone Resorption
Condition: Postmenopausal Osteoporosis
Intervention: Drug: Teriparatide 40-mcg subcutaneous injection
Outcome Measure: Bone turnover marker (blood sample)