I want to write a bit more about the options you have regarding preventing and managing osteoporosis because as more of us age it is becoming a growing problems. And we’ve all heard the horror stories of a hip fracture leading to a hospital stay leading to an infection, pneumonia and nothing else that is good. The bone growth drugs do benefit most people but they also have side effects.

Osteoporosis is defined as having a bone mineral density T score, which is the standard measure of bone density, of minus 2.5 or lower. Lesser degrees of bone loss, which is known as osteopenia, may or may not benefit from drug therapy.

So that you will better understand what you need to know there are two types of drugs for osteoporosis. The most prominent are called antiresorptives which are drugs that reduce bone breakdown by limiting the release of calcium from bone into the blood. This includes Fosamax, or generically known as alendronate, and Actonel. The second kind of drug is called bisphosphonates and they include Boniva and Reclast. They increase bone mass by reducing bone turnover. The problems with these drugs are possible stomach ulcers and inflammation of the esophagus. Rarely, and I am betting you know this story, the drug causes breakdown of the jaw. It made a sensational headline!

What you may not know, and what you should absolutely understand is that there is a disturbing side effect of patients who have been on one of these medications for some time and then find  a low-trauma fracture of a major bone. They ofen encounter a delay in healing or there is no complete healing at all. This is why there is now a warning that after five years on bisphosphonates people should take a break from the drugs for at least a year.

Other but less effective drugs at reducing vertebral fractures is calcitonin, a natural hormone sold as Fortical and Miacalcin. There is also the drug Forteo which needs to be self injected daily.

My suggestion, whatever meds you are on and after talking it over with your physician, is to continue taking calcium supplements and vitamin D which helps your body absorb the calcium. Even if you are on an osteoporosis drug, you need 1,200 to 1,500 mg of calcium a day in food and about a 1000 international units, IU, in supplement in vitamin D. Some people may be required to take 3000 or 5000 units, it all depends where you live, how much you are exposed to the sun, and what your vitamin D levels are in the first place. Again, talk to your doctor.

To your healthy aging.
Ruthan Brodsky

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Filed under: Conditions and Diseases

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