Bone is a living tissue. Our bodies break down old bone and replace it with new bone throughout our lives. Once we hit midlife, however, new bone growth slows down. Osteoporosis is when new bone growth and old bone breakdown are out of balance, with not enough new bone made to replace the old bone that’s lost.
Osteoporosis is common, affecting about 10 million Americans. Risk factors include aging, female gender, menopause, family history, and body type. Risk factors that can be modified (changed) include smoking, alcohol use, not getting enough exercise, or not eating enough fruits, vegetables, and foods containing calcium and vitamin D.
The Bone Health and Osteoporosis Foundation recommends the following daily calcium and vitamin D amounts. It’s best to get as much of these nutrients from food, but if you can’t get enough through your diet, supplements can be used. It’s also important to exercise regularly, stop smoking, and limit alcohol intake
| Women 50 and younger | Women 51 and older | Men 50 and younger | Men 51-70 | Men 71 and older | |
| Calcium | 1000 mg | 1200 mg | 1000 mg | 1000 mg | 1200 mg |
| Vit D | 400-800 units | 800-1000 units | 400-800 units | 800-1000 units | 800-1000 units |
Osteoporosis medications include:
- Bisphosphonates:
alendronate (Fosamax) – a weekly pill
ibandronate (Boniva) – a monthly pill or quarterly IV infusion
risedronate (Actonel) – a weekly or monthly pill
zoledronic acid (Reclast) – an annual IV infusion
- Estrogen therapy
- Parathyroid hormone analogs:
Teriparatide (Forteo) and abaloparatide
- Other medications:
denosumab (Prolia, Xgeva) is used in people who can’t take bisphosphonates, such as those with kidney disease
romosozumab
calcitonin salmon
Once diagnosed with osteoporosis, bone mineral density testing may be done every 1-2 years based on severity and fracture risk, or to check medication response.