Although a diagnosis of osteoporosis is based on the results of your bone mineral density scan (DEXA or DXA scan) , the decision about what treatment you need if any is also based on a number of other factors. These include your:
If you've been diagnosed with osteoporosis because you've had a fracture, you should still receive treatment to try to reduce your risk of further fractures.
You may not need or want to take medication to treat osteoporosis. However, you should ensure you're maintaining sufficientlevels of calcium and vitamin D . To achieve this, your healthcare team will ask you about your diet and may recommend making changes or taking supplements.
The National Institute for Health and Care Excellence (NICE)has made some recommendations about who should be treated with medication for osteoporosis.
Anumber of factors are taken into consideration before deciding which medication to use. These include your:
NICE has summarised its guidance for two groups of people:
You can read the NICE guidance by clicking on the links below.
Anumber of different medications are used to treat osteoporosis. Your doctor will discuss the treatments available andmake sure the medicines are right for you.
Bisphosphonates slow down the rate at which bone is broken down in your body. This maintains bone density and reduces the risk of fracture.
There are a number of different bisphosphonates, including
They're given as a tablet orinjection.
You should always take bisphosphonateson an empty stomach with a full glass of water. Stand or sit upright for 30 minutes after taking them. You'll also need to wait between 30 minutes and two hours before eating food or drinking any other fluids.
Bisphosphonates usually take 6 to 12 months to work and you may need to take themfor five years orlonger. You may also be prescribed calcium and vitamin D supplements to take at a different time to the bisphosphonate.
The main side effects associated with bisphosphonates include:
Not everyone will experience these side effects.
Osteonecrosis of the jaw is arare side effect that's linked with the use of bisphosphonates, althoughmost frequently with high-dose intravenous bisphosphonate treatment for cancer and not for osteoporosis.
Inosteonecrosis, the cells in the jaw bone die, which can lead to problems with healing. If you have a history of dental problems, you may need a check-up before you start treatment with bisphosphonates. Speak to your doctor if you have any concerns.
Strontium ranelate appears to have an effect on both the cellsthat break down bone and the cellsthat create new bone (osteoblasts).
It can be used as an alternative treatment if bisphosphonates are unsuitable. Strontium ranelate is taken as a powder dissolved in water.
The main side effects of strontium ranelate are nausea and diarrhoea . A few people have reported a rare severe allergic reaction to the treatment. If you develop a skin rash while taking strontium ralenate, stop taking it and speak to your doctor immediately.
SERMs are medications that have a similar effect on bone as the hormone oestrogen. They help to maintain bone density and reduce the risk of fracture, particularly of the spine.
Raloxifene is the only typeof SERM that's available for treating osteoporosis. It's taken as a tablet every day.
Side effects associated with raloxifene include:
Parathyroid hormone is produced naturally in the body.It regulates the amount of calcium in bone.
Parathyroid hormone treatments (human recombinant parathyroid hormone or teriparatide) are used to stimulate cells that create new bone (osteoblasts). They're given by injection.
Whileother medicationcan only slow down the rate of bone thinning, parathyroid hormone can increase bone density. However, it's only used in a small number of people whose bone density is very low and when other treatments aren't working.
Nausea and vomiting are common side effects of the treatment. Parathyroid hormone treatments should only be prescribed by a specialist.
Calcium is the major mineral found in bone, and having enough calcium as part of a healthy, balanced diet is important for maintaining healthy bones .
For most healthy adults, the recommended amount of calcium is 700 milligrams (mg) of calcium a day, which most people should be able to get from a varied diet that contains good sources of calcium .
However, if you have osteoporosis you may need more calcium, which will usually be in the form of supplements. Ask your GP for advice about taking calcium supplements.
Vitamin D is needed to help the body absorb calcium.All adultsshould consume 10 micrograms (mcg) of vitamin D a day.
Because vitamin D is found only in a small number of foods, it might be difficult to get enough from foods that naturally contain vitamin D and/or fortified foods alone. Soall adultsshould consider taking a daily supplement containing 10mcg of vitamin D.
For more information, read about who should take vitamin D supplements .
HRT is sometimes recommended for women who are experiencing the breast cancer , endometrial cancer , ovarian cancer , stroke and venous thromboembolism more than it lowers the risk of osteoporosis.
Discuss the benefits and risks of HRT with your GP.
In men, testosterone treatment can be useful when osteoporosis is caused by insufficient production of male sex hormones (hypogonadism).
Read about osteoporosis is a condition that weakens bones, making them fragile and more likely to break. Osteopenia is also a term used for bone density loss
Osteoporosis causes bones to become less dense and more fragile. Some people are more at risk than others.
Treating osteoporosis involves treating and preventing fractures and using medication to strengthen bones.
Your genes are responsible for determining your height and the strength of your skeleton, but lifestyle factors such as diet and exercise influence how healthy your bones are.
Having osteoporosis doesn't mean you'll definitely have a fracture. There are measures you can take to reduce your risk of a fall or break.
Bob Rees was diagnosed with osteoporosis after collapsing in pain on a family holiday.