Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Showing posts with label bone health. Show all posts
Showing posts with label bone health. Show all posts

Sunday, March 29, 2020

The surprising link between coffee and bone health

With our vastly increased risks of falls and thus broken bones another reason for your stroke hospital to have a 24 hour coffee station. It will never occur, your stroke hospital has no employee whose only job is to evaluate research on stroke and implement into hospital procedures.  I'm assuming my great quantity of coffee, 12 cups a day, is why I haven't yet broken my left hip after falling on it numerous times, on concrete, on ice.

The surprising link between coffee and bone health

Melissa Sammy, MDLinx | February 27, 2020
Ah, coffee—the beverage that makes the world go ‘round. This simple brew has been shown to not only increase longevity and enhance exercise performance, but also reduce the risk of type 2 diabetes and fight cancer. Now, we can add increased bone strength to the list of coffee’s many health benefits—thanks to new research published in The Journal of Clinical Endocrinology & Metabolism (JCEM).

Move over milk: Consuming this drink daily makes for stronger bones Researchers have found that people who regularly drink coffee tend to have stronger bones than those who don't.
Researchers from the University of Hong Kong found that coffee lovers tend to have stronger bones than their non-coffee drinking peers. Specifically, they found a robust association between habitual coffee consumption and the prevention of bone fractures in later life. The results are both surprising and significant because they run counter to decades of prior findings on the subject of coffee and bone health.
Some researchers have argued that coffee may adversely affect bone density and lead to osteoporosis, given the negative effect of caffeine on calcium absorption. But many of these studies have remained inconclusive, with researchers often reporting conflicting results.
“Inconsistent associations between coffee consumption and bone mineral density (BMD) have been observed in epidemiological studies,” wrote the authors of the JCEM report. “Moreover, the relationship of bioactive components in coffee with BMD has not been studied.”

This inconsistency in the literature led researchers of the current study “to identify coffee-associated metabolites and evaluate their association with BMD.” To that end, they assessed 564 healthy community-dwelling Chinese adults previously enrolled in the Hong Kong Osteoporosis Study—a large prospective cohort that began in 1995 to investigate the incidence of osteoporosis. The researchers separated self-identified coffee drinkers from abstainers, and asked participants to record the frequency of their coffee consumption.
They compared the BMD of those who reported drinking coffee regularly with those who didn't, and found that daily coffee drinkers had significantly higher BMD. Specifically, the researchers identified 12 serum metabolites that were much more highly concentrated among regular coffee consumers.
“Three metabolites, in particular, were associated with an increase in bone density in the population, and also, a decrease in the risk of fracture,” said Cleveland Clinic’s Chad Deal, MD, who did not take part in the study.
The metabolite 5-acetylamino-6-formylamino-3-methyluracil (AFMU; β = 0.012, SE = 0.005; P = 0.013) was significantly correlated with BMD at the lumbar spine, while 3-hydroxyhippurate (β = 0.007, SE = 0.003, P = 0.027) and trigonelline (β = 0.007, SE = 0.004; P = 0.043) were significantly associated with BMD at the femoral neck.
“Among these [12] metabolites, 11 known metabolites were previously identified to be associated with coffee intake and 6 of them were related to caffeine metabolism. Habitual coffee intake was positively and significantly associated with BMD at the lumbar spine and femoral neck,” the authors wrote.

Although the study was relatively small and largely based on self-reported data, some health experts, including Dr. Deal, have suggested that it offers sufficiently robust evidence in spite of its limitations. He noted that a potential benefit from this research comes from the identification of specific metabolites in coffee that are good for bone health—a discovery that could translate to the development of new drugs to help protect bone health in the future.
“For all those folks who drink lots of coffee and are concerned about the health effects of coffee, this is good news,” he said. “It appears to show that coffee is, in general, probably good for bone health.”
That said, Dr. Deal also advised heavy coffee drinkers with known low bone mass to test for calcium excretion levels, as caffeine is known to naturally increase the excretion of calcium through urine.
Furthermore, a final word of caution: Despite coffee’s host of positive health effects, the popular beverage does have its downsides. In addition to causing “the jitters” and restlessness in some folks, drinking coffee can raise cholesterol levels in select populations, as well as increase the risk of bladder cancer in males and non-smokers with high coffee consumption.
So, before you pick up that next cup o’ joe, be sure to carefully weigh the pros and cons, and remember—everything in moderation.

Thursday, December 5, 2019

Metabolites found in coffee may improve bone health

With your extreme fall risk post stroke your stroke team should be doing everything in its power to increase your bone strength. If your stroke hospital doesn't already have a 24 hour coffee station they have  been incompetent for years.

Did your doctor do anything with this bone health post from October 2019?


This also: Two Compounds in Coffee May Team Up to Fight Parkinson's  

I'm not medically trained, so you can't listen to me. Is your stroke hospital medically trained?

The latest here:


Metabolites found in coffee may improve bone health





Several bioactive metabolites found in coffee may be associated with a beneficial effect on bone mineral density among healthy adults who report regular coffee consumption, according to findings published in The Journal of Clinical Endocrinology & Metabolism.

Ching-Lung Cheung
“It is widely known that coffee contains caffeine, which has been shown to adversely affect bone health by accelerating calcium loss or reducing calcium absorption,” Ching-Lung Cheung, PhD, assistant professor in the department of pharmacology and pharmacy at the University of Hong Kong, told Healio. “Despite the well-reported adverse effect of caffeine on bone health, contradictory findings were often observed between coffee consumption and BMD in published studies. Our large-scale epidemiology study involving approximately 7,000 participants from the Hong Kong Osteoporosis Study showed that coffee consumption was associated with higher BMD, after accounting for major confounding factors. Using a metabolomics approach, we further showed that a few bioactive compounds in coffee may be responsible for the positive association between coffee consumption and BMD.”
Cheung and colleagues analyzed data from 564 healthy Chinese adults participating in the Hong Kong Osteoporosis Study, a prospective cohort study initiated in 1995 to investigate the incidence of osteoporosis (81.2% women; 91.8% nonsmokers). Participants were recruited between 2001 and 2010 (cohort 1; n = 329) and in-person follow-up visits occurred between 2015 and 2016 (cohort 2; n = 235). For both visits, participants self-reported coffee consumption via a food frequency questionnaire; participants reported how frequently they consumed coffee during the past year and on average how many cups (at 250 mL per cup) were consumed each time. Researchers conducted untargeted metabolomic profiling with fasting serum samples using liquid chromatography-mass spectrometry. BMD at the lumbar spine and femoral neck was measured via DXA. Researchers used linear regression and robust regression analyses to investigate the association between coffee consumption and BMD parameters.
For both cohorts, 42.4% of participants reported not drinking coffee and 14.4% reported consuming more than one cup of coffee each day.

Cup of Coffee 
Several bioactive metabolites found in coffee may be associated with a beneficial effect on bone mineral density among healthy adults who report regular coffee consumption.
Source: Shutterstock

The researchers found that 12 serum metabolites were positively correlated with coffee consumption, with 5-acetylamino-6-formylamino-3-methyluracil (AFMU), quinate, 3-hydroxypyridine sulfate, and trigonelline (N-methylnicotinate) showing the strongest association. Among these metabolites, 11 were previously associated with coffee intake and six were related to caffeine metabolism, according to the researchers.
The metabolite AFMU was associated with BMD at the lumbar spine (P = .013), whereas 3-hydroxyhippurate (P = .027) and trigonelline (P = .043) were associated with BMD at the femoral neck.
Among 453 participants with metabolomics data assessed at baseline and follow-up (median follow-up time, 10.3 years), 11 experienced a hip fracture after assessment (seven women). In Cox regression analysis adjusted for age, sex, weight, height, smoking status and fracture history, higher coffee consumption was associated with reduced fracture risk; however, results were not statistically significant.
The researchers noted that the inverse yet insignificant association observed between coffee consumption and hip fracture risk may be explained by the small effect size of coffee consumption on BMD improvement and the multifactorial nature of hip fracture.
“Although we believe that more studies should be done in this area, our message is that coffee consumption is not necessarily linked to osteoporosis, and it may even be associated with better bone health,” Cheung said. “In this study, we identified a few metabolites that are associated with increased BMD. It would be interesting to investigate if these metabolites are causally associated with BMD. Such investigation may lead to the development of a novel dietary supplement for improving bone mass.” – by Regina Schaffer
For more information:
Ching-Lung Cheung, PhD, can be reached at the University of Hong Kong, Department of Pharmacology and Pharmacy, 21 Sassoon Road, Pokfulam, Hong Kong; email: lung1212@hku.kh.

Tuesday, October 22, 2019

Oral Anticoagulant Choice Matters in Bone Health, Study Finds

So ask your doctor VERY SPECIFICALLY  why your anticoagulant was chosen. I just got rat poison(warfarin) because that was the only thing available at the time except for a couple of lovenox shots. 

So good to know your doctors know nothing specific about this and are just guessing in the dark.(suggest, propose, theory) Aren't you happy that there seems to be NO PROTOCOLS anywhere in stroke?  Stroke survivors are just guinea pigs in unregulated experiments.  And you are paying your doctor for that privilege.

Oral Anticoagulant Choice Matters in Bone Health, Study Finds

Investigators compare direct oral anticoagulants with vitamin K antagonists

Did your doctor do anything with this from November 2013 regarding prescribing intravenous bisphosphonates?

Falls, Fractures, and Osteoporosis After Stroke

 

  • by Contributing Writer, MedPage Today
Bone fractures are a risk to be considered when choosing the oral anticoagulant for a patient with non-valvular atrial fibrillation (Afib), a study suggested.
The risk of poor osteoporotic outcomes was significantly lower with direct oral anticoagulant (DOAC) compared with vitamin K antagonist (VKA) therapy, as follows:
  • Any fracture: 3.09% vs 3.77% (adjusted HR 0.85, 95% CI 0.74-0.97)
  • Major osteoporotic fractures: 2.29% vs 2.82% (adjusted HR 0.85, 95% CI 0.72-0.99)
  • Initiation of  medication: 2.44% vs 3.14% (adjusted HR 0.82, 95% CI 0.71-0.95)
  • Any fracture or starting osteoporosis medication: 5.21% vs 6.43% (adjusted HR 0.84, 95% CI 0.76-0.93)
"Because of a more favorable skeletal health profile, DOAC treatment could be preferred to VKA in patients with Afib with strong risk factors for osteoporotic fractures," said Casper Binding, BMedSc, of Copenhagen University Hospital Herlev and Gentofte in Denmark, and colleagues.
As the team noted in the study online in the Journal of the American College of Cardiology, VKAs like warfarin (Coumadin) have been widely used for stroke prophylaxis for decades. The newer DOACs have been shown to have efficacy similar to that of warfarin in preventing stroke in Afib and do not require international normalized ratio (INR) monitoring, Binding and colleagues explained.
Using data from the Danish National Patient Register, the investigators identified 37,350 people with non-valvular Afib as having had no prior use of osteoporosis medication and having undergone 180 days of oral anticoagulation with a VKA or a DOAC, including dabigatran, rivaroxaban, apixaban, or edoxaban.
Two-thirds of the cohort received DOAC rather than VKA treatment. The DOAC group was significantly older; included more women; and were more often on hormone-replacement therapy and to have had previous fractures, stroke, or a diagnosis of alcohol abuse.
"Studies suggest a link between warfarin and undercarboxylated osteocalcin, which is associated with low bone mineral density," the researchers wrote. "These results correlate with findings that propose a connection between warfarin and an increased risk of osteoporotic fractures."
Then there is the theory that dietary restrictions around VKA treatment could lead to low folic acid intake and a resulting risk of hyperhomocysteinemia, which can reduce bone strength, the researchers continued, adding that in the end, the main results are in line with those of a smaller study of Chinese patients.
"The results of our study not only support what other studies have suggested, but also more importantly they show that the risk reductions apply to nationwide data from a Western society and persist when all DOACs are analyzed and compared with VKA," the investigators said.
They noted that their analysis may be subject to residual confounding from unmeasured variables such as INR, body mass index (BMI), hemoglobin, and renal function.
Writing in an accompanying editorial, Brian Gage, MD, MSc, of Washington University in St. Louis, Missouri, said: "Because patients with low creatinine clearance or low BMI are both more likely to have an osteoporotic fracture and to be prescribed a VKA rather than a DOAC, residual confounding could have exaggerated the association between VKA and fracture."
"Thus, at least for patients who have Afib and no prior osteoporotic fracture (the population studied), the decision to prescribe a VKA or a DOAC should depend on the risks of ischemic stroke, hemorrhage, need for monitoring, and affordability rather than on the risk of osteoporotic fracture," Gage argued.
In summary, he said, the researchers "had a strong biochemical basis to search for a link between VKAs and osteoporotic fracture. Their well-done observational study provides additional evidence of this link, but residual confounding may have exaggerated the association."
The study was funded by an institutional scholarship awarded to Binding.
Binding and Gage disclosed no conflicts.