Osteoporosis Treatment – What's Available?
With contributions from Josh Duvachelle.
If you’re reading this, chances are you have osteoporosis. You probably already understand that osteoporosis has no cure. However, lifestyle modifications and medications can slow its progress. Some treatments for osteoporosis may even reverse it slightly and allow the bone to rebuild to some degree.
And you’re not alone! According to the International Osteoporosis Foundation (IOF), osteoporosis affects over 200 million women worldwide. Osteoporosis is the cause of 8.9 million fractures annually, which equates to an osteoporotic fracture every three seconds.
Also, osteoporosis is costly – according to the National Osteoporosis Foundation (NOF), fractures related to osteoporosis cost families and the healthcare system an estimated $19 billion annually. And this number is only expected to increase.
What is Your Best Osteoporosis Treatment Option?
According to the National Osteoporosis Foundation, your best strategy for fighting bone loss depends on a few key factors:
Your Age
Some medicines, such as certain estrogen treatments, are more appropriate for specific chapters of life.
For example, the NOF warns: “Osteoporosis medication is not recommended for healthy premenopausal women. However, young women who take medications or have disorders known to cause bone loss and fractures may benefit from osteoporosis treatment.”
Your Current Bone Strength Status
Some approaches, such as changing your diet, help to restore calcium to your bones. Others, such as weight-bearing exercise, reduces bone loss. The same is true for different herbal, alternative and conventional medications.
“A person with more severe bone loss or multiple broken bones may be recommended a different medicine than a person with less bone loss or no fractures,” reports the NOF.
Your Overall Health
Many women who have osteoporosis may also experience other health issues, such as high blood pressure, stress, diabetes, etc. Your doctor will look at your overall health to find the safest and most effective options for yourself.
Take estrogen-based osteoporosis remedies, for example. If you have had breast cancer or have a family history of breast cancer, your doctor may recommend against taking estrogen.
There is no one-size-fits-all approach to managing osteoporosis. But by looking at the big picture, and understanding your many treatment options, you can put together a plan with your doctor that helps you live our life to the fullest and enjoy optimal bone health and wellbeing.
Osteoporosis Medication Options and Information
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
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.
This drug class is the most commonly prescribed for osteoporosis. According to News Medical, “Bone is constantly undergoing a turnover process in which osteoblasts create bone and osteoclasts destroy it. Bisphosphonates inhibit the actions of osteoclasts by promoting their apoptosis (programmed cell death), which, in turn, slows bone loss.”
The benefit of bisphosphonates, aside from the fact that they slow down bone loss, is that they can also decrease bone pain associated with osteoporosis. Also, in cancer patients with bone damage, bisphosphonates are known to reduce the need for radiation and lower the risk of fracture.
Bisphosphonates can be broken down into two subclasses, which differ based on their mechanism of action:
- Nitrogenous bisphosphonates: pamidronate, alendronate, and zoledronate.
- Non-nitrogenous bisphosphonates: etidronate, clodronate and tiludronate.
The downside to bisphosphonates is that they must be taken correctly — if they are not taken correctly, they are known to cause esophageal ulcers.
