Osteoporosis

Bone is a living tissue. Our bodies break down old bone and replace it with new bone throughout our lives. Once we hit midlife, however, new bone growth slows down. Osteoporosis is when new bone growth and old bone breakdown are out of balance, with not enough new bone made to replace the old bone that’s lost.

Osteoporosis is common, affecting about 10 million Americans. Risk factors include aging, female gender, menopause, family history, and body type. Risk factors that can be modified (changed) include smoking, alcohol use, not getting enough exercise, or not eating enough fruits, vegetables, and foods containing calcium and vitamin D.

The Bone Health and Osteoporosis Foundation recommends the following daily calcium and vitamin D amounts. It’s best to get as much of these nutrients from food, but if you can’t get enough through your diet, supplements can be used. It’s also important to exercise regularly, stop smoking, and limit alcohol intake

Osteoporosis medications include:

• Bisphosphonates:

alendronate (Fosamax) – a weekly pill

ibandronate (Boniva) – a monthly pill or quarterly IV infusion

risedronate (Actonel) – a weekly or monthly pill

zoledronic acid (Reclast) – an annual IV infusion

• Estrogen therapy

• Parathyroid hormone analogs:  

Teriparatide (Forteo) and abaloparatide

• Other medications:

denosumab (Prolia, Xgeva) is used in people who can’t take bisphosphonates, such as those with kidney disease

romosozumab

calcitonin salmon

Once diagnosed with osteoporosis, bone mineral density testing may be done every 1-2 years based on severity and fracture risk, or to check medication response.