People with osteoporosis have a decreased bone density and an increased risk of fractures. Normally, bone constantly undergoes a cycle of formation and break down. When this balance tips in favour of bone resorption, it leads to a loss in bone mass over time and can result in osteoporosis. Factors that can contribute to this process include menopause, aging and poor nutrition. Medications for the treatment of osteoporosis work by aiming to alter this cycle, either by slowing bone resorption, or promoting bone growth. Lifestyle changes, including proper nutrition and exercise, are also important in osteoporosis treatment.
Osteoporosis literally means bone that is porous. Bones that are affected by osteoporosis become weaker and very brittle, and are susceptible to being easily fractured. Osteoporosis often occurs as a result of deficiencies of calcium. In women, it can also occur due to bone loss that is associated with menopause. Both men and women can be affected by osteoporosis, however, women are more prone to fractures. In the early stages of osteoporosis, there are usually no noticeable symptoms. When osteoporosis has advanced, you become at increased risk of fractures of the hips, spine and wrists, and may experience back pain. Severe osteoporosis can alsocause spinal deformities (kyphosis) and height loss as a result of a collapse vertebrae in the spine.
Medications for Osteoporosis
Bisphosphonates are drugs that prevent or slow down the break down process of bone. People who take bisphosphonates lose less bone mass but continue to build new bone, which gradually results in an increase in bone density. Some bisphosphonate medications also have calcium or vitamin D supplements added to them. Because bisphosphonates remain in bone for a long time, they usually continue to have beneficial effects for years after a patient stops taking them. The medication Recast is an IV form of bisphosphonate which only requires administration once each year to treat osteoporosis.
Calcitonin is another drug that prevents bone resorption. It is available as an injection or nasal spray. Calcitonin is a hormone that is naturally found in the body, where it has a role in regulating bone metabolism and the levels of calcium in bone. It is used to treat women with osteoporosis who are 5 years or more post menopause.
Raloxifene is a medication that is part of a class of drugs known as selective estrogen receptor modulators (SERMs). It mimics the effects of estrogen. Normally, estrogen plays a role in maintaining bone density in the body, and raloxifene has the same effect. It is occasionally used instead of hormone therapy in the treatment of women with osteoporosis.
Post menopausal women with osteoporosis also have the option of using hormone therapy, which is a combination of estrogen and progesterone. As already mentioned, estrogen helps to maintain bone density, and when estrogen levels fall following menopause, bone loses this protection. Hormone therapy aims to restore the protective effect of estrogen and prevent the loss of bone density. This treatment is available as a pill or a patch.
Another medication available for both men and women is Teriparatide, which is a parathyroid hormone that works by slowing bone loss as well as increasing the production of new bone. This is a type of drug is known as an anabolic drug, as it promotes the synthesis of new bone. It is administered as a daily injection for a maximum of 2 years.
Non-medicative treatment of osteoporosis
Proper nutrition and dietary modifications can be helpful in he treatment of people with osteoporosis. Ensuring good nutrition in the diet provides nutrients to help form and maintain bone. Increasing the amount of fruits and vegetables consumed in the diet can be beneficial for improving bone health and strength. Diets should have a good intake of calcium and vitamin D, which can be obtained from food sources or supplements. Foods that provide a good source of calcium include dairy products such as cheese, milk, and yoghurt, leafy green vegetables such as spinach, tofu, and salmon. Individuals with osteoporosis should also stop smoking and limit their intake of alcohol, as they have been found to negatively affect bone.
Exercise is also an important way of preventing and treating osteoporosis. Exercise helps improve bone health, as well as increase muscle strength, balance and coordination. Particularly, weight-bearing exercises are recommended, such as walking, jogging, and dancing. Other beneficial exercises include strength training and balance activities. However, individuals with osteoporosis should avoid exercises that involve a risk of falling, or high impact exercises that may result in fractures.