Osteoporosis Treatment

How quickly can osteoporosis worsen if it remains untreated?

The loss of bone in a post-menopausal woman who is not taking estrogen or any other medication is usually on the order of several percent, up to five percent per year, during the early post-menopausal years. Later, it's closer to one percent per year until perhaps one hundred years of age. This is not tremendously rapid, but it's really the chronicity that matters and if someone waits fifteen years after the menopause to start medicine, they could've lost a considerable amount of bone, and possibly have even had a fracture.

What types of medications are used to treat osteoporosis?

There are two main categories of medicine to treat osteoporosis. The most common category, and for which we have the most drugs, uses the principle of preventing bone breakdown. Now, normally bone is made and broken down everyday at a slow rate in adults. Certain conditions like oestrogen deficiency result in increased breakdown and not enough formation of bone. So, we have many drugs including oestrogen that prevent the breakdown of bone. Now, we have one fairly new drug, which actually stimulates the formation of bone. However, we only have one such drug in this category.

Which drugs control bone breakdown?

Bone breakdown which is caused by certain cells in the bone is prevented first of all by estrogen, testosterone which may turn into estrogen in males and then a series of drugs called Bisphosphonates. This has been around about 20 years or so. These are not related to hormones. They're interesting drugs is that you take them either by mouth or sometimes intravenously and they actually stick to the bone and stay in the bone a long time so you don't necessarily have to take these drugs everyday, in some cases once a year.

Which drugs stimulate bone formation?

With osteoporosis treatment, there is only one drug that stimulates bone formation. The hormone called parathyroid hormone actually stimulates bone formation. This is a hormone made by little glands in your neck which controls calcium metabolism to a great extent. Part of the hormone, not the whole hormone, has been synthesized and can be injected by the patient everyday and this stimulates bone formation. We have no other drugs available in the United States that do that.

Can osteoporosis be cured by medication?

With osteoporosis treatment, unfortunately I do not think we could consider that we have a cure for osteoporosis, which are people with very severe bone loss. We have a drug that can stimulate bone formation, but it does not bring someone from very low bone density to normal. So, at this time, unfortunately, there is no cure to osteoporosis by medication.

Are there any promising cures for osteoporosis on the horizon?

With osteoporosis treatment, I don't believe there are any promising drugs on the near horizon that will cure osteoporosis. I do wonder if stem cell therapy will be an interesting idea for looking for a cure for osteoporosis. The thought would be to put a stem cell that would turn into bone cells that make bone, and if you could target this to the skeleton adequately, conceivably one might have a cure for osteoporosis.

Are there any treatments for osteoporosis that don't involve medication?

We use nutritional means of treating osteoporosis without drugs, things such as Calcium and Vitamin D are both helpful. Other nutritional factors are not terribly well proven but there is some evidence that magnesium is important but so far as treating established osteoporosis, that probably wouldn't have a major effect.

Can alternative medicine reduce osteoporosis symptoms?

With osteoporosis treatment, in patients who have deformed vertebrae, and therefore deformed backs, muscle spasm is a considerable problem, and sometimes, arthritis and pinched nerves too. I believe physical therapy and acupuncture do have a role in some form of reducing the osteoporosis symptoms of these patients, and therefore to reduce the amount of pain.