Bone Density Studies Find Two Useful Supplements and Risks for Elderly
Women Who End HRT
MD, 15 November 2002
hormone therapy treatments may cause a decrease in bone mineral
density in elderly women, according to a new study published in
the November issue of The Journal of Clinical Endocrinology &
Metabolism (JCEM). Two other related studies published
in the same journal also demonstrate the effects of recombinant
human growth hormone (HGH) treatment in osteoporotic men and oral
dehydroepiandrosterone (DHEA) in treating young women with osteoporosis.
is a silent disease that is responsible for more than 1.5 million
hip fractures annually world wide.
hormone therapy leads to rapid bone loss in elderly women
July, researchers announced the ending of one portion of the Women's
Health Initiative (WHI) study due to evidence that questioned the
safety and effectiveness of the estrogen plus progestin treatment
in postmenopausal women. Now, researchers led by Dr. J.C. Gallagher
at Creighton University have revealed that elderly women who stop
taking hormone therapy experience significant losses in their bone
mineral density (BMD). These losses in BMD could lead to severe
osteoporosis and fractures.
a double-blind, randomized, placebo-controlled trial, these researchers
had previously studied the effects of three different treatments
in nearly 500 women ages 65-77 years over three years. One group
received estrogen therapy or estrogen plus progestin therapy in
women with a uterus; another received calcitriol alone; the third
received a combination of calcitriol plus estrogen or estrogen plus
progestin therapy.The women in all three groups experienced increases
in BMD during the treatments. A two-year follow-up study evaluated
how discontinuation of the therapy affected the BMD, bone markers
and calcium absorption and serum parathyroid hormone (PTH) levels
in the women.
found that after discontinuing the treatments for two years, women
in all three treatment groups experienced rapid bone loss. A majority
of the loss occurred during the first year following treatment.
Additionally, increases in calcium absorption and decreases in serum
PTH levels also reversed after the treatments were stopped.
recent hormone therapy findings in the WHI trial have caused many
women to discontinue their treatments. However, until now we did
not know how ending the hormone therapy would effect bone health,"
said Dr. Christopher Gallagher, lead investigator on the study.
"Our study demonstrates the critical need for these women to work
with their doctors to monitor their bone health and to consider
carefully the disadvantages of discontinuing hormone therapy and
to also find alternative treatments to maintain their bone mineral
density if they decide to discontinue the therapy."
with osteoporosis benefit from human growth hormone combined with
calcium and vitamin D3
most fractures occur in postmenopausal women, the disorder also
affects more than two million men. Furthermore, approximately one
third of all osteoporotic fractures occur in men. Few studies have
been conducted to examine the effects of human growth hormone (HGH)
on osteoporosis patients. Now, a study published in the November
issue of JCEM shows that HGH treatments can improve bone
mineral density (BMD) in men with idiopathic osteoporosis (ie, men
without any demonstrated hormonal, nutritional, or other risk factors
for diminished bone density).
Peter Gillberg and researchers at the University Hospital in Upsala,
Sweden studied the effects of continuous and intermittent HGH treatments
on bone turnover, BMD, and bone mineral content (BMC) in 29 men
between the ages of 27 and 62 who had idiopathic osteoporosis. The
men also received daily doses of calcium and vitamin D3. Patients
were treated for 24 months and then participated in 12 months of
follow-up. After two years, BMD and BMC had increased in both groups
of men. Then, after another 12 months, both the BMD and BMC had
increased further. Additionally, both treatment groups experienced
a decrease in their fat mass over the two year treatment period.
human growth hormone can be an effective treatment for men with
osteoporosis," explained Dr. Gillberg. "Our study shows that the
growth hormone treatments -- either continuous or intermittent --
can not only help build bone density, but can also maintain the
improved bone density for at least one year after the treatment.
The growth hormone treatments also caused a loss of fat in the subjects,
which can lead to other health benefits. Larger and longer placebo
controlled studies must now be conducted to further examine the
benefits of growth hormone treatment for men and women with osteoporosis."
young women with anorexia, DHEA aids bone health, weight gain, and
bone mineral density (BMD) is a common problem for young women who
suffer from anorexia nervosa. A third related study published this
month in JCEM compared the effectiveness of two hormone treatments
on increasing BMD in young women with anorexia. Previous studies
found that hormone replacement therapy (HRT) had mixed results in
improving bone health in anorexic women. Doctors at Children's Hospital
in Boston sought to determine whether dehydroepiandrosterone (DHEA)
would be effective in treating anorexic women, compared with HRT.
They treated 61 anorexic women between the ages of 14 and 28 with
either oral DHEA or conventional HRT for one year.
both groups experienced an increase in BMD and the DHEA group experienced
increases in the bone formation markers. Women in both treatment
groups experienced significant weight gain, which was unexpected
and attenuated the BMD increases that were observed. In both groups,
however, researchers found a correlation between bone formation
markers and increases in weight. Additionally, the women taking
DHEA experienced several psychological improvements including decreased
body image concerns (24 percent), improved attitude towards eating
(26 percent) and decreased anxiety (12 percent).
comparison of DHEA and HRT showed no significant difference in the
BMD measurements," said Dr. Clifford Rosen, one of the investigators
on the study. "Yet, our research did demonstrate that DHEA has a
positive psychological effect on anorexic women and may actually
reverse some of the emotional disturbances that accompany the disease.
Unexpectedly, DHEA also helped the women in our study gain weight,
which is significant for anorexic women. This physical effect of
DHEA must be further examined in the future."
to Dr. Catherine Gordon, lead investigator on the study, "the more
profound increases in bone formation markers and the anabolic factor,
IGF-I, seen in the DHEA treatment group suggest a potential therapeutic
advantage of this therapy, but more longitudinal research is needed."
is one of four journals published by The Endocrine Society. Founded
in 1916, The Endocrine Society is the world's oldest, largest, and
most active organization devoted to research on hormones, and the
clinical practice of endocrinology. Today, The Endocrine Society's
membership consists of over 10,000 scientists, physicians, educators,
nurses and students, in more than 80 countries. Together, these
members represent all basic, applied, and clinical interests in
endocrinology. The Endocrine Society is based in Bethesda, Maryland.
To learn more about the Society, and the field of endocrinology,
visit the Society's web site at www.endo-society.org.
Endocrine Society, via PR Newswire.