Osteoclasts Gone Wild

January 25, 2011 2 Comments

Osteoclasts are the cells that eat away bone.  Osteoclasts are normally kept under control by Estrogen in women and Testosterone in men.  Women suddenly lose Estrogen at Menopause.  Men gradually lose Testosterone over time.  Osteoclasts are like misbehaving teenagers. Once the control is lost, it is “Osteoclasts Gone Wild”.

Steroid medicines in pills or inhalers for asthma or other diseases can block the controls on Osteoclasts.  Smoking also allows bone to be eaten away faster.

Osteoporosis happens when bone is eaten away faster than bone is formed by the cells that make new bone matrix, the Osteoblasts.  We need to restore the balance of bone formation and resorption to treat or prevent Osteoporosis.  We have several options:

1.  Slow down the Osteoclasts – Antiresorptives

2.  Disable or Kill the Osteoclasts – Bisphosphonates

3.  Prevent Osteoclast Formation and Activation – RANK-Ligand Blocker – Prolia – Denosumab

4.  Reassert Hormonal Control – Modern Hormone Replacement Therapy

Estrogen-Agonist-Antagonist –Evista – Raloxifene

Testosterone for Men

5.  Speed up Bone Matrix Formation – the AnabolicForteo – Teriparatide

Jay Ginther, MD

Copyright November 2010

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  • sharon Rader

    I have to have a tooth pulled it is way in the back. and loose. I have Osteoporosis, I am doing quite well I feel. I am taking Prolia. But am told I cannot have Prolia in my system when i get this tooth pulled. What do I do.
    Last Prolia shot was given to me on Sept. 10, 2018.
    But that first shot of 2019 should be due March 10, 2019, how do I get that tooth pulled so that the Prolia is out of my system by March 10, 2019. Is there time. Supposed to take it every 6 months. Thank you sharonrader9@gmail.com (I am 78 years old)

    • Prolia is out of your system by 4-5 months after each shot
      That is the ideal time for tooth extraction
      Take your next Prolia shot after the extraction is healed
      Do not delay the next shot to more than 7-8 months after the previous one if you can avoid it

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