Osteoporosis (cont.)
How is osteoporosis treated and prevented?
The goal of osteoporosis treatment is the prevention of bone fractures by
stopping bone loss and by increasing bone density and strength. Although early
detection and timely treatment of osteoporosis can substantially decrease the
risk of future fracture, none of the available treatments for osteoporosis are
complete cures. In other words, it is difficult to completely rebuild bone that
has been weakened by osteoporosis. Therefore, prevention of osteoporosis is as
important as treatment. Osteoporosis treatment and prevention measures are:
- Life style changes
including quitting cigarette smoking, curtailing alcohol intake, exercising
regularly, and consuming a balanced diet with adequate calcium and vitamin D;
- Medications that stop bone loss and increase bone
strength, such as alendronate (Fosamax), risedronate
(Actonel), raloxifene (Evista), ibandronate (Boniva), calcitonin (Calcimar), and zoledronate (Reclast);
- Medications that
increase bone formation such as
teriparatide (Forteo).
Lifestyle changes
Exercise, quitting cigarettes, and curtailing alcohol
Exercise has a wide variety of beneficial health effects.
However, exercise does not bring about substantial increases in bone density.
The benefit of exercise for osteoporosis has mostly to do with decreasing the
risk of falls, probably because balance is improved and/or muscle strength is increased.
Research has not yet determined what type of exercise is best for osteoporosis
or for how long. Until research has answered these questions, most doctors
recommend weight-bearing exercise, such as
walking, preferably daily.
A word of
caution about exercise: it is important to avoid exercises that can
injure
already weakened bones. In patients over 40 and those with heart disease,
obesity, diabetes mellitus, and high blood pressure,
exercise should be prescribed and monitored by their doctors. Finally, extreme
levels of exercise (such as marathon running) may not be healthy for the bones. Marathon running in
young women that leads to weight loss and loss of menstrual periods can actually
cause osteoporosis.
Smoking one pack of cigarettes per day throughout adult
life can itself lead to loss of 5% to 10% of bone mass. Smoking cigarettes
decreases estrogen levels and can lead to bone loss in women before menopause.
Smoking cigarettes can also lead to earlier menopause. In postmenopausal women,
smoking is linked with increased risk of osteoporosis. Data on the effect of regular
consumption of alcohol and caffeine on osteoporosis is not as clear as with
exercise and cigarettes. In fact, research regarding alcohol and caffeine as
risk factors for osteoporosis shows widely varying results, and is
controversial. Certainly, these effects are not as powerful as other factors.
Nevertheless, moderation of both alcohol and caffeine is prudent.
Next: Calcium supplements »
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