Treatments for Osteoporosis

What's the Score?

In your early 30s if you're a woman and at the age of about 40 if you're a man, your skeleton naturally begins to slowly lose bone faster than your body can replace it and very gradually thins as you age.

If you have osteoporosis, it's a different story. By the time you're diagnosed, your bones will already have lost significant density, making them fragile and easy to break.

Diagnosis

Bone density tests may be used to measure your bones' strength. There are several types. The most accurate, dual energy X-ray absorptiometry, (DXA) uses X-rays to detect bone thinning, usually on the hip or spine. Portable machines use X-rays or sound waves to test smaller bones in fingers, wrist, heel or shin. A T-score of -1 or above means your bones are normal. A score of -1 to -2.5 is a warning that you have low bone density; a score under -2.5 means osteoporosis. Experts recommend that women 65 and older be routinely screened.

Treatments

To begin, treatment for osteoporosis will focus on medications to slow bone loss and reduce the risk of fractures, as well as lifestyle changes to improve general wellbeing.

Supplements

Calcium is important for making bone tissue, but how much do you need? Adults up to age 50 require 1000mg of calcium daily; postmenopausal women (and men over age 65) should get 1200-1500mg a day. If dietary sources aren't enough, add calcium supplements. Calcium needs a partner in its bone-protection work: vitamin D. Most adults need 400 IU daily. With osteoporosis, you may require 600 to 800 IU daily.

Medications

• The first choice for many patients are drugs called bisphosphonates: alendronate (Fosamax) and risedronate (Actonel). Both drugs have been shown to lower the incidence of fractures.
• If you are a postmenopausal woman, your doctor may recommend HRT since it replaces lost oestrogen that can prevent rapid bone loss while increasing bone density. HRT has been linked to blood clots, breast cancer and other problems.
• Selective oestrogen receptor modulators (SERMs) are another class of drug being prescribed. SERMs prevent bone loss throughout the body, but they carry an increased risk of blood clots so they are not right for everyone.
• Strontium ranelate (Protos) is another class of drugs being used in treatment that are given by injections.

Herbal Help

Certain herbs are thought to help:

• Black cohosh (Cimicifuga racemosa) contains phyto-oestrogens (oestrogen-like substances) that protect against bone loss.
• Red clover (Trifolium pratense). The isoflavones extracted from this herb may slow bone loss.
• Horsetail (Equisetum arvense) contains substances believed to strengthen bone.

WARNING: Use only one of these at any given time and discuss your plans with a health professional.

Surgery

If you have a severe break or other problems such as osteoarthritis, joint replacement is an option. This operation replaces part of a hip or knee with man-made materials. If you have a collapsed spinal vertebra, a new therapy called vertebroplasty may relieve pain. Vertebroplasty involves injecting a cement-like substance into the fractured body of the vertebra, which stabilises the bone as it sets.

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