Treatment and prevention of osteoporosis
Diet and Medication
Diet
We need to help children and teens build up their bone strength as they grow. To do this we need to improve their intake of calcium and vitamin D.
| 1-10 | 1,000 mg |
| 11-18 | 1,600 mg |
| 19-50 | 1,100 mg |
| 50 and older | 1,500 mg |
One glass of milk contains about 300 mg (milligrams) of calcium, which is 30% of USRDA on nutrition labels. Click for more information on calcium in foods.
Good sources of calcium include lowfat yogurt, lowfat milk, cheese, salmon, and broccoli. Look for foods which have added calcium, such as orange juice, cereal, or bread. If dairy products upset your stomach, you can take calcium supplements. The best supplements also have vitamin D added. Avoid foods with large amounts of sodium or salt because large amounts of sodium or salt can actually make your body lose calcium.
Just having enough calcium in your diet does not guarantee you will not get osteoporosis, but it is good prevention.
Your body cannot absorb calcium without Vitamin D, so it's also important to have Vitamin D in your diet. It's recommended to get between 400 and 800 International Units (approximately .01 to .02 mg) of Vitamin D daily- consult your food's nutrition labels or a doctor for more information. (Taking more than 800 International Units can be harmful.)
Good sources of Vitamin D include sunshine, milk, breads and cereals, egg yolk, fish, butter, and multi-vitamins.
Medication
Three main medications are used to treat osteoporosis:
- Fosamax (alendronate sodium):
Fosamax must be taken on an empty stomach, first thing in the morning. It must be taken with a large glass of water at least thirty minutes before eating or drinking. It's recommended to drink some water first to lubricate your throat and esophagus. You must remain upright during the thirty minutes after taking Fosamax. It decreases fractures of spine, hip, and wrist by about 50%.
Five and ten milligram doses are used for treatment. Some side effects reported include: severe heartburn, chest pain, abdominal or stomach pain, headache, bone pain, and difficulty swallowing.
- Actonel (risedronate sodium):
Actonel, an antiresorptive agent, should be taken on an empty stomach with a large glass of water at least 30 minutes before eating. It may be tolerated by patient with active gastrointestinal disease.
Contraindicated in patients unable to sit or stand upright for at least 30 minutes.
The dosage used for prevention is 5 milligrams daily or a 35 milligram dose once a week. Adverse reactions include dysphagia, esophagitis, esophageal or gastric ulcer, gastritis, abdominal or stomach pain and bone pain.
- Miacalcin (calcitonin):
Salmon calcitonin is a hormone that stops bone destruction. It is taken in a nasal spray form that provides 200 units of the drug. There is an injectable form but it is rarely prescribed. It is considered safe but a somewhat less effective intervention for osteoporosis. However, it can decrease spine fractures by about 40%, and is frequently used to reduce the pain of spine fractures.
It is usually used as an alternative to hormone replacement therapy or Fosamax. It's recommended for women who are more than five years after menopause. Some side effects reported include: runny nose, nosebleed, back and/or joint pain, headache, nausea, vomiting, diarrhea, and allergic reaction (if you are allergic to calcitonin-salmon).
- Evista (raloxifene):
Evista is a selective estrogen receptor modulator , which means it provides beneficial effects of estrogen without some of the dangerous side effects. It's another alternative to treat osteoporosis for patients who are after menopause. It prevents bone loss and reduces spine fractures 40-50%.
Reported side effects include blood clots, hot flashes, and leg cramps.
- Note: when taking medication for osteopenia or osteoporosis, you should also take calcium with a Vitamin D supplement.
Too much calcium?
If a person takes in 3,000 to 4,000 milligrams of calcium per day, their kidneys may not be able to clear the excess out, and the person will have an increased risk of kidney stones.
3,000 to 4,000 milligrams of calcium daily is roughly equivalent to 12 glasses of milk or 18 antacid tablets with calcium per day.
Exercise
Weight-bearing exercise is important for the treatment and prevention of bone thinning. The best exercise for this is walking at a fast pace several times per week. Weight training programs also help increase bone mass, but swimming does not help build bone mass as much as other exercises. Before people over age 40 start any exercise program, we recommend seeing a doctor to make sure exercise is safe and there are no medical reasons that would prevent exercising safely- like high blood pressure or heart problems. People at risk for osteoporosis may wish to have a bone densitometry test before starting their exercise program. It is recommended that people exercise four to six times per week, especially for those who are not active at work.
People who already have thinning bone should see a physical therapist to help design an exercise program that will minimize their chances of bone fracture during exercise.
Decreasing your risk of fracture
People need to make healthy choices to decrease their risk of fracture.
- Quit smoking.
- Limit alcohol consumption.
- Ensure that your house is safe- remove throw rugs that can be tripped over or slipped on.
- Walk with an appropriate cane or walker if you are unsteady.
- Turn lights on so the elderly can see what is in their path when walking.
- Improve strength to improve steadiness and balance when walking.
- Eat properly and exercise .