Treatment and Prevention of Osteoporosis

This is my 3rd consecutive post on osteoporosis. Previously we have learned about some important informatio as well as risk factors of developing of osteoporosis. Today we will learn about the treatment options and preventive measures.

So, What are the treatment option?

The goal of treatment is to prevent osteoporosis or reduce further loss of bones!

Read the previous sentence again.

Number one goal is to prevent osteoporosis. And number two is to reduce further loss of bones. That means our main concern must be on preventing developing of osteoporosis and unfortunately, if already developed, then to reduce further loss. The ways of reversing the process of osteoporosis and regaining the lost bones are yet to come. No treatment is available which can replace the lost bones effectively. Some agents have shown effectiveness in preventing further loss of bone but their side effects are also problematic.

Following treatment options are available which help the patient preventing further loss of bone and hence preventing fractures. The important side effects are mentioned too.

• HRT(Hormone replacement therapy)- Long-term use may cause breast cancer
• Bisphosphonates: Oesophagitis and osteonecrosis of the jaw are two important side effects. ( Alendronate, etidronate, risedronate, zoledronic acid, etc are included in this group)
• Raloxifene: Some reports of vascular complications
• Teriparatide: It has potentiality in increasing bone formation
• Denosumab: Osteonecrosis of Jaw is the side effect.
  image source
  image source

What preventive measures should be taken?

• Adequate intake of Calcium either through diet or oral supplementation: Recommended daily dose of calcium is 1200-1300 mg per day for both sex. Postmenopausal lady and those whose dietary intake is not adequate (due to any reason) should take oral supplementation of calcium. Usually, two forms of oral calcium tablets are available; calcium carbonate and calcium citrate. Anyone of them can be taken but later one is absorbed better in the digestive tract.

• Sunlight exposure and Vitamin D supplementation: Significant exposure to sunlight of the face, arms and hands are necessary to produce enough vitamin D in our body. As per rule, at least 15-30 minutes exposure (in all climate but in winter it might need up to 50 minutes per day) is required for getting sufficient natural vitamin D. People at risk should measure their blood vitamin D level (25-hydroxy vitamin D) and if the count is below the optimal level (at least 75 nmol/L), oral supplementary Vitamin D should be taken. In that case, daily 25-50 mcg or 1000-2000 IU of vitamin D in the form of cholecalciferol have to be taken orally.

• Regular exercise: Moderate exercise against gravity such as walking ( a brisk walk of 30 times at least 4 times per week), running, jogging is better to do on regular basis.

• Lifestyle moderation: Smoking cessation is highly recommended. Limiting alcohol and caffeine intake are highly appreciated. Improve nutritional status (if not optimum) and maintain BMI over 18. Taking extra care to prevent fall is necessary ( avoid sedative medications).

• Use hip protectors: Osteoporotic patients may wear hip protectors
  
  image source A picture of a hip protector

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