Osteoporosis

The FDA released a review this week that indicates that certain osteoporosis medications (bisphosphonates) may not provide additional fracture prevention benefit if taken for more than five years. Patients with less severe osteoporosis are most likely not to benefit from additional therapy. The information comes in the wake of previous studies showing troubling side-effects from such medications.

A hip fracture can be a life-changing event; it is too often a life-shortening event. An ounce of prevention is worth a pound of cure! The most important interventions to prevent osteoporosis are diet, exercise and not smoking. These recommendations apply to both men and women.

Experts recommend that premenopausal women and men consume at least 1000 mg of calcium per day; this includes calcium in foods and beverages plus calcium supplements. Postmenopausal women should consume 1200 mg of calcium per day (total of diet plus supplements). Adequate vitamin D intakes reduces bone loss and fracture rate when the calcium intake is adequate. Blood tests can measure the vitamin level; generally a daily supplement of 800 to 1000 IU of Vitamin D3 will ensure a good blood level.

Exercise may decrease fracture risk by improving bone mass in premenopausal women and helping to maintain bone density for women after menopause. Furthermore, exercise may decrease the tendency to fall due to weakness in both men and women.

Stopping smoking is strongly recommended for bone health because smoking cigarettes is known to speed bone loss.

One can read further information about preventing osteoporosis in Up to Date. The National Osteoporosis Foundation has a response to the bisphosphonate controversy and is an excellent resource for bone health for men, women and children.