Osteoporosis: Treatment and Safety Tips
According to the National Osteoporosis Foundation, around 44 million Americans either have osteoporosis or have low enough bone mass that they're at risk for the disease. For women, the disease usually begins to set in after menopause when estrogen production slows. Studies have shown that slender women as well as white and Asian women are at greater risk than others.
My doctor says I have osteoporosis. What can I do about it?
Prevention is key, but there's a great deal you can do to keep from losing more bone and to increase your low bone density.
Men over 50 will be advised to exercise and increase calcium and Vitamin D in their diets (see below). Women, who are often more severely affected by the disease, will get the same advice and one or more of the following drug treatments may be recommended as well.
Bisphosphonates (brand names Fosomax, Actonel): These drugs reduce bone loss, increase bone density, and reduce the risk of fractures.
Calcitonin (brand names Miacalcin, Calcimar, Fortical): This is the synthetic version of a natural hormone given to postmenopausal women to slow bone loss, increase spinal bone density and reduce the risk of spinal fractures.
Raloxifene (brand name Evista): This drug offers estrogen-like benefits to bone.
Parathyroid hormone (Brand name Forto): This drug is given to postmenopausal women and men who are at high risk for a fracture. It stimulates new bone formation and increases bone density.
Be sure to talk to your doctor about the benefits and risks of each therapy, so that together you can choose the one that's best for you.
What can I do to slow down further bone loss if I already have osteoporosis?
As with most health issues, diet and exercise are the key to getting and staying healthy. Exercise and good nutrition can slow down bone loss, and may even be able to reverse it in some cases. Here are some tips:
Watch your weight. Try to put on some pounds if you're underweight.
Diet. You need a diet rich in both calcium and Vitamin D, which helps your body absorb calcium and build strong bones. Experts recommend that men and women under 50 consume at least 1,000 mg (many say 1,200 mg) of calcium per day. People over 50 should consume 1,200 mg. The National Osteoporosis Foundation recommends 800 to 1,000 IU of vitamin D for anyone age 50 or older. The best option is to get the nutrients naturally. For calcium, eat dairy products and green leafy vegetables; for vitamin D, seek out fortified products (like milk and cereal) or foods naturally rich in vitamin D like eggs and salmon.
Get some sunshine. Sunlight also gives us vitamin D, so try to get at least 10 to 15 minutes of direct early morning or late afternoon sunlight on your face and arms three times a week. If you can't get all of the right nutrients naturally, you can take calcium and vitamin D supplements.
Exercise. Experts recommend regular "weight-bearing" exercise (in which your feet and legs bear the weight of your body), such as walking, running, stair climbing, or dancing. This type of exercise can slightly improve your bone density and also gives you strength, agility and balance which will help you avoid falls. Aerobic exercise (like swimming or biking) will help build muscle but should be accompanied by a weight-bearing exercise for your bones as well. Weight training or resistance training twice a week also helps prevent bone loss and may even increase bone density slightly, and can be started at almost any age.
Cut down on bad habits. Don't smoke tobacco, cut down caffeine, and drink alcohol only in moderation. All these substances have been linked to osteoporosis.
If I have osteoporosis, how can I protect myself from bone fractures and breaks?
If you've lost bone density, your bones aren't as strong as they used to be, even if your muscles are. Falls are especially dangerous for people with osteoporosis. Here are some ways to prevent injury:
- Don't lift heavy objects and avoid using ladders and chairs to reach for things above you head. Instead, ask for help..
- Don't overdo the exercise; start an exercise program like walking slowly and gradually build up speed and distance.
- Wear good shoes: no heels or slippery soles.
- Don't let your pride get in the way of using a cane or walker if it helps you.
- Have handrails installed on stairways, in bathtubs, and other places you may lose your footing.
- Try to avoid icy, wet and slippery surfaces; use nonslip mats in the bathroom and kitchen.
- Take care of your vision so you can better avoid falls; get a new prescription for your glasses if necessary.
- Use bright lamps and night-lights.
- Use good nonskid pads under all your rugs, and make sure there are no edges you can trip on; keep your floors uncluttered to help avoid falls.
- Put more phone extensions around the house so you don't have to walk as far to get the phone.
National Osteoporosis Foundation http://www.nof.org
The Osteoporosis Book: A Guide for Patients and Their Families (Oxford University Press)
This book by Nancy E. Lane, MD at University of California at San Francisco explains the disease in terms easy to understand.
Rapuri PB, Gallagher JC, Kinyamu HK, Ryschon KL. Caffeine intake increases the rate of bone loss in elderly women and interacts with vitamin D receptor genotypes. Am J Clin Nutr 2001 Nov;74(5):694-700
Ward KD, Klesges RC. A meta-analysis of the effects of cigarette smoking on bone mineral density. Calcif Tissue Int 2001 May;68(5):259-70
van der Voort DJ, Geusens PP, Dinant GJ. Risk factors for osteoporosis related to their outcome: fractures. Osteoporos Int 2001;12(8):630-8
Osteoporosis Screening. U.S. Preventive Services Task Force. http://www.ahrq.gov/clinic/3rduspstf/osteoporosis/
Disease Statistics. National Osteoporosis Foundation. http://www.nof.org/osteoporosis/stats.htm
Patient Brochure: Vitamin D and Your Bone Health. What Women and Men Over 50 Need to Know. American Medical Women's Association. http://www.amwa-doc.org/index.cfm?objectId=974574C7-D567-0B25-51ED183FD9BE2CF5#how
Medications to Prevent and Treat Osteoporosis. National Osteoporosis Foundation. http://www.nof.org/patientinfo/medicaitons.htm
BMD Testing: What the Numbers Mean. National Osteoporosis Foundation. http://www.nof.org/osteoporosis/bmdtest.htm
National Osteoporosis Foundation. Osteoporosis: Men. http://www.nof.org/men/index.htm
National Osteoporosis Foundation. Fast Facts. http://www.nof.org/osteoporosis/diseasefacts.htm
National Osteoporosis Foundation. New Clinician's Guide to Prevention and Treatment of Osteoporosis 2008. http://www.nof.org/professionals/Clinicians_Guide.htm