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β-Hydroxy β-methylbutyric acid [note 1] (HMB), otherwise known as its conjugate base, β-hydroxy β-methylbutyrate, is a naturally produced substance in humans that is used as a dietary supplement and as an ingredient in certain medical foods that are intended to promote wound healing and provide nutritional support for people with muscle wasting due to cancer or HIV/AIDS.
β-Hydroxy β-methylbutyryl-coenzyme A (HMB-CoA), also known as 3-hydroxyisovaleryl-CoA, is a metabolite of L-leucine that is produced in the human body. [1] [2] Its immediate precursors are β-hydroxy β-methylbutyric acid (HMB) and β-methylcrotonoyl-CoA (MC-CoA).
They study found that administering low-dose testosterone undecanoate (TU) at a rate of 20 mg per day to elderly men with low serum testosterone and osteoporosis effectively increases bone mineral density in the lumbar spine and femoral neck, and improves bone turnover, similar to the standard-dose TU (40 mg, per day) treatment.
In those with postmenopausal osteoporosis denosumab decreases the risk of fractures but increases the risk of infection. [19] A 2013 review concluded that it is a reasonable treatment for postmenopausal osteoporosis. [20] A 2017 review did not find benefit in males. [21]
The FAST 1 device consists of multiple needles in a probe that penetrates the manubrium once manual pressure is applied. [16] The Bone Injection Gun (BIG) device is a small, plastic, disposable, spring-loaded device that has a trigger that shoots the IO needle into the IO insertion site, which is more than likely in the proximal tibia. [16]
Zoledronic acid is also indicated for the treatment and prevention of postmenopausal osteoporosis; the treatment to increase bone mass in men with osteoporosis; the treatment and prevention of glucocorticoid-induced osteoporosis; the treatment of Paget’s disease of bone in men and women. [4] [6]
[1] [2] [4] [5] Recombinant human parathyroid hormone is used in the treatment of osteoporosis in postmenopausal women at high risk of osteoporotic fractures. [3] A significant reduction in the incidence of vertebral fractures has been demonstrated. [3] It is used in combination with calcium and vitamin D supplements. [1] [4]
[2] [3] [4] The use of thiazide diuretics, and gonadal hormone replacement has also been recommended, with the use of calcitonin, bisphosphonates, sodium fluoride or anabolic steroids also suggested in refractory cases. [5] Alternate day use may not prevent this complication. [6] It is also known as glucocorticoid-induced osteoporosis. [7]