More About Your Heart

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Last week I gave you all some links sent to me by the NIH to help women come to terms with the possibility of heart disease. What is it you need to know about to determine if you need to be worried?

Here are some of the basics.

1. What is your blood pressure, glucose, and cholesterol? These 3 things are the early warning signs of potential harm to your heart and blood vessels.

An elevated blood pressure occurs for a variety of reasons but basically the blood vessels are too narrow and the heart has to work harder as a pump to get the blood to flow through and make it to the organs. The heart over time can enlarge, and not work as effectively.

An elevated glucose causes problems with the walls of the blood vessels, making them less healthy, inflamed and eventually not effective as conduits for the blood flowing through.

Elevated bad forms of cholesterol can infiltrate into the lining of the blood vessels, causing blockages. These can eventually rupture, causing a complete blockage. When this happens in the brain, it is a stroke; in the coronary blood vessels it is a heart attack.

2. What are your genetics for heart disease? In other words, have many family members had early heart attacks and strokes?

Having a strong family history of heart disease indicates there is a tendency to inflammation in your blood vessels that contributes to poor health of arteries. This genetic predisposition may include diabetes, high cholesterol, high blood pressure.

Having a family history does not mean you are fated to have an MI or stroke, but it does mean you need to be very careful what you do in terms of lifestyle and habits. You can avoid the fate of your genes with careful living.

3. What are your health habits? Yes, yes; this is what we medical people preach about day in and day out!

It is the one most important modifiable action you can take however, which is why we stress healthy habits so much. You have the power to change the fate of your genes!

Exercise helps the heart get a good work out, it exercises the muscle and gets the blood flowing all over your body. It uses up the excess calories you may have eaten. It lowers cortisol levels that are elevated in most of us due to the stress of our lives. This lower cortisol following exercise causes the muscle layer around the outside of the blood vessel to relax a little, making the tube a little wider and easing the heart from having to pump so hard. The idea is for your heart to work hard during exercise, and not all the time. Additionally, exercise helps your liver make more of the good cholesterol which then helps the body get rid of the bad cholesterol.

A healthy diet low in animal fats, trans fats, and saturated fats that come from fried foods, packaged and processed baked foods; helps to keep cholesterol lower and inflammation in the blood vessels lower. Then the cholesterol flowing through your blood stream doesn’t have as much inflammation to latch onto, creating a plaque or potential blockage.

Lowering sugar in the diet also helps reduce inflammation, avoid diabetes with its’ destructive actions; and helps with weight.

Sodium is a major contributor to high blood vessel for many people through retention of fluid and tightening to the blood vessel walls, making them more narrow.

Maintaining a health weight reduces the amount of blood vessels your heart has to pump blood too, as fat needs blood vessels also. There is less mileage that the heart has to pump blood through. The actions that it takes to maintain a healthy weight also helps the heart, and is described above.

Do you smoke cigarettes or use nicotine products? Nicotine contributes to heart disease mostly through the inflammation and disease to blood vessel walls. Nicotine also contributes to tightening of the blood vessels, making them more narrow. The inflammation and narrowing then helps cholesterol do its’ bad thing with blockages.

Do you get enough good quality sleep? Hey, everything has to rest! Sleep helps aid in repair of the body, lowering of inflammation, mobilizing excess fluid.

OK, quick tips:

  • Instead of frying foods, saute in a little olive oil or other healthy oil
  • Add very little salt to food, use other seasons like pepper and herbs, spices
  • Get out and move every day, figure out a way this will work for you
  • Get a good nights sleep, work on sleep habits to aid this occuring
  • ditch the sodium, nicotine products, fast foods, fried foods, fatty meats. Make them a rare occurrence
  • decrease sugar, white starches like bread, pasta, potatoes, rice; as they basically act like a big dose of sugar in the body
  • limit alcohol and caffeine products to a healthy consumption
  • have your glucose, cholesterol and blood pressure monitored regularly and talk to your provider about what to do to reduce them if they are elevated.

Think about it, the only rest your heart gets is between each beat. Not to scare you, but that muscle keeps going, all the time. Why would you not be kind to it, protect it, pay attention to it?

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Is Your Heart As Healthy As You Think?

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We never really thought about our hearts when we were younger, did we?

Aside from the issue of love and relationships, we have pretty much taken our hearts for granted all these years. Until it starts  palpitating, jumping wildly around in our chest for no reason.

Now we are paying attention.

We may feel like someone who never remembers to have the oil changed in their car until is starts stalling or hesitating.

The good news is, it is likely not too late-depending on how much you have abused your body with bad habits. It is certainly never too late to improve a few things.

We have to realize that we are at risk for a heart attack or a stroke at this age of menopause, just like all the men we know, care about and love.

Take some time at your next medical appointment and talk about your heart health and how you can preserve or improve it. Along with some helpful tips and information from the NIH  included in these brochures, you can think about ways to start the conversation with your provider.

Heart Health and Changes to Your Heart Health With Age

Heart Health for Women

Both of these links have pdf forms you can down load and print, give it to a woman you care about who may still be ignoring their heart. Help spread the word that we women are at much at risk for heart disease, stroke or heart attack as men. This is one area we have equality, whether we want it or not!

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Mammograms and Fear: is avoidance an option?

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Breast cancer is scary, no getting around it. It is especially scary when we know someone who has struggled with it.

Mammograms are painful, more painful for some of us than for others. Add pain to fear, and it is no surprise many of us avoid the ordeal all together.

The most current recommendations for mammogram screening recently published by the USPSTF call for women to have screenings begin at age 50 and occur every other year. Beginning screening at 40 is at the discretion of the individual, taking into account their concerns and risk factors. These recommendations are contrary to the American Cancer Society, and the American College of Obstreticians and Gynecologists(ACOG).

One in six women with develop breast cancer in their 40′s, and there has been a 35% drop in breast cancer death since the mid 1980′s. This coincides with the regular use of mammograms for breast cancer screening. It is no wonder the two most learned medical societies on the subject do not agree with these recent recommendations.

When you are at higher risk for breast cancer, avoiding your mammogram is not really a good option. Sure, it is your choice to not get a mammogram. If you are at risk though, and you cannot change that risk; doesn’t it make sense to be proactive? To catch something before it is a big problem?

Avoiding the problem will not make it go away, but it may make the problem more profound when it lands on your doorstep.

Sure, there is a lot of confusing information about the benefit of mammograms. Many screening tests can bring up abnormalities that need to be evaluated, and are found to be benign. So now we have pain, fear, and extended fear over a false positive mammogram finding. I understand the desire to avoid testing all together.

There are steps you can take however, to help avoid some of the pain and some of the fear.

1. If you are at high risk for breast cancer, talk to your provider about having an MRI performed instead of mammography. It is more accurate, and less painful; but unfortunately not always covered by insurance.

2. If you have dense breast tissue but do not qualify for MRI, get a 3D mammogram. It is more accurate in looking at abnormal appearing dense breast tissue.

3. Bring a friend to your screening test to give you emotional support.

4. Decrease your risk factors: cut down on alcohol, exercise and optimize your weight, stop smoking, reduce the consumption of toxins in your water and food.

It is often women with several family members with breast cancer that are most fearful, for good reason. If you know someone like this who avoids screening altogether, lend them your support. Encouraged them to get a mammogram, it could ultimately ease their minds!

Categories : breast cancer, Menopause
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Quality Sleep:why we need it and how to get it

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How can we get back to the days where we got in bed, fell asleep, and didn’t wake up until morning?

I bet for many of us, this is a distant memory. As we get older, many of us will do whatever we can to fall asleep. The National Sleep Foundation recently revised the recommended hours of sleep we all need at the different stages of our lives. Adults are recommended to get 7-9 hrs, nightly!

There is a lot we can do to improve our sleep without taking medications. First though, you have to decide that your sleep is a priority; not something to fit in at the end of the day!

We are all busy, and our modern conveniences has made us even busier. Add to that the constant connectivity that some of us want, others of us are expected to have. Many a job does not allow a 9-5 mentality, we are expected to answer emails late into the night. For some of us working for a company that is world wide, we have to be available late into the night for time zones behind us, then early in the morning for time zones ahead of us. Or is it the other way around! This hardly seems sustainable.

Constant sleep deprivation can be harmful to our health. A lot of repair to our body occurs while we sleep, sort of like a computer going to standby, scrubbing out unnecessary bits of broken information. In addition, good sleep is essential for healthy weight control through a series of hormones that are secreted while we sleep. None of us want to gain weight much less acquire the inflammatory conditions and diseases that obesity and insulin resistance place us at risk for.

So it comes down to making choices and setting boundaries as best we can.

  • Your may not be able to be on many committees or groups as you would like, limit them to what you can reasonably do
  • With a job that requires out of office email answering, talk to your supervisor about setting time limits. You can “on” 24/7 more when you are young, but it takes so much more out of you after 40 or so. It wears you down
  • Set a plan for relaxation at night an hour before you want to fall asleep. This hour should be void of ALL electronics. Read an old fashioned book, or listen to music and daydream.
  • Do the obvious dietary things: avoid caffeine after noon, don’t eat late at night, limit alcohol as this causes a rebound awakening when the alcohol wears off, sugar and big desserts can undermine sleep with the glucose rush
  • Exercise helps tremendously with sleep, done any time of day except within a few hours of bedtime for some people
  • Keep lights low and sound low to help the sleep center of your brain secrete melatonin, which quiets the awake center

Medications can certainly be helpful with sleep, but many of them do not mimic the normal sleep cycle. You may be asleep, but it may not restore you like a natural sleep does. Many of these medications are also habit forming and addictive. There is some rebound insomnia next night after use, and sometimes some depression the next day after using Ambien, Lunesta, or Sonata. These meds can be helpful for those rare instances when you must ensure a quick sleep induction, but regular use can be a slippery slope.

Certain times of our lives can contribute to sleep problems, but working on healthy sleep habits and limited use of sleep medications can get you through these years without undue deprivation or overuse of medications.

Follow the tips I have listed above and let me know how it works out. Better yet, send me some of your own tips.

I personally find taking a relaxing shower and getting in bed with light reading and a cup of decaf tea, 30-45 minutes before I feel I need to fall asleep; works 75-85% of the time. Having gone through menopause and sleep deprivation rivaling having a newborn, that is good enough for me!


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We women deal with many physical and emotional changes during and after menopause. Some of these changes can take a real toll
on our relationships, including our sex life.

To complicate matters, it’s often difficult to find straightforward,
trustworthy information about how to deal with issues like changes in our
libido, pain during sexual intercourse.

That’s why I’m excited to share with you that Vibrant Nation, the leading
online community for women 45+, is having its first ever Live webcast
discussion, Sex After Menopause. On March 31, 2015 at 1:00pm EST,
Vibrant Nation sexual health expert and blogger Dr. Barb DePree will lead
a panel of women in sharing their stories and advice for getting that spark
back in the bedroom.

Disclosure: I am participating in a Vibrant Influencer Network campaign. I
am receiving a fee for posting; however, the opinions expressed in this
post are my own. I am in no way affiliated with Pfizer and do not earn a commission or percent of sales.


How Rainbows Relate To Your Health

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Spring is around the corner and so are fresh fruits and vegetables, the farmer’s market; and sunshine!

After spending a week in a cold NYC at the recent Integrative Health Conference, I am ready! I usually go once yearly for my shot of motivation on improving diet and life balance. After many years of going to this conference, it has become ever more clear that a healthy diet, activity and stress reduction are powerful medicines against illness.

It is increasingly talked about in medical and health news, that eating a rainbow color of fresh foods is key for good health. There are nutrients and compounds in whole foods (nuts, legumes, vegetables and fruits) that are capable of controlling how our genetic code is expressed!

If you are genetically predisposed, it is possible that your diet and lifestyle can determine or influence whether you will develop diabetes, heart disease, or even cancer. It is astounding that plants and greens have the power to prevent diabetes in a person from a family where diabetes is rampant.

It is all in your choices and what is most important to you.

This year’s conference was to some degree focused on gut health and how a poor diet can lead to inflammation in your body, triggering eczema, arthritis, migraines to name a few things. It seems that healthy bacteria in our gut helps to create a proper barrier, to prevent inflammation. Additionally, regular elimination gets rid of toxins; including the metabolites of estrogen. Getting rid of these metabilites has been postulated to decrease your risk of breast cancer!

My take home message that I pass to my readers is this:

  • eat a variety of fresh plant foods daily, try to get the rainbow in!
  • eating more greens and fruits and veggies increases fiber in your gut as well as healthy bacteria; increasing regularity and ridding yourself of toxins
  • try to get protein from nuts and legumes and limit animal protein to highest quality you can afford, maybe eat a little less at each serving to afford better quality sources
  • make time to cook, after all, food is important in our lives and shouldn’t be delegated to what is most convenient
  • drink lots of water, not from plastic bottles; to flush out toxins filtered by the kidneys
  • limit sugar and processed foods, start with 1 or 2 small changes and build on it regularly
  • ENJOY YOUR LIFE! You only have one life, work some fun into your day or week, and spend time relaxing!
  • turn off electronics once in a while, set these boundaries for work if needed

In the last 2 weeks, I have managed to do some of this. How much can you do, or do you need to do?

This can be you next action: take some time to decide what your goals are for your health, and what you can do to achieve those goals. Be positive about yourself and your abilities to change. Write down affirmations and take them with you when you leave the house. Read them when you feel temptation to take a short cut that works against your health.

You can do it! Two steps forward and one step back is still forward momentum. Keep going!




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One of the most profound changes you may be experiencing entering and transitioning through menopause is a lack of desire and inability to enjoy sex. While you may still crave intimacy with your partner, having sex may not be high on your list.

This doesn’t help us feel like the woman we want to be, as we are getting older!

So what is going on, and what can you do about it?

Much of the lack of desire can be attributed to lower estrogen levels, AND lower testosterone levels. We all know these hormones are not being produced in the same abundance, but a 90% reduction of estrogen production sure does explain some things!
There are other factors to consider:

  • you may not like how you look if you have gained weight and lost some muscle and support
  • you may be tired if you are not sleeping as well
  • you may have grown apart from your husband through years of working, raising children or tending to family issues
  • it may hurt to have sex, either from a lack of lubrication in the vagina, or arthritis pain in back and hips

Most of these issues can be remedied, and some remedies will help with desire. It may be interesting for you to know that the sexual response does change with menopause.

It is widely recognized by experts the the DESIRE for sex often comes AFTER the activity has started and you are getting warmed up, so to speak. What I mean is, the desire that used to drive you to seek sex isn’t the first feeling any more. This comes after your are started and feeling good, and is normal with menopause.

What a relief to know what you are experiencing is normal, now you just have to learn to work around this in order to have some intimacy fun with your partner.

Some simple things you can do to get started feeling sexy again:

  • Spend some time with your partner doing fun things, to get back that feeling of closeness and partnership.
  • Talk to your medical provider about easing the discomfort of intercourse, controlling hot flashes and sweating
  • Work on your energy level by getting sleep, exercising, eating well to avoid bloated feeling
  • Work on weight control so you are happier with how you look

There are many strategies and treatments to help with the many issues contributing to sexual difficulties.

Join me and other experts from Vibrant Nation in an upcoming  Google Hangout about these very issues!

Getting Your Sexy Back  is happening Feb. 19th.; check back in the next few days to sign up and get the details. It’s free, and sure to give you lots of tips!




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What You Should Know About Osteoporosis

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Osteoporosis and osteopenia are the consequences of aging, and all menopausal and post menopausal women are at risk. This is a problem as these conditions place you at risk for breaking a hip or fracturing your back with a significant enough fall. The inactivity these fractures cause, place you at risk for other serious medical conditions.

Bone thinning, which is what both of these conditions are, occur in response to a genetic predisposition, aging, poor nutrition, inactivity as well as other factors associated with some medications and medical conditions. The trigger is often the decrease of estrogen production that happens with the menopausal transition.

It may surprise you to find out bone is not a static calcium filled mold. It is a dynamic, living tissue that is constantly being repaired by being reabsorbed and renewed by the cells within it.

As we age, the bone building cells slow down while the bone resorbing cells continue to dissolve older bone. New bone is formed more slowly as a result. If your diet is low in calcium and Vitamin D, the bone you form may not be very strong. If there is enough bone loss to place you at risk for a fracture from a fall, due to decreased bone strength; you are diagnosed with osteoporosis.

Are you at risk for Osteoporosis? Perhaps if you are part of one of the following groups more at risk for this:

  • older women and men of northern European decent
  • Asians, especially women
  • 45% of postmenopausal women have low bone density.
  • Caucasian women have a 40% risk of a forearm or spinal or hip fracture (usually from a fall) in their lifetime.
  • Caucasian men have a 13% risk.

Interestingly, those of African decent have a decreased incidence of osteoporosis

The risks and causes of Osteoporosis include:

  • Age
  • Race
  • Smoking
  • Excess Alcohol intake
  • Certain Medications like corticosteroids, anti-seizure, anti-organ-transplant-rejection drugs and chemotherapy
  • Obesity
  • Underweight
  • Malabsorption
  • Kidney Disease
  • Liver Disease
  • Spinal Cord injury
  • Diseases of the Bone Marrow
  • Hereditary Bone Development Diseases
  • Endocrine and Metabolic diseases like Hyperthyroidism, Cushing syndrome, Hypogonadism

Although the main causes are 1) Estrogen deficiency and 2) changes of age,1/3 of all men and women with Osteoporosis have another coexisting cause of bone loss!How can you prevent and/or treat Osteoporosis?

Your bones are dynamic and constantly being remodeled.  Providing your body with the raw materials in the form of fresh, organic food is very important. The minerals you need are freshest in these foods.

A diet high in protein and minerals including calcium, phospherous, magnesium and zinc. Bone of comprised of these items, as well as blood, and if you have an insufficient amount of these minerals in your system, the body will remove them from bone to replace what is needed.  There is a balance between minerals so that if one is too low the other is excreted.

Low Vitamin D3 levels can also adversely affect bone density through poor utilization of the calcium you consume.

To prevent osteoporosis and help already weakened bones try these actions:

  • keep protein to a minimum – .8grams per pound of IDEAL body weight (excess protein causes mineral loss through the kidney). T00 much protein is actually detrimental to bone health!
  • eat lots of fresh fruits and vegetables to get important nutrients for bone support
  • do resistance exercises for 30 minutes 3 times a week – as good as estrogen in post-menopausal women. this helps activate bone building cells
  • practice balance exercises – falls are the main cause of fractures
  • learn to fall – take a basic judo course or Akido orientation
  • reduce stress – the stress hormone cortisol kills the bone forming cells called osteoblasts
  • discuss whether estrogen therapy is safe and indicated for you for a short while
  • bisphosphonate drugs can help for a few years but need to be stopped and they can be difficult to tolerate.

Osteoporosis is often over looked as a healthy concern, but can have a serious negative impact on your life by reducing mobility, strength and balance. Your bones are as important as the rest of you, they are part of the vehicle that allows you to do the things you like to do!

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I know, as you stand in front of the calcium supplements your medical provider has urged you to start taking; your mind goes blank and confusion sets in.

It sounds so easy, “start taking calcium supplements daily”. “Ok” you say, that is one health action that seems easy for you to initiate. Until you stand before the mind boggling array of supplements available.

This post will hopefully make your decision easier.

The first thing to do is acquaint yourself with how to determine the amount of calcium you may be getting in your foods and beverages. This is easy if you are consuming something with a nutritional label on the container. Reading the nutrition label, you will see on the very bottom a percentage of calcium provided. This percentage is based on 1000 mg recommended by the FDA daily. Take that number and multiply by 10; that is the mg provided in that serving. For example, the yogurt I eat at lunch, Fage, lists 15% in the one serving container. So that provides 150 mg.

We menopausal women need between 1200-1500 mg a day. It is hard to get all that in the diet. For instance, milk provides a whopping 300 mg per 8 oz glass, but you would have to consume4-5 glasses a day to get the total recommended amount. That is a lot of calories, and most weight conscious women are not going to consume so many calories in milk.

Cheeses, especially the harder ones, provide a good amount of calcium. Greens also have calcium and this is harder to quantify. My ballpark estimate is a cup of cooked greens probably has 75 mg of calcium. Many foods and juices are now fortified with calcium, so this can be an easy way to get a good bone building serving of calcium(and Vitamin D). The NIH has a decent list of calcium content of foods for you to tally.

You get the picture, look at what you consume, add it up. The difference between what you get and what you need can be made up with supplements.

Ok, which supplement?

The most common forms are calcium carbonate, and calcium citrate.

Calcium Carbonate is the most common form of supplement, and the form used to supplement foods and juices that do not contain dairy or calcium naturally. It has the highest amount of elemental calcium, but is the hardest to digest. It requires more stomach acid to absorb, something that can be difficult as we age as stomach acid production can decrease for some people with aging. Additionally, if you take a heart burn medicine, you also may not absorb this form of calcium as readily.

Calcium Citrate is the second most common form. It is easier to absorb, but you do have to take more tablets as it has a lower percentage of calcium. You can take it on an empty stomach; and many supplements have the bonus of adding Vitamin D to it.

Calcium Phosphate has a high percentage of calcium but is not as easily absorbed as the above two. It is not as common and may produce more gas and constipation as other forms.

Many people like the idea of Coral Calcium, as it seem natural. It is basically a form of calcium carbonate derived from fossilized coral reefs. The manufacturers have made many health claims that have never been proven. Additionally, I have issues with using a resource that is endangered, as living coral reefs are.

Oyster shell calcium can also be a favorite as it is derived from a natural source. These forms have been found in some cases to contain high levels of lead and other toxic metals.

A new form of calcium supplement, KoAct, has had some mention in the medical press. It is a branded calcium collagen supplement that in a small study, showed improved reduction of bone loss as compared to an equivalent dose of calcium carbonate and vitamin D.  Call me a sucker, but my recent bone density revealing osteopenia has me taking action. I am giving this supplement a try and have found it to be tolerable and not causing the common problems of gas and constipation.

As you try different supplements for tolerability, try to add some calcium in your diet. I usually suggest to my patients that they take a supplement containing 400-500 mg of calcium morning and evening. Then eat something with calcium mid day, like yogurt or cheese stick. If you eat cereal in the morning, use 8 oz of milk and drink it all. Then take your supplement at lunch and after dinner. You can easily switch it around, but you cannot take it all at once. Your gut can only absorb up to 500 mg of calcium at a time, so it has to be spaced out. When someone wants a specific recommendation, I will often suggest Caltrate twice daily. Its a good supplement of calcium citrate with vitamin D, is easily tolerated and affordable.

We need calcium for many functions within the body, including heart, blood vessel, and muscle function. What we don’t get in our diet, our body will take from the bones to fulfill this need. As we age, our bone making cells within the bone slow down. So you can see how a deficit can occur.

Take your calcium, and remain strong and mobile as you move through menopause and beyond!


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I was recently contacted by the International Osteoporosis Foundation regarding a new social forum they have developed. Their aim is to increase conversations between women and professionals regarding the serious health consequences of osteoporosis; as well as to discuss available therapy and life style changes to help improve bone density.

Seeing first hand the devastating impact immobility can place on women as they age, I eagerly support such a great resource for us. Here’s what they have to say:

OsteoLink is a direct response to unmet needs in osteoporosis communications. In 2009, the International Osteoporosis Foundation commissioned a survey of over 1,600 people with osteoporosis and health professionals in 12 countries in Europe and Australia that found significant gaps in communication and understanding about living with osteoporosis.

An increasing number of people are seeking health information online and ‘Silver surfers’ are on the rise — in Europe people aged over 55 are the fastest growing group of internet users. Health-care social networking is beginning to harness the power of the internet to bring networks of people together to improve personal management of health conditions and create widespread advocacy.

OsteoLink provides a platform for conversations and aims to improve communication between people who live with osteoporosis and their health-care providers, in the hope that this leads to better disease management. It gives patients from around the world, their friends and families the opportunity to pose questions to those going through a similar situation and address any concerns directly. Through the exchange of knowledge and providing support for one another the ambition is to help improve health outcomes. Osteolink is a growing online community with 1’100 members to date, and is accessible in English, German, Greek and Swedish.

By connecting and exchanging experiences with other osteoporosis patients and interacting with health-care professionals about daily troubles, Osteolink strives to bring comfort and reassurance to people. It’s ultimate goal being to improve the bone, muscle and joint health of our communities. [Some recently discussed topics were osteoporosis treatment, exercise, bone-healthy diets, useful tips and recipes. Questions addressed included: “I just tried this recipe this weekend which was fantastically delicious but also is a good source of calcium”; “Does anyone who is in the 30's have Osteoporosis? What treatment has been given you?”].

Join the conversation: http://osteolink.org/

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