What is the treatment for osteoporosis?
Treatments for osteoporosis focus on slowing down or stopping bone loss, preventing bone fractures by minimizing the risk of falls, and controlling pain associated with the disease. Treatment is aimed at increasing bone density. Doctors treat osteoporosis by prescribing calcium and vitamin D, by recommending weight-bearing exercises and by modifying other risk
factors. In addition, several effective medications are available. For women, estrogen replacement therapy, alendronate (Fosamax), risedronate (Actonel), raloxifene (Evista) and nasal calcitonin (Miacalcin),
The first step is to consume or take an adequate daily amount of calcium and vitamin D. Daily intake of 1200-1500 mg (through diet and supplements) is recommended. Take calcium supplements in doses of less than 600 mg. Your body can only absorb so much at one time. The best way may be to take one supplement with breakfast and another with dinner. Daily intake of 600-800 IU of vitamin D is needed to increase bone mass. If dietary intake of calcium is inadequate, you can obtain calcium through supplements. Calcium carbonate or calcium citrate are the preferred calcium supplements. Vitamin D is also needed to help the body absorb calcium. Most people obtain enough vitamin D through diet and through the action of ultraviolet rays from the sun on skin. You can learn more about these supplements by clicking on the link below.
Bisphosphonates are a type of drug used for both the prevention and treatment of osteoporosis in postmenopausal women. The two bisphosphonates currently approved for osteoporosis - alendronate (Fosamax) and risedronate (Actonel) - prevent existing bone loss and reduce the risk of spinal and hip fractures. These bisphosphonates have been shown to increase bone mass in the spine and hips and reduce the incidence of fractures. A bisphosphonate must be swallowed with a full glass of water (6 to 8 ounces) on arising for the day, and no other food, drink, or drug should be consumed for the next 30 minutes. Because bisphosphonates can irritate the lining of the esophagus, the person must not lie down after taking a dose for at least 30 minutes, and then must not lie down until after something has been eaten.
For most women who've gone through menopause, the best treatment for osteoporosis is hormone replacement therapy (HRT), also called estrogen replacement therapy. Many women participate in HRT when they undergo menopause, to alleviate symptoms such as hot flashes, but hormones have other important roles as well. They protect women against heart disease, the number one killer of women in the United States, and they help to relieve and prevent osteoporosis. HRT increases a woman's supply of estrogen, which helps build new bone, while preventing further bone loss.
For people who can't or won't take estrogen, two other medications can be good choices. These are alendronate and calcitonin. Alendronate and calcitonin both stop bone loss, help build bone, and decrease fracture risk by as much as 50%. Alendronate (sold under the name Fosamax) is the first nonhormonal medication for osteoporosis ever approved by the FDA. It attaches itself to bone that's been targeted by bone-eating osteoclasts. It protects the bone from these cells. Osteoclasts help your body break down old bone tissue. Calcitonin, a hormone that inhibits bone resorption, comes as a nasal spray that is approved for treatment of osteoporosis. It is generally considered a safe but possibly less effective treatment for osteoporosis. The main side effects of calcitonin are nasal irritation from the spray form, and nausea from the injectable form. While calcitonin slows bone loss and reduces the risk of fractures, it appears to be less effective than ERT or biphosphonates. As with some of the other newer medications, it is significantly more expensive than ERT.
A number of drugs known as selective estrogen-receptor modulator (SERM) have been designed with the goal of producing the same benefits that estrogen has on the bones and cholesterol levels without increasing the risk for hormone-related cancers.The goal of these agents is to maximize the beneficial effect of estrogen on bone and to minimize or antagonize the deleterious effects on the breast and endometrium. Raloxifene, a SERM approved by the FDA for the treatment and prevention of osteoporosis, has been shown to reduce the risks of vertebral fracture by 36 percent in large clinical trials. Tamoxifen, used in the treatment and prevention of breast cancer, can maintain bone mass in postmenopausal women. However, effects on fracture are unclear. Raloxifene (Evista) is selective estrogen-receptor modulator used for the prevention and treatment of osteoporosis. Raloxifene can reduce the risk of spinal fractures by almost 50%.
A form of parathyroid hormone, called teriparatide (Forteo), was approved for treating osteoporosis. Given by a daily injection, it will probably be reserved for the worst cases of osteoporosis, those that failed to respond to other treatments. Although high persistent levels of parathyroid hormone can cause osteoporosis, daily injections of low and intermittent doses of this hormone actually stimulate bone production. Unlike most treatments for osteoporosis, including bisphosphonates, the benefits may persist even after the injections have been stopped.
There are no surgeries specifically for treating osteoporosis itself. However, a procedure called vertebroplasty can be used to treat any small fractures in your spinal column due to osteoporosis. It can also help prevent weak vertebra from becoming fractured by strengthening the bones in your spinal column. The procedure involves injecting a fast-hardening glue into the regions that are fractured or weak. A similar procedure, called kyphoplasty, uses balloons to widen the spaces that need the glue. (The balloons are removed during the procedure.)
Lifestyle modification should also be incorporated into osteoporosis treatment. Exercise is very important for slowing the progression of osteoporosis. Although mild exercise does not protect bones, moderate exercise (more than three days a week for more than a total of 90 minutes a week) reduces the risk for osteoporosis and fracture in both older men and women. And everyone who is in good health should aim for more. Exercise should be regular and life-long. Before beginning any strenuous exercise program, older patients, those at risk, or those who have serious medical conditions should have a general physical examination.
More information on osteoporosis
What is osteoporosis? - Osteoporosis is a thinning and weakening of the bones, usually associated with the aging process. Osteoporosis is a disease, often with no detectable symptoms.
Building and maintaining skeletal health - Factors involved in building and maintaining skeletal health are adequate nutrition and body weight, exposure to sex hormones at puberty, and physical activity.
What types of osteoporosis are there? - Osteoporosis can be classified in various ways based on diagnostic categories, etiology. Osteoporosis can be classified as either primary osteoporosis or secondary osteoporosis.
What causes osteoporosis? - Osteoporosis is related to the loss of bone mass that occurs as part of the natural process of aging. Osteoporosis results when there is excess bone loss without adequate replacement.
What are the risk factors for osteoporosis? - Many disorders are associated with increased risk of osteoporosis. Osteoporosis is far more prevalent in women after menopause due to the loss of the hormone estrogen.
What're the risk factors for primary osteoporosis? - Risk factors for primary osteoporosis include age, gender, race, figure type, lifestyle, diet, and lack of sunlight.
What're the risk factors for secondary osteoporosis? - Risk factors for secondary osteoporosis include genetic disorders, hypogonadal states, endocrine disorders,hematologic disorders, nutritional deficiencies, drugs.
What are the consequences of osteoporosis? - Consequences due to osteoporosis are increased risk of fracture with minor trauma, frequency of traumatic events from lifting and bending impact.
What are the symptoms of osteoporosis? - Patients with uncomplicated osteoporosis may be asymptomatic or may have pain in the bones or muscles, particularly of the back. Osteoporosis becomes apparent in dramatic fashion.
How is osteoporosis diagnosed? - The diagnosis of osteoporosis is usually made by your doctor using a combination of a complete medical history and physical examination.
What're the treatments for osteoporosis? - Treatment for osteoporosis includes eating a diet rich in calcium and vitamin D, getting regular exercise, and taking medication to reduce bone loss and increase bone thickness.
What osteoporosis medications (drugs) are available? - Medications (drugs) to cure osteoporosis include bisphosphanates (Fosamax), calcitonin (Miacalcin), raloxifene, estrogen, and selective estrogen receptor modulators (SERMs).
How to treat osteoporosis in men? - Alendronate and teriparatide have been approved to treat osteoporosis in men. Calcitonin may work in men, treatment with testosterone appears to increase bone density.
How to treat osteoporosis in women? - The non-hormonal bisphosphonate drugs, alendronate and risedronate prevent and treat postmenopausal osteoporosis. Raloxifene is approved for preventing and treating osteoporosis.
What lifestyle changes can help osteoporosis? - Alcohol consumption should also be kept within safe limits. Supplements of calcium plus vitamin D may help maintain bone density. Limiting sodium and avoiding junk food.
What osteoporosis exercises are suggested? - Exercise is very important for slowing the progression of osteoporosis. Taking regular exercise is the single most important action improve the strength of their bones.
What osteoporosis diet is suggested? - A good calcium intake is essential throughout life for healthy bones. Vitamin D helps the absorption of calcium from the intestines. Reducing salt may be useful for osteoporosis patients.
What can be done to prevent osteoporosis? - For prevention and treatment of osteoporosis, patients should be encouraged to stop smoking, limit alcohol consumption and perform weight-bearing exercise.
Osteoporosis and calcium - Calcium could alter the physical-chemical properties of the bone mineral. The daily recommended dietary calcium intake varies by age, sex, and menopausal status.
Osteoporosis and magnesium - Magnesium supplementation is as important as calcium supplementation in the treatment and prevention of osteoporosis.
Osteoporosis and vitamin D - Vitamin D is necessary for the absorption of calcium in the stomach and gastrointestinal tract and is the essential companion to calcium in maintaining strong bones to prevent osteoporosis.