Osteoporosis Management

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OSTEOPOROSIS TREATMENT

Medication can help to decrease your risk of fractures. In addition to medication, there are other measures that you can take to improve the management of your condition. 

Your doctor can talk to you about the risks and benefits and help you decide about the best treatment for your situation.

CONSERVATIVE MANAGEMENT

Eating a balanced diet and being physically active can be beneficial at every stage of osteoporosis. Specific foods that contain nutrients such as calcium and vitamin D can help maintaining strong bones and the forming of new bone.

Sources of calcium include milk and other dairy products such as cottage cheese, yogurt, hard cheese and green vegetables like broccoli. Vitamin D is found in foods like orange juice, yogurt and fortified cereal,  where they add vitamin D. Many people do not get enough calcium and vitamin D from their diet. Your doctor might suggest nutritional supplements to help reduce your risks.

Exercise is an important way of maintain bone and muscle strength. You can do this by performing weight-bearing activities such as walking or jogging.

You should aim to include balance exercises as part of your routine – improving your balance can help to decrease your risk of falling and breaking a bone.  If you are not already physically active, you should start slowly and build up gradually to avoid injury.

Speak to your doctor or a physiotherapist if you are unsure about the exercises you should do. You care coach can also assist. 

MEDICATION

Below are examples of medication available to treat osteoporosis.

  • Bisphosphonates - Bisphosphonates are drugs that decrease the rate of breakdown and removal of bone. They are widely used for the prevention and treatment of osteoporosis in postmenopausal women. They need to be taken first thing in the morning on an empty stomach with a glass of water. You then need to wait 30 or 60 minutes, depending on which one you take, before eating or taking any other medication. Examples of bisphosphonates are alendronate and ibandronate.
  • "Estrogen-like" medications — There are drugs that cause some estrogen-like effects on the bone. These are called selective estrogen receptor modulators (SERMs). Examples include raloxifene and tamoxifen. This group of medication prevent postmenopausal bone loss. SERMs are not recommended for premenopausal women.
  • Hormone therapy — Estrogen may be an appropriate treatment for prevention of osteoporosis in young women whose ovaries do not make estrogen. This treatment may be given as a skin patch or orally, such as a birth control pill. An example is denosumab.
  • Parathyroid hormone/parathyroid hormone-related protein — Parathyroid hormone (PTH) and parathyroid hormone-related protein (PTHrP) are unique osteoporosis drugs because it is the only medication that works by increasing bone formation. PTH/PTHrP therapy is effective in the treatment of osteoporosis in postmenopausal women and in men. An example of a PTH drug is teriparatide and an example of a PTHrP analog is abaloparatide. These may be appropriate treatment options for some people with severe osteoporosis.

 

Written by Dr Ruusa Shivute | Health Window

Reference: Miller PD. Management of severe osteoporosis. Expert Opin Pharmacother. 2016;17(4):473-88.


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