Osteoporosis (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Catherine Burt Driver, MD
Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.
In this Article
- Osteoporosis facts
- What is osteoporosis?
- What are osteoporosis symptoms and signs?
- What are the consequences of osteoporosis?
- Why is osteoporosis an important public health issue?
- What factors determine bone strength?
- What are osteoporosis risk factors and causes?
- How is osteoporosis diagnosed?
- Who should have bone density testing?
- What is the treatment for osteoporosis, and can osteoporosis be prevented?
- Exercise, quitting cigarettes, and curtailing alcohol
- Calcium supplements
- Vitamin D
- Hormone therapy (hormone replacement therapy, menopausal replacement therapy)
- Medications that prevent bone loss and breakdown
- Choosing an osteoporosis medication
- Prevention of osteoporosis caused by long-term corticosteroids
- Monitoring osteoporosis therapy medication
- Prevention of hip fractures in elderly people with osteoporosis
- What are complications of osteoporosis?
- What is the prognosis (outlook) for patients with osteoporosis?
- Osteoporosis FAQs
- Find a local Internist in your town
Who should have bone density testing?
The National Osteoporosis Foundation guidelines state that there are several groups of people who should consider DXA testing:
- All postmenopausal women below age 65 who have risk factors for osteoporosis
- All women aged 65 and older
- Postmenopausal women with fractures, although this is not mandatory because treatment may well be started regardless of bone density
- Women with any of more than 50 medical conditions associated with osteoporosis; a primary-care physician can scan a patient's list of medical illnesses to determine if one of these conditions is present
- Women whose decision to begin treatment for osteoporosis might be aided by bone density testing to determine the presence or absence of osteoporosis or osteopenia
The National Osteoporosis Foundation guidelines state that bone density testing does not need to be performed if a person has a known osteoporotic fracture because the patient will be treated for osteoporosis with or without a bone density study. In addition, bone density testing is not appropriate if the person undergoing the test is not willing to take treatment based on the results. Therefore, if bone density testing is done, it should be performed on people willing to take some specific action based on the results.
What is the treatment for osteoporosis, and can osteoporosis be prevented?
The goal of treatment of osteoporosis is the prevention of bone fractures by reducing bone loss or, preferably, by increasing bone density and strength. Although early detection and timely treatment of osteoporosis can substantially decrease the risk of future fractures, none of the available treatments for osteoporosis are complete cures. In other words, it is difficult to completely rebuild bone that has been weakened by osteoporosis. Therefore, prevention of osteoporosis is as important as treatment. The following are osteoporosis treatment and prevention measures:
- Lifestyle changes, including quitting cigarette smoking, curtailing excessive alcohol intake, exercising regularly, and consuming a balanced diet with adequate calcium and vitamin D
- Medications that stop bone loss and increase bone strength, such as alendronate (Fosamax), risedronate (Actonel), raloxifene (Evista), ibandronate (Boniva), calcitonin (Calcimar), zoledronate (Reclast), and denosumab (Prolia)
- Medications that increase bone formation such as teriparatide (Forteo)
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