Osteoporosis: Who moved my meds?

In our modern busy lifestyles we don’t give much thought to what our bones might be up to. But the fact of the matter is that they’re probably as busy as you. Bones are continually making and losing material, but after a certain age they may be losing more than they’re restoring. Then you have to consider a whole lot of life changes from diet to exercise to medication.

However, finding the right medication for osteoporosis is sometimes a tricky business, especially considering that often, until a bone breaks, we may not know we even have the disease. On the other hand, sometimes you can do everything right, and still have a problem with diminishing bone density. At this point invariably, you are going to be prescribed medication.

Often our first line of defence is to work the natural route: diet, exercise, calcium and vitamin D. And anything else our friends recommend while sitting comfortably on the couch. However, eventually you may be faced with the only choice left, and that is specific medication designed to slow the progression of osteoporosis, and in some cases, assist with the rebuilding process to a certain degree. Still, the stark truth is that once bone as crumbled away it’s not going to grow back again.

Taking the pill

Because loss of estrogen can play a pivotal role in bone density loss after menopause, it is still recommended as the best prevention for post-menopausal bone loss. However, Hormone Replacement Therapy is not suitable for everybody and should be discussed in detail with your doctor

There are several medications directly designed to assist with osteoporosis – both the decline and the concomitant conditions of bodily aches, discomfort and inconvenience. In nearly all cases, Bisphosphonates are the most common medications prescribed for osteoporosis treatment, including:

1)      Alendronate (Fosavance/Fosamax)

2)      Risedronate (Actonel)

3)      Ibandronate (Boniva)

4)      Zoledronic acid (Aclasta)

Alternative medications can include some fascinating names:

Some hormone-like medications also are approved for preventing and treating osteoporosis, such as raloxifene (Evista).

Denosumab (Prolia) is a newer medication shown to reduce the risk of osteoporotic fracture in women and men. Unrelated to bisphosphonates, Denosumab might be used in people who can’t take a bisphosphonate, such as people with reduced kidney function.

Teriparatide (Forteo) is typically reserved for men and postmenopausal women who have very low bone density, who have had fractures or whose osteoporosis is caused by steroid medication. Teriparatide has the potential to rebuild bone.

Abaloparatide (Tymlos) is the newest osteoporosis medication. Like teriparatide, it has the potential to rebuild bone. In a research trial comparing these two treatments, Abaloparatide appeared to be as effective as teriparatide but was less likely to cause an excess of calcium.

If you feel you’ve just swallowed a medical textbook and are now contemplating the discomfort of large-word indigestion, just remember the benefits of these drugs. Healthy bones do their job, which is to continuously refurbish themselves. The purpose of medication for osteoporosis is to slow bone breakdown. The older you get, and after menopause, bones break down faster. Osteoporosis medications put a brake on the process. When you maintain bone density in this way, you decrease the risk of breaking a bone as a result of osteoporosis.

So when you next swallow a pill, remember to swallow the name as well. Remember it. Those long unpronounceable names may just stand between you and a fracture. Don’t lose your meds. A lot of research and development and late nights went into developing that pill, so get to know it as a friend and keep track of how it’s helping you.

Bisphosphonates have been shown to be safe and effective for up to 5 years of treatment, depending on the medication. Many people are happy with any one of these brands, and anything that shows a definite sign of improvement, is good.

Always supplement medication with a healthy lifestyle

You should never depend on medication alone to help your osteoporosis. The old cry of exercise, diet and no smoking or alcohol still rings true.

Exercise: Weight-bearing physical activity and exercises that improve balance and posture can strengthen bones and reduce the chance of a fracture. The more active and fit you are as you age, the less likely you are to fall and break a bone.

Diet: Eat healthily and pay attention to the value of green veggies. Dairy products (milk, cheese, yoghurt etc), contain the highest amounts of calcium and is definitely still the best, cheapest way to ingest your daily calcium. Vitamin D is simple enough – just get out there in as much sunshine as you can, up to 30 minutes per day.

Smoking: This is definitely a bone killer! The inhaled smoke is a poison that damages bones, preventing the rebuilding process so necessary to maintaining bone density.

Alcohol: Make sure you drink in moderation – one or two drinks per day may be fine – but always give yourself a couple of days off per week.

Love your bones! Treat all medications with respect. Feeling good, feeling better is the best outcome to aim for.

NOFSA (National Osteoporosis Foundation South Africa)

NOFSA is the only non-profit, voluntary health organisation dedicated to promoting lifelong bone health. We focus on reducing the widespread prevalence of osteoporosis while working to find a cure for the disease, and by supporting research and developing programmes of education and advocacy.

Find out more about our work at: www.osteoporosis.org.za

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