How do we treat Osteoporosis?


Vitamin D, as well as calcium, is essential to preventing osteoporosis and may reduce other health risks such as diabetes and immune system disorders. While exposure to sunlight provides vitamin D, northerners are at risk of seasonal vitamin D deficiency because winter sunlight in northern latitudes does not contain enough ultraviolet B for vitamin D production. Milk fortified with vitamin D3 contains 100 IUs per 250 ml glass. Foods such as margarine, eggs, chicken livers, salmon, sardines, herring, mackerel, swordfish and fish oils (halibut and cod liver oils) all contain small amounts. Supplementation is necessary to obtain adequate levels as dietary intake has minimal impact. Most multivitamins provide 400 IUs of vitamin D3. Some calcium supplements also contain vitamin D3.

Age and Daily Calcium Required
4 – 8 1000mg
9- 18 1300mg
19 – 50 1000mg
50 + 1200mg
Pregnant 18+ 1000mg

There are two kinds of bone cells, osteoblasts which form new bones and osteoclasts are for breaking down old bone cells. These two types of cells go hand-in-hand in the process to renew bone tissues just like bodily tissues. Medications prescribed to people suffering from osteoporosis can either slow down the progression of osteoclasts or stimulate the osteoblasts to form new bone cells. These often mimic the normal functions of cells to prevent the bones from fracturing. Please keep in mind that these medications are to be discussed with your doctor.
The following are the most commonly prescribed medicines for osteoporosis:

Bisphosphonates
A family of drugs used to prevent and treat osteoporosis. There are four bisphosphonates currently approved for use in Canada and the USA: alendronate (Fosamax ®), etidronate (Didrocal ®), risedronate (Actonel ®) and zoledronic acid (Aclasta®. Also available are: Actonel® Plus Calcium and Fosavance® (Fosamax® with vitamin D).

Calcitonin This is a hormone found naturally in our bodies. It is made by the thyroid gland and controls the activity of the osteoclasts (bone-eroding cells). A synthetic form of calcitonin (Miacalcin*NS®) is used in a nasal spray. Calcitonin slows down the work of the osteoclasts. This allows the osteoblasts (bone-building cells) to work more effectively. Nasal calcitonin maintains or minimally increases bone density and prevents fractures of the spine. It also reduces the pain associated with vertebral fractures.

Denosumab (Bone Metabolism Regulator)
In a new class of drugs, Denosumab is for osteoporosis treatment called a human monoclonal antibody that prevents RANKL-RANK interaction and thereby inhibits osteoclast formation.

Parathyroid hormone (PTH)
Parathyroid hormone (PTH) and its analogue, teriparatide, are a new class of osteoporosis treatments called bone formation agents.

Reference: http://www.osteoporosis.ca/index.php/ci_id/5520/la_id/1.htm

Edited by Rachel Horwitz.

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