Osteoporosis is a disease that weakens bones to the point where they break easily—most often, bones in the hip, backbone (spine), and wrist. Osteoporosis is called a “silent disease” because there typically are no symptoms in the early stages of bone loss, until developing fractures or collapsed vertebra results in back pain.
There are many medications available to treat osteoporosis and reduce the risk of fracture. They fall into two basic categories: antiresorptives and anabolics.
With antiresorptive medicines, the goal of treatment is to prevent further bone loss and reduce the risk of fractures. Antiresorptive drugs include bisphosphonates (alendronate, ibandronate, risedronate, zoledronic acid), denosumab, calcitonin, estrogen/estrogen-progestin, an estrogen agonist/antagonist (raloxifene), and a tissue specific estrogen complex (estrogen/bazedoxifene). Antiresorptive drugs work by slowing the resorption or breakdown part of the remodeling cycle.
With anabolic medicine, the goal of treatment is to rebuild bone, increase bone mass, repair microscopic defects in bone, and reduce the risk of fractures. Anabolics work by stimulating the formation part of the remodeling process. More bone is formed than is taken away. The result is stronger bone that is less likely to break. Teriparatide, a parathyroid hormone analog, and abaloparatide, a parathyroid hormone-related protein analog, are the FDA-approved anabolic medicines available on the market.
All of these drugs reduce the likelihood of having fragility fractures. They come in a range of formulations, from daily tablets to yearly intravenous infusions. There is no best medication for everyone. Individual health history and preferences are taking into considerations by the health care provider.
How Long to Take Osteoporosis Medications?
Teriparatide and Abaloparatide are the only drugs for osteoporosis that have a defined treatment length. The FDA recommends that treatment be limited to no more than two years. There is a great deal of variability in terms of ideal treatment duration for other medications. Some drugs, like raloxifene and denosumab, leave the body quickly. Their effects generally disappear after one stops taking them. Some drugs, like bisphosphonates, stay in the bones after stop taking them — some longer (alendronate, zoledronic acid) than others (risedronate, ibandronate). They may continue to work and offer protection even after one stops taking them. The most effective regimen and duration depends on the individual drug, the individual patient, and her/his level of fracture risk.
With effective drug treatment, bone density stays the same or improves without additional fractures.
Maintain Normal Calcium and Vitamin D Levels
Annual physical and blood work is important to check calcium and vitamin D levels. Bone density screening should be planned at least every two years or as recommended by the Doctor, who will also recommend supplements for your needs. These preventive measures are covered by most health insurance policy.
Whatever medication prescribed to protect your bones, it won’t work without enough calcium and vitamin D. Calcium tablets are good for filling in when you can’t get enough in your diet, but it is always better to get calcium from food. Because there are not as many food sources of vitamin D, supplements are generally recommended for most people.
Although there are effective treatments, primary prevention is mostly based on lifestyle changes:
Balance diet with rich protein, calcium and vitamin D. Eat more vegetables, fruits and whole grains. Choose healthy sources of protein and fat
Limit sugar, salt and phosphate additives: Too much salt in your diet also can be harmful. Not only can salt cause high blood pressure, but too much salt also can increase the amount of calcium you excrete from your body with urination. Aim for a limit of 2,300 mg of salt daily — the equivalent of about one teaspoon. Phosphorus is used as an additive in many processed foods. Too much phosphorus in your diet can interfere with how much calcium is absorbed through your small intestine.
Take calcium and vitamin D supplements, if dietary intake is insufficient. Women over 50 and all adults over 70 should get at least 1,200 mg of calcium each day, as recommended by NIH.
Sunshine is important to maintain adequate vitamin D levels, as sun exposure is the natural way the body makes vitamin D.
Exercise regimen including weight- bearing physical activities (walking/jogging), resistance and balance.
Maintain normal BMI/body weight, not smoking, limit alcohol and caffeine consumption.
Action call: Take action for your bone health today; don’t put it off. Contact QualityLifeForum@outlook.com for a free call. An individualized coaching program can help you achieving your personal health goals.
Osteoporosis are far more common in women than men. Menopause is the most common cause of osteoporosis in women. Preventing bone loss is an important concern in the menopause and during post-menopausal stages. Osteoporosis is a disease that weakens bones to the point where they break easily—most often, bones in the hip, backbone (spine), and wrist. Osteoporosis is called a “silent disease” because there typically are no symptoms in the early stages of bone loss, until developing fractures or collapsed vertebra results in back pain. Medications are available for effective treatment. Maintain adequate calcium and vitamin D levels are essential. Healthy and active life style benefits bone health for life time.
Disclaimer: This information is for educational and informational purposes only. It is not medical advice. Consult your healthcare professional for personal conditions.
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