Osteoporosis is a condition characterized by progressive bone loss that increases the risk of fractures, even from just doing one’s daily activities. It is a major health problem because it can result in serious and debilitating fractures of the hip or the spine, which can make previously independent individuals require constant help from their family or caregivers.
The exact cause of osteoporosis is unknown, but the major risk factors that contribute to the development of this condition include aging, heredity, poor nutrition, sedentary lifestyle, use of certain medications and conditions like thyroid disease.
Osteoporosis affects more than 40 million Americans and contributes to millions of bone fractures annually. It is estimated that the number of fractures linked to osteoporosis may reach more than 3 million cases in the next decade.
Older people have a lower total bone mass and therefore have a greater risk of developing osteoporosis. Women over the age of 50 years are more likely than men in the same age group to be affected by the disease. After the age of 35 years, the body produces less new bone to replace lost bone material. Five to ten years after menopause, women lose bone mass much faster than they build bone. Men begin to lose bone faster after the age of 65.
Signs and Symptoms
Osteoporosis makes the bones porous, but it often develops gradually. No symptoms are apparent initially until a fracture occurs. In the later stages, it may result in loss of height, a stooped appearance, and a rounded upper back. These occur due to the partial collapse of the weakened vertebrae. Bone pain may or may not be present.
Osteoporosis is usually diagnosed through clinical examination, bone x-rays, measurement of bone density, and special laboratory tests. Other causes of low bone mass, such as osteomalacia or hyperparathyroidism, must be ruled out by doing additional tests. These tests may include a complete blood count, serum chemistry levels, liver function tests, thyroid-stimulating hormone levels, tests for 25-Hydroxyvitamin D levels, 24 hour urine calcium/creatinine, and testosterone and luteinizing hormone/follicle-stimulating hormone levels.
Once bone is lost, it cannot be replaced. There is no treatment that can reverse osteoporosis. The treatment for osteoporosis therefore focuses on prevention of further bone loss. Proper nutrition and adequate exercise are key to improving bone health, but other pharmacologic treatments may be needed, as well. These include:
- Estrogen Replacement Therapy, which is recommended for postmenopausal women at risk for osteoporosis and fractures.
- Selective Estrogen Receptor Modulators, which can help increase bone mass and decrease the risk of fractures.
- Calcitonin, a nasal spray which helps decrease bone loss, offer pain relief, and reduce risk of fracture.
- Bisphosphonates, which can significantly increase bone mass and prevent hip and spine fractures.
- Denosumab, is a humanized monoclonal antibody that decreases bone loss by inhibiting the activity of osteoclasts (cells that destroy bone). It is also used in cancer patients with bone metastases to reduce bone loss.
The National Osteoporosis Foundation recommends that these treatments should be reserved for postmenopausal women and men over 50 years who present with a hip or vertebral fracture or evidence of low bone mass.
At American Infusion Centers we use the following drugs for osteoporosis: