Osteoporosis: Understanding Atypical Femoral Fractures
Atypical femoral fractures are rare complications that can arise from prolonged use of anti-resorptive osteoporosis treatments, such as bisphosphonates or denosumab. These fractures are characterized by a horizontal break in the femur that occurs without trauma, often preceded by thigh pain and frequently affecting both legs. Causes and Risk Factors These fractures occur due to […]
Osteoporosis: The Importance of Re-Fracture Prevention and Understanding Bone Density
One of the main parts of my job involves running the “Re-Fracture Prevention Clinic.” As the name suggests, it’s all about preventing further fractures, as having one fracture significantly increases the risk of more. I have the pleasure of screening all patients with fractures treated at my hospital. Understanding Bone Density and Fracture Risk Often, […]
Bone Health: Osteoporotic Fractures and Mortality Risk
The Seriousness of Osteoporotic Fractures A broken bone is often considered an irritating but relatively minor ailment. However, an osteoporotic fracture from minimal trauma, especially of the hip or spine, is associated with an increased risk of further fractures and reduced mortality for 5-10 years. This means that someone who has a major fracture is […]
Thyroid Dysfunction: Understanding Hashimoto’s Disease and Persistent Symptoms Despite Thyroxine
Hashimoto’s symptoms despite thyroxine replacement is a complex and heavily requested topic that is not completely understood. Before diving into this, it’s important to discuss Hashimoto’s Disease (HD) and the role of antibodies. What is Hashimoto’s Disease? Hashimoto’s Disease causes low thyroid function due to the destruction of the thyroid gland by T-lymphocytes. This condition […]
Thyroid Dysfunction: Understanding Persistent Symptoms in Hypothyroidism Despite Thyroxine Replacement
Studies estimate that 5-10% of people still experience symptoms of hypothyroidism (HD) despite being on thyroxine replacement therapy. Unfortunately, in these situations, individuals often feel dismissed or not listened to and may resort to less regulated or potentially dangerous treatments like animal desiccated thyroxine or high-dose iodine. Why Might Symptoms Persist Despite Thyroxine? There are […]
Athlete Health: Iron Infusions and hypophosphataemia (low phosphate)
Recently, I’ve had a few friends feeling unwell after an iron infusion, and I’ve recommended they have their phosphate levels checked. Low phosphate (hypophosphataemia) is a relatively common side effect of iron infusions. Although it is usually mild and lasts only a few days, it can sometimes be dangerously low and persist for weeks to […]
Athlete Health: Keto diet and Bone Health in Athletes
I recently presented an interesting paper at our journal club and thought I’d share the insights here. Study Overview A group of 30 race walkers were randomized to isocaloric diets (same amount of calories) that were either very low carbohydrate (0.5g/kg) or high carbohydrate (8.6g/kg). They then embarked on a 3.5-week training camp. The study […]
Athlete Health: Can I Track and Train to My Cycle if I’m on the Pill?
A common question among athletes and fitness enthusiasts is whether they can track and train according to their menstrual cycle while on the pill. Let’s break it down. What is Training to Your Cycle? Training to your cycle involves tracking where you are in your menstrual cycle, such as before or after ovulation (follicular vs. […]
Menopause: Vitamin B6 Toxicity and Neuropathy
Vitamins and minerals are essential for health, but more is not always better. Recently, there have been reports of patients experiencing peripheral neuropathy (nerve damage affecting movement and sensation in the limbs) due to excess vitamin B6 (pyridoxine). While B6 is important for nerve and immune function, too much can be harmful. Benefits and Uses […]
Menopause: Shedding Light on Menopause and Premature Ovarian Insufficiency
Menopause and premature ovarian insufficiency (POI) are topics that don’t get enough attention. Menopause is defined as the point when a woman has gone 12 months without a period. The phase leading up to this is known as perimenopause, during which the egg count declines, and the brain increases the production of LH and FSH […]