Treatment. Osteoporosis

Osteoporosis treatment

Osteoporosis treatment prescribed by your doctor usually depends on estimating your chances of breaking the bone in the next ten years by analyzing your tests results. If you are not at increased risk of breaking a bone, your osteoporosis treatment might not involve medications and will focus on modifying risk factors for bone loss and falls.

Osteoporosis medications

The most widely used medications for osteoporosis treatment in both men and women are those known as bisphosphonates. Examples of these osteoporosis medications include:

• Risedronate (Actonel, Atelvia)
• Zoledronic acid (Reclast, Zometa)
• Alendronate (Fosamax, Binosto)
• Ibandronate (Boniva)

Side effects of these osteoporosis medications include difficulty swallowing, abdominal pain, nausea, and an increased risk of inflammation of the esophagus or ulcers of the esophagus. When the medication is taken correctly, these side effects are less likely.

Injected forms of these osteoporosis medications do not cause an upset stomach, but the injectable form is more expensive. Long-term use of these osteoporosis treatment drugs has been associated with an uncommon problem of cracking and possible breaking of the thighbone. They can also affect the bone of the jaw. This is most likely to happen after the extraction of a tooth. Therefore, a patient should always have a dental examination before starting bisphosphonate osteoporosis treatment.

Hormone-related therapy

If estrogen replacement therapy is started relatively quickly after the onset of menopause, it can help maintain bone strength and density and reduce the risk of osteoporosis and serve as an osteoporosis treatment. However, estrogen therapy also has side effects, including blood clots, heart disease, and breast and endometrial cancer. 

Raloxifene (Evista) is an alternative to estrogen which can assist in preventing the loss of bone density and decrease the risk of osteoporosis in postmenopausal women but does not have some of the side effects of estrogen. This osteoporosis medication can also help reduce the chance of some kinds of breast cancer. However, it can increase the risk of blood clots and hot flashes. In men, testosterone replacement therapy can help with bone density, but usually, other medications are recommended to decrease the risk of osteoporosis. 

Other osteoporosis medications

For people who cannot tolerate the common medications for osteoporosis, or for those who need more extensive osteoporosis treatment, doctors may recommend: 

• Teriparatide (Forteo): This medication stimulates the growth of new bone for osteoporosis treatment. It is injected under the skin.  
• Denosumab (Prolia): This medication is also given by injection and works better than bisphosphonates for osteoporosis treatment. Side effects may include muscle and back pain.

Osteoporosis prevention

There are three very important and straightforward ways to keep your bones healthy and prevent osteoporosis. They are:

• Make sure you get enough calcium
• Make sure you get enough vitamin D
• Make sure you get regular exercise

Calcium

Both men and women need calcium to keep their bones healthy and for osteoporosis prevention. If you are between 18 and 50 years old, you need 1,000 milligrams per day. If you are a woman, when you turn 50, you need 1,200 milligrams daily and if you are a man, increase your daily intake to 1,200 milligrams when you turn 70. The best sources of calcium to include in your diet are: 

• Cereals and orange juice fortified with calcium
• Soy products, like tofu
• Canned sardines or salmon, including bones
• Dark green leafy vegetables
• Low or no-fat dairy products

If you cannot get enough calcium from the foods you eat, ask your doctor to recommend a supplement. Be careful because taking too much calcium has been linked to kidney stones and heart problems. The total daily calcium intake, including diet and supplements, should not exceed 2,000 milligrams for people over the age of 50. 

Vitamin D

In order for your body to absorb calcium, vitamin D is needed. The sunlight is a good source of this vitamin, but many people do not get enough, especially those living in northern climates, those who are confined to the home, or those who use sunscreen or who avoid the sun due to skin cancer. The exact daily dose of vitamin D required has not been established, but most physicians recommend adults get 600 to 800 IU (international units) per day from diet and supplements combined. If blood studies show you are low in vitamin D, your doctor may recommend a higher daily dose. Up to 4,000 IUs per day are safe for adults and teenagers. 

Osteoporosis exercise

Regular osteoporosis exercise helps lower the loss of bone tissue and builds strong bones, and it provides the most benefits when it is started at a young age. Exercises for osteoporosis such as strength training can benefit you by strengthening the bones and muscles in the upper part of the spine and your upper arms.

A weight-bearing activity like running, stair climbing, skiing, walking, jogging mainly helps the bones in the lower spine, legs and hips. Osteoporosis prevention is still considered an osteoporosis treatment. Low impact activities like cycling, swimming, working out on machines, and training on elliptical machines are great at providing a workout for the cardiovascular system. Still, they do not provide as much benefit to the bones as weight-bearing exercises for osteoporosis.

Pathological changes

All types of osteoporosis are caused by the imbalance between the amount of bone being formed and the amount of bone being lost. Under normal circumstances, new bone is constantly being formed, in fact, up to 10% of all the body’s bone mass may be being replaced at one time. This process takes place through the work of special cells called osteoclasts and osteoblasts.

Osteoporosis develops either because as the bones grow and develop, they do not lay down a strong foundation, too much bone tissue is reabsorbed, or not enough bone tissue is formed, or any of these factors are working together. Hormones greatly influence the rate at which bone is reabsorbed. Calcium and vitamin D also has an impact on this. The structure and makeup of the bones also change with the process of aging and affect the development of osteoporosis.