Aromatase Inhibitors: Bone Effects Can Be Serious

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    Exclamation Aromatase Inhibitors: Bone Effects Can Be Serious


    Aromatase Inhibitors: Bone Effects Can Be Serious

    Tue Jun 13, 8:00 PM ET

    Aromatase inhibitors can cause significant bone loss over the long term, according to new research presented in Atlanta at the annual meeting of the American Society of Clinical Oncology.

    Although researchers have known that this new class of hormone therapy for breast cancer is harder on bones than tamoxifen, the new results are helping them understand how serious the differences are -- and will lead to ways to better manage this side effect.

    The new findings come from a large international clinical trial known as ATAC (Arimidex and Tamoxifen, Alone or in Combination), which in 2004 showed that the aromatase inhibitor Arimidex (anastrozole) was better than tamoxifen at preventing breast cancer recurrences in women past menopause. The current study involved about 300 women from the original trial.

    The researchers measured bone density in the women on both drugs at the beginning of the trial and after 5 years of hormone therapy. They found that women in the tamoxifen group had slightly improved bone density.

    But women in the Arimidex group had about 6% reduced bone density in the lower back (lumbar spine) and about 7% reduced bone density in the hip. Normal bone loss for women in this age group over this period of time is only about 2%-3%, said lead study author Robert Coleman, MD, professor of medical oncology at Weston Park Hospital in Sheffield, England.
    Strong Bones Resist Damage Better

    But not all women on Arimidex suffered the same amount of bone loss. About 15% of women whose bones were normal at the study's start still had normal bone density after 5 years of treatment, and none developed osteoporosis. All the women who did develop osteoporosis while on Arimidex had weakened bones to begin with, Coleman said.

    This information is helpful for doctors planning follow-up for women on Arimidex, Coleman said. Patients who are at risk of bone loss should be monitored for it every couple of years, and can be advised to exercise and take calcium and vitamin D supplements. Some women may need to be treated with bisphosphonates.

    Although the information revealed in this study is not surprising, it is important, said Len Lichtenfeld, MD, deputy chief medical officer for the American Cancer Society.

    "We need to bear in mind that this is a side effect that can have serious consequences," he said. "Hip fractures can be deadly, especially in older women."
    Vitamin D May be Key

    A second study presented at Saturday's conference suggests that how much vitamin D a woman has in her body when she starts taking an aromatase inhibitor may influence how serious her bone loss will be. This research involved a different aromatase inhibitor, Aromasin, (exemestane).

    Women in the study had all had surgery for early breast cancer and then were randomly assigned to take Aromasin or a placebo. As expected, women on Aromasin had higher levels of bone loss. But the researchers were surprised to see that even women on placebo had high levels of bone loss.

    The team suspected vitamin D might be the cause, said study leader Per Lonning, MD, PhD, professor of medical oncology and radiation oncology at Norway's Bergen University.

    "Vitamin D status is a potential risk factor for bone loss," he explained.

    When Lonning and colleagues measured blood levels of vitamin D, they found something Lonning calls "quite provocative."

    Among women with low levels of vitamin D, there was a significant difference in bone loss between the Aromasin group and the placebo group. But there was no such difference when the women had sufficient vitamin D in their blood.

    That suggests vitamin D levels are playing some role in the bone loss associated with aromatase inhibitors, Lonning said.

    "We can't make a final conclusion from this paper, but it's important to study further," he said.

    Citations: "Effect of anastrozole on bone mineral density: 5-year results from the 'Arimidex,' Tamoxifen, Alone or in Combination (ATAC) trial." Abstract #511, presented June 4, 2006, at the annual meeting of ASCO. First author: Robert E. Coleman, MD, Weston Park Hospital, Sheffield, UK.

    "Vitamin D deficiency: A threat to bone health in breast cancer patients during adjuvant treatment with aromatase inhibitors." Abstract #554, presented June 3, 2006, at the annual meeting of ASCO. First author: Per Lonning, MD, PhD, Haukeland University Hospital, Bergen, Norway.

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    Interesting.Good post.
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    I am going to share a story with you guys. I looked my best one year ago, but I wasn't truely healthy. I had been on SD for a third of the year and Rebound XT for another third. I had literally sucked the estrogen out of my body. I had very little water, little estro and some pretty little swollen muscles. I have had to totally reevaluate what my idea of looking hard was worth. So instead of using a blanket of hormones to fix my training/ diet problems. I have become the strongest I have ever been in my life with the least androgen use in the last 9 months. The point of all this, AIs are NO JOKE. There are more problems than meets the eye for tweeking your bodies nattie hormones. Bone health is paramount. To quote MJ when he was cool, "Make that change."
    My The 1 LOG: http://anabolicminds.com/forum/steroids/254164-my-one-log.html
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    Quote Originally Posted by motiv8er
    I am going to share a story with you guys. I looked my best one year ago, but I wasn't truely healthy. I had been on superdrol for a third of the year and Rebound XT for another third. I had literally sucked the estrogen out of my body. I had very little water, little estro and some pretty little swollen muscles. I have had to totally reevaluate what my idea of looking hard was worth. So instead of using a blanket of hormones to fix my training/ diet problems. I have become the strongest I have ever been in my life with the least androgen use in the last 9 months. The point of all this, AIs are NO JOKE. There are more problems than meets the eye for tweeking your bodies nattie hormones. Bone health is paramount. To quote MJ when he was cool, "Make that change."
    I am in agreeance on this one bro, but please refrain from ever quoting Man in the Mirror...
    Letro, and Adex showed me how estro is important to SEX, and muscle building. Precontest I was dosing .75 of Letro, and .25 of Adex ed. for 30 days only, sucked alot of the fat from my pooch, and tits, and my legs, but Sex wise, I was NO GOOD, knee wise I was no good, knee pains were chronic, and hip pains were unbearable, but I did not whine I grinned and beared it. But overall AI's can do great damage overall to bone health as you need some levels of fat to to cushion your bones...
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    I have certainly become OK with great sex and a healthier body. I might have 2% more bf and a lil love handles; but dam I am healthy. It was neat to see what I could do, but it didn't make me feel better. I will get to where I was and surpass it, the right way.
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    Quote Originally Posted by motiv8er
    I have certainly become OK with great sex and a healthier body. I might have 2% more bf and a lil love handles; but dam I am healthy. It was neat to see what I could do, but it didn't make me feel better. I will get to where I was and surpass it, the right way.
    Nice. If only everyone could think like you!

    I am just wondering, what if I try rebound reloaded on its own? Will it have an effect or it would be better just to skip that?
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    Rebound reloaded is great, as I have had the tweaked version in PCT, no probs as far as soreness and joints, and bone probs... great Wood at most times, while my grunt had it and it made hime on Moody SOB...
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    Quote Originally Posted by motiv8er
    I am going to share a story with you guys. I looked my best one year ago, but I wasn't truely healthy. I had been on superdrol for a third of the year and Rebound XT for another third. I had literally sucked the estrogen out of my body. I had very little water, little estro and some pretty little swollen muscles. I have had to totally reevaluate what my idea of looking hard was worth. So instead of using a blanket of hormones to fix my training/ diet problems. I have become the strongest I have ever been in my life with the least androgen use in the last 9 months. The point of all this, AIs are NO JOKE. There are more problems than meets the eye for tweeking your bodies nattie hormones. Bone health is paramount. To quote MJ when he was cool, "Make that change."
    Thanks for your candor.
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    Quote Originally Posted by yeahright
    Thanks for your candor.
    No problemo. On top of that, going back to one of the greatest reasons I personally lift weights is to develop better bones. I broke a ton of bones in my childhood, I often wonder if it was because I was reared on soybean formula (and later lots of ritilin in adolesence). (Trust me, had to!) So working against one of my greatest health needs to be a pretty boy wasn't wise. I evetually said this isn't for me and started over with my fall bulk last year. I feel great, and isn't that a big part of why we do this?
    My The 1 LOG: http://anabolicminds.com/forum/steroids/254164-my-one-log.html
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    Quote Originally Posted by Apowerz6
    Rebound reloaded is great, as I have had the tweaked version in post cycle therapy, no probs as far as soreness and joints, and bone probs... great Wood at most times, while my grunt had it and it made hime on Moody SOB...
    Thanks, I may give it a shot after my x-factor..
  

  
 

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