Are These Osteoporosis Treatment Options Right for You?
If you’re reading this, chances are you have osteoporosis. You probably already understand that osteoporosis has no cure — once you’ve lost bone density, you can’t regain it. However, lifestyle modifications and medications can slow its progress. Some may even reverse it slightly — but never completely.
Medication Options by Gender
Some medications are hormonal and are only approved for women. These medications include calcitonin (Fortical and Miacalcin), estrogen, and estrogen agonists/antagonists (Evista).
Other medications are available for men and women. These include bisphosphonates (Actonel, Atelvia, Fosamax, and Reclast), denosumab (Prolia) and teriparatide (Forteo).
Bisphosphonates can be given to both men and women and they work by slowing bone loss. Depending on the drug, they may be given once weekly or once monthly. Reclast is actually given once yearly as an intravenous medication and is known to increase bone strength.
The downside to bisphosphonates is that they must be taken correctly — if they are not taken correctly, they are known to cause esophageal ulcers.
Estrogen agonists/antagonists have a mechanism of action similar to estrogen when it comes to protection of bone, but without some of the side effects of hormonal therapy.
Evista is known to build bone mass, similar to estrogen. Unlike estrogen, it does not increase the risk for breast or uterine cancer. However, it does increase the risk for blood clots.
Forteo is a synthetic form of parathyroid hormone (PTH). It increases bone density and actually causes new bone to grow.
Forteo is given via injection. The downside to this medication is that the injection is daily, as opposed to some of the other medications, which are much less frequent.
Hormonal Replacement Therapy (HRT)
HRT, such as estrogen or a combination of estrogen and progestin, prevent fractures and preserve the bone that is already there. However, estrogen therapy does increase the risk of breast and uterine cancer.
What Else Can Be Done?
As with all drugs, there are pros and cons to medication therapy. You should weigh the pros and cons carefully with your doctor when selecting a medication for your osteoporosis treatment.
That being said, there are a variety of other self-care measures that can be undertaken to preserve bone density.
Perhaps one of the best things you can do for yourself is quit smoking. Along with increasing the risk of a variety of types of cancers and chronic conditions, wreaking havoc on your skin and your blood vessels, it also speeds up bone loss. If you need one more reason to quit, this is it.
Start an exercise routine. Your exercise routine should include weight-bearing exercises for osteoporosis that promote balance and posture. These types of activities can reduce your risk of a fall, which in turn can decrease your risk of a fracture. They can also strengthen your bones.
Modify your diet to ensure you’re getting enough calcium. Calcium in food maintains bone. It is recommended that adults aged 19 to 50 get 1,000mg of calcium per day, and over the age of 50 get 1,200mg of calcium per day.
Calcium should ideally be taken in from food sources as research is showing that oral supplements may increase the risk of heart disease, but more research needs to be done. Foods that contain calcium include dairy products such as milk, yogurt and cheese, tofu, salmon, broccoli, cauliflower, and leafy green vegetables.
Ensure you’re getting enough vitamin D. Vitamin D helps the body to better absorb calcium. We can get vitamin D through food sources or through supplementation.