Lupron induced Osteoporosis

Rainbow Health: Pubertal suppression/ hormone blocking in trans & gender diverse youth Guide misses this side effect

Image from New Era Pharmacy

Many find themselves on the Lupron journey: Precocious Puberty, Endometriosis and Prostate Cancer patients all have had experience with Lupron that have informed the darker consequences of this prescription drug.

Indeed even Chemical Castration literature reviews very serious consequences of the same drugs now routinely prescribed for children undergoing ‘transition’. One would therefore expect the 'informed consent for children (with parents present or absent) would have the same level of information available to convicted pedophiles, whose lawyers are concerned about the use of chemical castrations.

“ as we have experienced in treating prostate cancer, chemical castration may have serious side effects. Drugs such as medroxyprogesterone acetate, cyproterone acetate, and LHRH agonists, (includes Lupron)

when administered for chemical castration, can induce a significant decline not only in serum testosterone but also in estradiol. Estrogens play an important physiological role even in men because they have beneficial effects on skeletal growth and bone maturation, brain function, and cardiovascular biology. Therefore, chemical castration is associated with various side effects, including osteoporosis, cardiovascular disease, and impaired glucose and lipid metabolism (11). Depression, hot flashes, infertility, and anemia can also occur. Given that the minimal duration of treatment is 3 to 5 yr for severe paraphilia when a high risk of sexual violence exists (10), the side effects of chemical castration can increase in a time-dependent manner.”

Cleveland Clinic provides harsh side effects for chemical castration. https://my.clevelandclinic.org/health/treatments/22402-chemical-castration

But they notably do not show the same effects for the same prescriptions in their transgender clinic. I wonder what’s going on? Are trans youth evaluated to have less Human Rights then sexual offenders. Trans rights are human rights I want to emphasize for the purposes of knowing the side effects of the the drug Lupron.

https://my.clevelandclinic.org/about/community/lgbt-health/transgender-medical-services

Lupron prescriptions have been evaluated a plethora of patients, literature, and have in fact even reached the courts.

Lupron Induced Osteoporosis

BY SAMANTHA BOWICK DECEMBER 13, 2017

“Women who suffer with endometriosis do not have many options for treatment. As a result, many women try Lupron because they are desperate to be pain and symptom free. I was one of these women. In 2011 and 2013, I tried Lupron for a total of three doses and wish I knew then what I know now.

In 2010, I was diagnosed with endometriosis laparoscopically. After that, I tried everything from many different types of birth controls and pain medications to depression medications that can also be used to treat pain. Nothing worked. My doctor at the time suggested Lupron to me and I was desperate. I felt like I had already put my life on hold long enough because of this disease and just wanted to be out of pain. However, now I feel like I am suffering the consequences and it didn’t even get rid of my pain.

In 2015, I was diagnosed with osteoporosis. Prior to this, I had never had a bone scan done, not even before being administered Lupron. In 2009, I was diagnosed with Vitamin D deficiency and have been taking a supplement ever since. Three months before being diagnosed with osteoporosis, I stress fractured my knee and was told at my age, it should not have happened. In 2014, I had a hysterectomy because of endometriosis; I couldn’t take the pain anymore and had disease on both ovaries.

Before this, I had never had bone problems or been told that I could. I blame Lupron and strongly believe using it as a treatment for endometriosis led to me having osteoporosis. At 27 years old, I am still trying to work with doctors to determine if there are any treatments I can do because people my age having osteoporosis is rare. Many medications women use for osteoporosis could negatively impact my bones even more because of my age. If I don’t use any treatment, I could suffer from even more fractures or bone breaks the older I get. Right now, my average T-score for my left hip is -3.6 and was -3.3 when I was first diagnosed. I have no idea when my bones became so brittle. In my case, I wish I would have never tried Lupron as now I know this is one of the many side effects of this terrible treatment for endometriosis and something I will have to deal with for the rest of my life.

There are not studies done on medications for osteoporosis in my age group because there are not enough people with the disease to study. The medications my current doctor wants me to try would be a daily injection I would give myself in the abdomen for two years. They are known to possibly cause osteosarcoma, a bone cancer. Based on my history, I don’t like my odds. At this time, I don’t know how I will try to treat osteoporosis. I am planning on looking into natural ways of treating the disease and see how that goes.”

Lupron is a drug provided to girls who are ‘transitioning’.

According to Reuters

Puberty blockers and sex hormones do not have U.S. Food and Drug Administration (FDA) approval for children’s gender care. No clinical trials have established their safety for such off-label use. The drugs’ long-term effects on fertility and sexual function remain unclear. And in 2016, the FDA ordered makers of puberty blockers to add a warning about psychiatric problems to the drugs’ label after the agency received several reports of suicidal thoughts in children who were taking them.

More broadly, no large-scale studies have tracked people who received gender-related medical care as children to determine how many remained satisfied with their treatment as they aged and how many eventually regretted transitioning. The same lack of clarity holds true for the contentious issue of detransitioning, when a patient stops or reverses the transition process.

The National Institutes of Health, the U.S. government agency responsible for medical and public health research, told Reuters that “the evidence is limited on whether these treatments pose short- or long-term health risks for transgender and other gender-diverse adolescents.”

But what are Canadian clinicians being provided as information? How would a parent know if their child was adequately advised of the possible side effects of Lupron if he/she is ousted from the referrals and affirming care?

This is the Rainbow Health Ontario pubertal suppression/ hormone blocking in trans & gender diverse youth Guide
”Pubertal Suppression Quick Reference Guide”

“Possible longer-term effects (of Lupron)

“Lower bone density: GnRH analogues will slow down the uptake of calcium by the bones. Measures to protect bone health should be encouraged: keeping active (weight-bearing exercise), ensuring good calcium and Vitamin D uptake (1,000 IU of Vitamin D and at least 650 mg of calcium daily).

It is unknown if using this medication increases the chance of osteoporosis in older age.” [yet there appears to be a lot of information that indeed there are very concerning long-term side effects. the material doesn’t seem to ask the clinician to provide informed consent to the child- often without parent and with pro-affirmation guidance.]

“Growth/height: If taken during a growth spurt, it will slow down the rate of growth. This may delay growth plate closure, leading to slightly taller adult height or it may cause overall lessening of adult height for those assigned male, particularly if they start estrogen later.

Future fertility: Use of these medications could temporarily (not permanently) interfere with fertility. This will depend on when during puberty they are started. If a youth knows they would like to have biological children in the future, they may want to consider fertility preservation before starting therapy. [WHAT YOUTH KNOWS THAT - I HAVE SEEN ADULTS NOT KNOWING THAT FOR NEAR 2 DECADES OF THEIR FERTILE LIVES. IS THIS AN ADEQUATE duly consideration for a child? ]

These medications are not contraception and do not prevent sexually transmitted infections (STIs). Precautions against pregnancy and getting a STI must still be taken. When GnRH analogues are stopped, puberty restarts within 3-6 months.”

It seems you just need to take your calcium and you’ll be ok. The harms are presented in a very positive light.

“For years, Sharissa Derricott, 30, had no idea why her body seemed to be failing. At 21, a surgeon replaced her deteriorated jaw joint. She’s been diagnosed with degenerative disc disease and fibromyalgia, a chronic pain condition. Her teeth are shedding enamel and cracking.

None of it made sense to her until she discovered a community of women online who describe similar symptoms and have one thing in common: All had taken a drug called Lupron.

Thousands of parents chose to inject their daughters with the drug, which was approved to shut down puberty in young girls but also is commonly used off-label to help short kids grow taller.

The drug’s pediatric version comes with few warnings about long-term side effects. It is also used in adults to fight prostate cancer or relieve uterine pain and the Food and Drug Administration has warnings on the drug’s adult labels about a variety of side effects.

More than 10,000 adverse event reports filed with the FDA reflect the experiences of women who’ve taken Lupron. The reports describe everything from brittle bones to faulty joints.

In interviews and in online forums, women who took the drug as young girls or initiated a daughter’s treatment described harsh side effects that have been well-documented in adults.

Women who used Lupron a decade or more ago to delay puberty or grow taller described the short-term side effects listed on the pediatric label: pain at the injection site, mood swings and headaches. Yet they also described conditions that usually affect people much later in life. A 20-year-old from South Carolina was diagnosed with osteopenia, a thinning of the bones, while a 25 year-old from Pennsylvania has osteoporosis and a cracked spine. A 26 year-old in Massachusetts needed a total hip replacement. A 25-year-old in Wisconsin, like Derricott, has chronic pain and degenerative disc disease.

The FDA is also reviewing deadly seizures stemming from the pediatric use of Lupron and other drugs in its class. While there are other drugs similar to Lupron, it is a market leader and thousands of women have joined Facebook groups or internet forums in recent years claiming that Lupron ruined their lives or left them crippled.

But the FDA has yet to issue additional warnings about pediatric use, and unapproved uses of the drugs persist.

Meanwhile, pediatricians and industry researchers are criticizing doctors for using Lupron to help kids with normally timed puberty grow taller, an “off-label” practice that was shown more than a decade ago to cause harm.”

“A different drugmaker-sponsored study, completed long after Fleming’s letter, looked at children who had taken Lupron for precocious puberty from 1991 to 2009. The 2010 study, which was submitted to the FDA, reported that seven of 55 kids had suffered serious side effects, but said the only serious side effects possibly related to Lupron were the growth of a preexisting tumor, deteriorating vision and severe asthma exacerbation.

“According to the National Institutes of Health repository of clinical research, which lists adverse effects discovered in studies, there are two serious side effects of Lupron that aren’t mentioned in the drugmaker’s 2010 study: a bone disorder and a disease-caused fracture, an omission which looks “puzzling” to Dr. Ned Feder, a staff scientist at the Project on Government Oversight.”

“It does seem to me that that is certainly a point of criticism,” Feder said. “What are they doing? Is this an accident?

“About 900 reports cite side effects that children below age 13 have suffered, mostly within months of taking Lupron. Those reports frequently note injection-site pain but also include dozens of cases of bone problems, such as pain or disorders, and the inability to walk.

“Among men who take Lupron, its label warns of increased risk of heart attacks, strokes and sudden death. Drug labels are developed jointly by the FDA and the companies involved.

“The drug made headlines two years later. Justice Department officials announced a civil and criminal settlement with Lupron’s then-maker. Prosecutors said the Lupron sales team rewarded doctors prescribing the drug for prostate cancer with ski trips, golf outings and bribes. In a court document, one gynecologist said a salesperson told him he “could earn $100,000 annually” by treating the women in his practice with Lupron.

The settlement resulted in a corporate guilty plea for conspiracy to violate prescribing laws and one of the largest fines at the time — $875 million.”

If you are a personal injury lawyer you will want to look at the suit and analyze in your jurisdictions the adequacy of information being provided to ‘children’, without their parents present in order to have their ‘affirmation care’ provided for. Is the system pinballing kids through their own future bone loss and harm without adequate disclosure or should those drugs be pulled for those purposes?

“Living With Long Term Problems

Valerie Ward (Photo courtesy of Valerie Ward)

“Valerie Ward, 25, who lives outside of Pittsburgh, said she took Lupron for precocious puberty, from age 9 to 12. Like Derricott, Ward said she sees a carousel of medical specialists for excruciating muscle and bone pain, depression, weakness and fatigue.

The symptoms mystify each woman’s doctors. Yet they sound all too familiar to Chandler Marrs, a researcher who has studied Lupron’s side effects in adult women under treatment for uterine disorders.

Marrs, an endocrine specialist who studies women’s health, said she was surprised by the severity and duration of Lupron’s side effects, so she posted a survey aimed at getting more information. With little funding to do outreach, more than 1,000 surveys came back.

The women reported a wide range of symptoms: 30 percent cited severe joint pain, 29 percent, severe body aches; 26 percent, cracking teeth, and 20 percent reported osteoporosis. More than half reported moderate to life-threatening depression. Fifteen percent of the women rated their suicidal thoughts as life-threatening to severe.

Marrs believes a uniting factor explains the diverse and severe range of symptoms. Lupron cuts off a woman’s estrogen, eliminating a key hormone called estradiol that regulates the energy centers of the cell, the mitochondria.”

The examination of the clinical guidance leads to a conclusion that the side effects are minimized. Moreover whether the ‘clinicians’ believe it or not, the ability of a child to parse this information in order to meaningfully provide informed consent may be a further matter of debate. Until recently that matter wasn’t up for debate.

By putting a wedge between the parent and the child, there is further possibility that those evaluating whether the care is appropriate for the child, are paid by the system and thus have an economic conflict of interest. Who has their hand on the pause button? If the system doesn’t, what have we learned about inherently unfair systems that presupposes a result. They exist and need more attention not less.

“At 20, Ward says she felt like her health was failing. She had muscle weakness so severe that she could barely lift her arms to wash her hair. Debilitating pain coursed through her body. Doctors puzzled over her blood disorder. She’s been hospitalized after feeling suicidal and depressed.

Last year, at 25, she suffered a seizure that resulted in a cracked vertebra.

“It was the most intense pain I felt in my entire life,” Ward said.

Then came another diagnosis: osteoporosis.

The condition would come as little surprise to anyone familiar with Lupron’s use in adults. Adult women using the drug to induce menopause after uterine disorders are warned on the drug’s adult label not to take an initial course longer than six months to avoid serious bone density loss. They are also encouraged to take hormonal “add-back” drugs to soften the side effects.

A Journal of Clinical Oncology study published in 2005 of men who take Lupron for prostate cancer found that it “significantly increased” the risk of fractures, with prolonged use raising the risk. Yet the impact on kids’ bones is still up for debate.”

There appears to be no debate in my mind: there is a difference between how clinicians instructed by Rainbow Health would advise a child and how Valerie Ward would instruct them.

Legally there appears to be a dangerous discrepancy in available information. This discrepancy might be found to negligent or even fraudulent misrepresentation leading to a prescription that ultimately harms the child.

This area appears ripe for further analysis. If women are losing their jaw bones when they’ve had the opportunity to build bones, what happens to a child who has had barely enough time on this earth before the ‘care’ system has decided their best interest? If on the one hand the evidence is VERY SERIOUS long term ADVERSE consequences exist and the clinician handbook presents the facts that these issues are ‘unknown’. Those who claim to have the best interests of the child have to look hard at Lupron. Yet Rainbow health uses language that dances around the issue.

“It is unknown if using this medication increases the chance of osteoporosis in older age.”

IMO the material ab initio flies in the face of common sense, and all clinicians prescribing Lupron to children will not be presenting a truthful version of the pain they may encounter as their future selves.

Then add to that the fact parents have been sidelined without evidence, to be the enemy of the child’s best interest, and may not even be aware of a referral to a gender clinic.

In addition, even if the child has a parent present they may not be provided a truthful account of the hormones serious long term consequences. The clinicians themselves may not have that information if they rely on Rainbow Health.

Further the entire team of caregivers in the system and those from the referral source may be lulled into a safety profile by the online and publicly available care brochure which seems to be pro-Lupron. Thus the child and/or parent may be surrounded by a team of caregivers none of whom show any reticence for the administration of Lupron. This gives another layer of ‘plug for the drug’. Those psychiatrists, school boards, clubs provide referrals under the comfort that the transition system has vetted Lupron and is ok with it. It is the drug de rigueure prescribed to delay puberty.

Therefore all along the way the system provides adults that have an opportunity to be a check or balance and instead affirm not only the transition, but the prescription of drug. With that weight on the one side, how can a parent or child evaluate Lupron.

There appears no counterbalance or even emergency information of serious irreparable harm. And this is a piece about Lupron alone. There are other articles available about suicide attempts because of the transition and the percentage of kids who want to de-transition. I’m not addressing these in this piece

The system produces the gloss and veneer of no harm to these prescriptions, while not providing the information known and available. Human Rights used to include informed consent.

How can we pretend a whole group of admittedly vulnerable youth, don’t deserve the human right of informed consent before a medical treatment. That we gloss over this with the analysis seems part of the anvil nature of the one sized fits all shoe horning Lupron into children “transitioning their gender’. While simultaneously pumping the idea that waiting to the age of majority would be harmful to the child.

It seems the system denies the harm of Lupron, sets up all the adults within the system, appearing to support Lupron while having insufficient information to actually provide informed consent.

Yet these same adults are propped up to the child as being in the best position to evaluate any possible dangers, while their parents are being portrayed as the ‘real dangers’ to affirmation.

So again the system affirms Lupron even when some adults are completely silent on it, and others are recommending it, simply by virtue of being a number of the ‘authorities’ providing the care. Thus school boards, teacher, psychiatrists, principles, doctors are refer into a system and each have an opportunity to caution against Lupron but either are not provided accurate information or do not take the trouble. Setting up the system in this fashion creates a system negligence that allows the perpetration of harm. Because the child is being guided that he or she’s care is being entrusted to those and by those who ‘know better’ then even his or her parents.

Therefore how would anyone decide against Lupron if every adult in the system pushes it as the Gold standard in transition ‘care’. You would be in good company to want to trust the ‘medical system’ as having your best interest. Look how many … oh wait another topic.

Given I’m writing to a broader audience I am holding many punches I don’t usually. But I do think its important to evaluate Lupron objectively especially givens how readily it is now prescribed for ‘gender care’.

Is the medical team provided sufficient disclosure by the rainbow health or other hospital systems in order to guide clinicians adequately? How would any child be able to evaluate long term consequences if the clinician isn’t even apprised of them? Is that hand book negligent? If I am able to find this literature it is astounding though that any teacher, nurse, doctor, educator worth their salt can’t likewise do so.

However for the point of reference, if the material that guides clinicians is publicly available like it is does it provide to other workers in the system confidence to also side on the side of Lupron prescription? ie/ the nurses, psychiatrists, teachers? When pain at the injection site is provided as a consequence and infertility is presented as reversible the whole material underrepresents the harm. It is not just a child or parent but all those in the system who feel a certain way about the care and will represent a Lupron prescription as a positive outcome for the child.

But if you asked Valerie Ward or a defense lawyer defending a pedophile, would you come to a different conclusion notwithstanding your position on ‘affirming gender’. And if this is a gaping hole of inappropriate medical consent, are there any others in the system you should want to investigate?

Should there be a counter-indication on this use of Lupron for children? Are the materials ab initio a massive liability for hospitals, schools, and referring doctors or organizations. If I can find the pro-Lupron handbook for clinicians, so should all those in the process. Therefore they know that the child will not be presented accurate information about harms and that the parent may be eliminated from the equation. maybe the question isn’t who is to blame but how many? Class action lawyers sharpen their pencils please.