How Does Abaloparatide Affect Osteoporosis?
It's an interesting thing to look at, and the mechanisms behind how drugs affect the body should definitely be analysed in greater detail.
A question I received on another Quora was worded as such:
What are the pros and cons of taking Tymlos (abaloparatide) for osteoporosis?
Of course, it looks like a lady would be experiencing issues with osteoporosis and a doctor most probably prescribed abaloparatide for her.
We’d have to understand why abaloparatide is approved for such use.
Mainly because:
Women undergoing menopause are more likely to experience symptoms of primary hyperparathyroidism (PHPT).
When one has PHPT, the excess parathyroid hormone (PTH) in their blood will contribute to bone mineral resorption. In other words, their bones are more likely to dissolve back into their blood. So the key thing is to balance the PTH activity - we don’t want excess PTH.
Having abaloparatide helps to balance out PTH activity such that the rate of bone resorption can be reduced.
Having said all that, though…
That is just one way of balancing out PTH activity.
Because the doctor won’t necessarily tell us that PTH hormone levels in the blood can also be elevated by other factors, such as a Vitamin D deficiency.
Most of the time, the doctors that we see only tell us a part of the story without delving into the other factors that may also result in the production of those symptoms.
But why only that part?
It’s very likely that there is an available drug for such a scenario, and that’s what they’d be prescribing (or marketing) to their patients.
It’s a reason why some patients are prescribed drugs for certain problems but those drugs don’t work for those patients - because the drug is targeting a part of the overall mechanism that ain’t the problem.
As a result, though…
Imagine if one who was on the cusp of osteoporosis were deficient in Vitamin D but were prescribed abaloparatide. What would be bad about that?
The big, bad problem is that the problem ain’t gonna be dealt with sufficiently.
Plus, it’s gonna be way more expensive.
How much does it cost to have a walk in the sun? Or if one were to supplement with a good dose of high quality Vitamin D?
Much less than the US$1,768 for a monthly dosage of abaloparatide, you reckon?
But it ain’t just the PTH problem that supports bone resorption, is it?
There’s also stuff like inflammation that can promote resorption too, and that is by enhancing the activity of bone mineral-dissolving osteoclast cells - and abaloparatide ain’t gonna be regulating the inflammatory response. PTH does not have any influence on the osteoclast cells either - the osteoclasts lack PTH receptors.
And we need to understand that our bones opearate in a state of dynamic equilibrium - a healthy bone has as much new bone mineral being formed as old bone mineral is being eliminated. We’d need the osteoclasts to be working in harmony with the bone-forming osteoblasts cells. We’d need to reduce bone resorption, and that could then be a PTH issue or an osteoclast issue - it’s anybody’s guess, really. Just that the abaloparatide option is gonna be way more expensive.
At the same time, because our bones are in a state of dynamic equilibrium, we’d also need to understand that we have to target both the bone formation and the bone resorption sides of the equation. That’s when our diets and our lifestyles become so much more important.
Unfortunately, prevention is always better than cure. We do need to achieve this mean feat of balancing out the multiple aspects of our busy lives, such that abaloparatide may be rendered unnecessary for the sake of our wallets (note: “may” doesn’t necessarily mean “definitely” - it might still be helpful for some people.)
Drugs aren’t a one size fits all “solution”. Even when they’re marketed as such.
Do feel free to refer to 9 Nutrients That Support Healthy Bone Development for more information on how we can switch up our diets to support healthy bones!
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