How physicians treat osteoporosis
Treatment for osteoporosis actually begins in the teen years using an ounce of prevention. This is definitely one case where that ounce of prevention before the age of 30 is truly worth a pound of cure at 55 years. Although prevention is the safest option, the Federal Drug Administration does have several medication options which are available for treatment that currently appear to have a low side effect threshold.
Many of us would like to be able to take a quick pill and have the problem fixed. But, if you just take a pill the results will be much less than satisfactory. Treatment for a complex condition requires a treatment plan that encompasses several variables. Aside from the medications that are approved for treatment of osteoporosis there are other measures which should be instituted to receive the full benefits.
By getting the correct amount of calcium, vitamin D, vitamin K2, magnesium and weight bearing exercise in the teen years individuals will increase their bone mass density between the ages of 25 and 35. Although the most benefit from exercise in the treatment is in the early adult years it also has benefits in older adults to decrease the bone thinning process.
Weight-bearing exercises are important; however they do not need to be Olympian efforts. 30 minutes of weight-bearing such as weight lifting, jogging, soccer, tennis, rowing or racquetball a day is enough to see results in an individual of any age. The exercises should place stress on the bones so that although walking and swimming are great cardiovascular exercises they are not appropriate in the treatment of osteoporosis.
By changing lifestyle choices in individuals who are at risk for low trauma structures, individuals can also decrease their risk. Doctors and researchers know that cigarette smoking, excessive alcohol intake and the long-term use of corticosteroids all place in individual at greater risk for osteoporosis and the resulting fractures. By decreasing or eliminating these risk factors individuals can also help to improve the use of the medications or therapies that may be instituted in your treatment plan.
One of the first medication treatments used to stimulate the growth of new bone, as opposed to delay the thinning process, was Forteo. The active ingredient is a chemical part of human parathyroid hormones which works to regulate the use of calcium and phosphate in the bones. The medication is administered through daily injection. There have been strong cautions issued since the preapproval studies because of an increased incidence of osteosarcoma in laboratory rats. While the osteosarcoma is a rare but deadly cancer of the bone, researchers have found that the use of this medication in individuals who suffer from Paget\’s disease will place them at greater risk for developing this cancer. (1)
In mid-1990s the FDA approved the nonhormonal treatment of osteoporosis called alendronate and marketed as Fosamax. Fosamax falls into a class of drugs called bisphosphonates, which also includes Actonel. Both of these medications work by slowing the thinning of the bones and not by increasing the in amounts of bone laid down.
Evista is another drug used in the treatment of osteoporosis and is in a class of drugs known as selective estrogen receptor modulator\’s. This class of drugs is believed to work by allowing the medication to act on certain tissues as estrogen does but not on other tissue. So although it acts as estrogen on bone tissue it does not on soft tissue. Both Evista and Actonel have been shown in studies to reduce the risk of fracture in the spine.
Calcitonin is a pharmaceutical hormone supplement that has a role in calcium metabolism and improving the use of calcium in the building of new bone tissue. In the past it was available only as injection, but now the Federal Drug Administration has approved it as a nasal spray.
Interestingly, studies have also found that the use of fluoride, long known for fighting dental cavities, also stimulates building new bone. However, the bone that is built is usually abnormal and weaker than normal bone in patients with osteoporosis. Unfortunately, many of the drugs also known for building bone in individuals with osteoporosis, do not build bone in the same manner in which the body normally does. In other words, the microstructure continues to be abnormal and the bone is not as strong. (2,3)
In some studies individuals have found using estrogen in women also taking the class of drug bisphosphonates has had good results. However, since hormone replacement guidelines changed in 2003 because of the increased risk of breast, ovarian and uterine cancer there are many less women taking hormone replacement therapy.
Most importantly however, is the integration of calcium, vitamin D and vitamin K2 in to the treatment plan for anyone who has osteoporosis. These vitamins and minerals are necessary for the body to either slow the process of osteoporosis or lay down new bone-whether instigated by exercise or medication. It is possible to take an excessive amount of calcium. So while it may be necessary for the treatment of osteoporosis, an excessive amount will also cause painful kidney stones.
http://www.ncbi.nlm.nih.gov/ Teriparatide Injection
(2) Australian Dental Journal: Water Flouidation, Osteoporosis, Fractures
(3) Linus Pauling Insitute Oregon State University: Flouride