Brief Answer:
Post menopausal and senile osteoporosis

Detailed Answer:
Dear XXXXXXX

Thanks for contacting Ayurveda with your health concern and summing up your case history following points are to be considered for better management of the case.

1. going by your age [64], the condition fits under Primary Osteoporosis: Post Menopausal [Type I] and progressing to Senile [Type II]: age [> 70].

2. As Describe earlier:
. Age: 50 years or more [64 in your case]
. Sex: Female
. Menopause [achieved]
. sedentary life style [present] leads to regional osteoporosis, are risk factors for osteoporosis, but one should look for other secondary causes for the same, which is desired from your side, like:

1. Nutritional:
. Diet low in calcium, proteins? [mal absorption, malnutrition]
. Any excess of caffeine, alcohol,smoking

2. Any Endocrinal Disease?

3. If your are using Diuretics [water pills] to control your blood pressure, which cause loss of calcium via urine thus can lead to osteopenia and Study conducted on eHealthMe shows that 96.26% of females who have osteopenia had experienced Lymphoedema [which could be cause and effect in your case]

4. Preventive Aspect:
i. Calcium intake; 1.0-1.5 g per day [banana, XXXXXXX fruit, grapes,coriander, raisins, milk, green vegetables, lemon,mint,papaya,amla,guava,pineapple,turnip,tomato, apple,orange.

ii. Moderate Vitamin D intake: 400-800 IU per day or calcitriol 0.25~g/day
[ carot, beetroot,spianch,radish,mint,amalaki rasayan,soyabean,cucumber, cabbage,vitamin D fortified: pineapple/yogurt/milk/dry mushroom/banana/ cod liver oil/sunshine.

iii. Moderate Phoshorus intake: cheese,peanut butter,chicken,nuts,caramel, whole grain bread.

iv. Avoidance of alcohol, cigarette, tobacco.

v. Periodic assessment of skeletal status and bone mineral.

vi. Single Drug which is extremely helpful and beneficial in post menopausal osteoporosis is 'Shatavari' which can be explained with the help of its active chemical constituent- Steroidal Saponins which are Phytoestrogens. Phytoestrogens acts as SERM's [selective estrogen receptors modulators] and stimulate osteoblastosis ans supress osteoclastosis and thus help in preventing bone loss.

Dose: Shatavari Churan [shatavari powder]: 6gm/day [thrice daily with milk] for 10 weeks

vii. Prescription Medicine which are effective in your condition is/are:

. BONTON [Vasu]: 1 capsule twice a day.
. REOSTEO [Himalaya]: mainly indicated for post menopausal/senile osteoporosis: 2 tablets twice daily

PS. In modern medicine they also have SERM's [raloxifene,idoxifene,tamoxifene], action is similar as described.

Please revert back for any further necessary clarifications and management.

Dr. Munish
Naimittika

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Brief Answer:
Combining Shatavri with Diet & Life style planning

Detailed Answer:
Dear XXXXXXX

Thanks for reverting back.

1. Since 'diuretic' is one culprit for your decreased bone mass, ask you doctor for any substitute of the same i.e. 'Thiazide diuretics' which decreases bone resorption.

2. Initially you may start with 'Shatavri' Powder, since it enhances bone formation and decreases bone resorption and balances bone remodeling and hence can prevent bone loss and helps in increasing bone mass.

PS. make sure you buy/get original Shatavari in raw form and make a powder of it and then use as described earlier, you will also get it online but make sure they are from reputed Pharma like Baidyanath/Ayush/Patanjali.

I have personally used powder manufactured by Ayush Pharma, in my patients with beneficial and encouraging results [as suggested by periodic investigations and relief in symptoms.

3. Since periodic assessment is essential, thus after two and half months [10 weeks], check with Bone Density and Vitamin D and Serum Calcium levels and then revert back for further line of management.


Dr. Munish
Naimittika

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Brief Answer: XXXXXXX SHATAVARI CHURNA(POWDER)

Detailed Answer:
Dear XXXXXXX

Thanks for reverting back.

1. You can go ahead with XXXXXXX but make sure that on the bottle it will be written as: given in General debility, weakness & loss of immunity, so don't get mislead since it is a good food for menopausal women.

2. If you have any doubts please get them clarified with me, before starting to follow the advice, since these are just suggestions and are not a doctor’s prescription. [They are not substitutes for direct consultation with your doctor]

PS. I'm in talk with my Fellow Doctor who is also shipping single drugs across Europe, if the things gets materialized I will let you know if you want to purchase the same [at your perusal]


Dr. Munish
Naimittika

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Brief Answer:
Shatavari Substitute & Necessary Action

Detailed Answer:
Dear XXXXXXX

Thanks for reverting back.

1. If shatavari is available in your town in raw form, you can make powder of the same from an Ayurveda Pharmacy or other Industries, since you are providing the original raw material.

2. In case you are not still comfortable with the drug, just purchase 'BONTON' of Himalaya Pharmacy and take 2 tablets twice daily for 2 months.

3. Since on Calcium and Vitamin D: periodic assessment of blood level is necessary and since calcium causes constipation [slowing of bowel movement] take a light laxative like 'trifla churan' at bed time.

4. Do let me know your mail address so that if he agrees to ship the same, we can further discuss the options.
Best Wishes


Dr. Munish
Consultant & Physician
Naimittika Clinic

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