The best form of treatment is prevention. This is fundamental to osteoporosis. This disease can be improved by the proper use of nutrients, exercise and hormones.
Every positive lifestyle change helps, even to those who are genetically predisposed to greater bone loss.
The bone tissue that has already been lost over the years cannot be easily replaced, but there is some evidence that treatments can lead to an increase in bone density, in particular hormone replacement therapy (HRT). The main aim of other forms of osteoporosis treatment is to minimise further bone loss.
Preventive Measures
The following preventive measures are based on minimising the influence of ageing on the progressive loss of protein and calcium from the bone.
The changes in lifestyle will be beneficial at any time, and work best together. It must be appreciated that the benefits obtained only last as long as the positive, healthy lifestyle lasts. As with medical treatments, bone loss will re-occur if your way of life begins to slip into a less healthy routine.
Nutrients - a balanced diet
Calcium is an essential component of bone, but there are many others required for bone development and maintenance such as vitamins D, K and C, magnesium and copper.
Vegans potentially have a greater risk of a low dietary intake of calcium. Alternative calcium food sources include vegetables and cereals.
Excess alcohol damages the process of bone turnover. Sticking to a moderate intake is recommended.
Slimming diets often involve reducing the intake of calcium rich foods such as dairy products and can result in low levels of the protective oestrogen if taken to the extreme.
Stop smoking
Smoking more than doubles the risk of osteoporosis. It exerts a toxic effect on bone in men and women alike, and can cause women to have an early menopause. It may also increase the risk of hip fracture in later life.
Supplements
Calcium and vitamin D supplements may be beneficial. Women going through the menopause are often recommended to increase their calcium intake to 1500 mg per day, which can be difficult to obtain without the help of supplementation.
Calcium supplementation has been shown to be beneficial in slightly decreasing bone loss in women who have passed through the menopause more than 5 years previously, but is not an effective treatment on its own. Calcium supplements taken at the same time as HRT can, however, reduce the oestrogen dose required for HRT.
A combined calcium and vitamin D supplement may be particularly useful for the elderly and housebound, who receive little sunlight or have a poor diet. This option should be discussed with your doctor first of all, as extra calcium is not advisable for those with a history of kidney stones.
Take exercise - weight bearing
A lack of weight bearing exercise, such as walking, predisposes to suffering from osteoporosis. Exercise is required to strengthen the bones through stressing them.
Hormone Replacement Therapy (HRT)
The main treatment for osteoporosis can also be used in its prevention. Hormone replacement therapy (HRT) helps to decrease the rate of bone loss, particularly after the menopause.
To ensure the full benefits, HRT should be started within 5 years of the menopause.
HRT also be used to treat men with the condition, due to the fact that testosterone increases bone density. This treatment can be used in men even if there is no defficiency in the male sex hormones.
HRT increases the bone density in the spine and hip and decreases the risk of hip and spinal fractures in post-menopausal women. It needs to be continued for many years for the long-lasting benefits, but can be effective even at the age of 70. The treatment is available in over 30 different forms, as tablets, skin patches, implants or gels.
SERMS - An alternative to HRT
More and more women are looking towards an alternative to HRT, due to its associated risks.
There is a new generation of synthetic hormone replacement, known as SERMs (Selective Estrogen Receptor Modulators) which reduce the risk of osteoporosis and heart disease, but apparently do not have the increased risk of certain cancers that accompany traditional HRT. Raloxifene is licensed for the prevention and treatment of osteoporosis in post-menopausal women.
Ipriflavone and Isoflavones
Ipriflavone is a synthetic isoflavone derivative which appears to inhibit bone resorption.
Medicinal Intervention
Other medicines available to treat osteoporosis are:
- Calcitonin is a hormonal injection that prevents the osteoclasts (cells that break down bone) from working properly, so allowing the osteoblasts (bone building cells) to work more efficiently. One form, Salcatonin (Calsynar) is licensed for the treatment of post-menopausal women. The injection may also be given to men who have started to develop the disease, to prevent further bone loss, by inhibiting the release of calcium from the bone. The injection has a pain killing effect, and can be used for a short time after a spinal fracture.
- Biphosphonates (non-hormonal) work by turning off the osteoclasts, so allowing the osteoblasts to work more efficiently. There are three types; Cyclical disodium etidronate (Didronol PMO) with calcium carbonate which is used for osteoporosis of the spine; Alendronate sodium (Fosamax), which has a similar action to etidronate, and claims to be effective at reversing osteoporosis at other important bones as well; and finally risedronate (Actonel). Both the etridonate and alendronate are licensed for the treatment of osteoporosis caused by corticosteroids and for the prevention of osteoporosis in women who have low bone mass.
- Calcitriol is a synthetic form of active vitamin D, for the absorption of calcium, and is used for the treatment of osteoporosis of the spine.
20/05/2009