Osteoporosis - Treatments

Last Updated on Thursday, 20 May 2010 23:56

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Osteoporosis Treatments

Medical treatment for osteoporosis usually focuses on slowing down or stopping the mineral loss. If you have broken a bone as a result of osteoporosis then you are more likely to break another. The aim of all treatments is to lower your risk of future fractures and there are a range of effective medications that do just that. Some are available only from specialists. Talk to your doctor about the best treatment for you.

Medical Treatments for Osteoporosis

HRT: Earlier, hormone replacement therapy (HRT) was commonly prescribed for postmenopausal women. However, this is no longer the case due to the frequent side effects of this treatment.
Bisphosphonates: Bisphosphonates have revolutionised the treatment of osteoporosis and are the most commonly prescribed treatment. Bisphosphonates are non-hormonal drugs that maintain bone density and reduce fracture rates. These include alendronic acid or alendronate (Fosamax), cyclical etidronate (Didronel PMO), ibandronate (Bonviva), risedronate (Actonel) and zoledronic acid (Aclasta).
Bisphosphonates work in primarily two ways, reduction in the rate of bone turnover and interference with the bone destroying action of osteoclasts. Bisphosphonates are all poorly absorbed when taken by mouth so it is important to take them on empty stomach.
Calcitonin: Calcitonin is a hormone produced by the thyroid gland and inhibits the cells that break down bone. Calcitonin is especially effective in active osteoporisis with rapid bone loss. Calcitonin also has a painkilling effect and has shown to reduce acute pain of crushed and fractured vertebrae in about 75% of cases. Calcitonin is primarily used for osteoporosis in post menopausal women for whom HRT is contraindicated. It is given by injection or nasal spray and has a number of potential side effects, including allergic reactions.
Selective Estrogen Receptor Modulators (SERMs): Selective Estrogen Receptor Modulators (SERMs) have a similar effect on bone as the hormone oestrogen. They help to maintain bone density and reduce the risk of fracture. Raloxifine (Evista) mimics oestrogen in working against osteoporosis, espcially of the spine. It has the added benefit of reducing cholesterol, countering artery and heart disease.

Supplement treatments for osteoporosis

Calcium: Calcium is the first line treatment for osteoporosis. Calcium, Vitamin D and Magnesium can help prevent the loss of calcium from your bones, especially after the menopause (Endocrinol Metab Clin N Am 1998, 27(2) 389-398). Increase your dietary intake of calcium to keep your bones strong by eating more cheese, sardines, broccoli and dark leafy vegetables.

Recommended Calcium Intake:

Teenagers: 1000mg
Men aged 20-60: 1000mg
Women aged 20-45:1000mg
Pregnant and nursing women: 1200mg
Women over 45 without HRT: 1500mg
Women over 45 with HRT: 1000mg
Men over the age of 60: 1500mg

Lifestyle measures

Weight bearing exercises such as walking and dancing, as well as muscle strengthening exercises are recommended. Regular exercise for at least 30 minutes a day is recommended to prevent further loss of bone mass. It may also result in a small increase in bone density.

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