A combination of medication and diet changes helps to keep osteoporosis at bay and prevent future bone fractures, as advised by the Department of Endocrinology at Singapore General Hospital (SGH).
Continued from previous page.
Who should be tested for osteoporosis?
- Early menopause before 45 years
- Had previous fracture from fall
- Immediate family member with osteoporosis
- Thin or underweight
- Frail as a result of long-term illness
- Women with conditions associated with osteoporosis such as rheumatoid arthritis
- Prolonged use of corticosteroids or thyroid medication
How to prevent osteoporosis
- Engage in regular weight-bearing exercise. Do this at least 3 times a week, but it is important to avoid exercise that can injure weakened bones. Patients who have not exercised before or suffer from medical problems should consult their doctor first.
- Diet – get enough calcium, vitamin D and phosphorus either through food or supplements. An adult under 50 needs 1,000 mg of calcium daily. Adults over 50 need over 1,200 mg of calcium daily.
Vitamin D is needed by the body to absorb calcium and can either be obtained through the skin from exposure to sunlight, or through diet. An adult under 50 years needs 400-800 IU of vitamin D daily while adults over 50 need 800-1000 IU of vitamin D daily.
If you have difficulty getting the calcium and vitamin D that you need from your diet, you can take supplements.
How to treat osteoporosis
Although there is no cure for osteoporosis, several treatments are available that can prevent further bone loss and improve bone strength. This can significantly reduce the risk of fractures. Medication, exercise and nutrition all play a role in treatment.
Medication for osteoporosis
Currently most of the approved osteoporosis medications are known as ‘antiresorptive’ agents because they stop resorption (or depletion) of bone mineral from bones. Medicines that can stimulate bone formation are also available. Your physician can help you decide which treatment is best for you.
If you are diagnosed with osteoporosis, your physician may recommend one of the following medications: Bisphosphonates that include agents like Alendronate (Fosamax®), Risedronate (Actonel®), Ibandronate (Bonviva®) and Zoledronic Acid (Aclesta®). Selective Estrogen Receptor Modulators such as Raloxifene, Nasal Calcitonin (Miacalcin®), the newer agent Strontium (Protos®) that may have a double action of stopping bone resorption and stimulating bone formation, or the anabolic (bone forming) medication Teriparatide (Forteo®) that is given as a daily injection. Denosumab (Prolia®) is a relatively new medication, a fully human monoclonal antibody that is given as a 6-monthly injection, for the treatment of osteoporosis. It is important to note that the choice of drug therapy can be complex. Your treatment will be tailored for you.
See previous page for the
risk factors, causes and symptoms of osteoporosis.