“Osteoporosis” literally means “porous bones.” The bones become weaker, increasing the risk of fractures, especially in the hip, spinal vertebrae, and wrist. Bone tissue is constantly being renewed, and new bone replaces old, damaged bone. In this way, the body maintains bone density and the integrity of its crystals and structure. Bone density peaks when a person is in their late 20s. After the age of around 35 years, bone starts to become weaker. As we age, bone breaks down faster than it builds. If this happens excessively, osteoporosis results.
Treatment aims to:
slow or prevent the development of osteoporosis
maintain healthy bone mineral density and bone mass
maximize the person’s ability to continue with their daily life
This is done through preventive lifestyle measure and the use of supplements and some drugs.
Drug Therapy Involves:
Bisphosphonates: These are antiresorptive drugs that slow bone loss and reduce fracture risk.
Estrogen agonists or antagonists, also known as selective estrogen-receptor modulators, SERMS), for example, raloxifene.
(Evista): These can reduce the risk of spine fractures in women after menopause.
Calcitonin (Calcimar, Miacalcin): This helps prevent spinal fracture in postmenopausal women, and it can help manage pain if a fracture occurs.
Parathyroid hormone, for example, teriparatide (Forteo): This is approved for people with a high risk of fracture, as it stimulates bone formation.
RANK ligand (RANKL) inhibitors, such as denosumab (Xgeva): This is an immune therapy and a new type of osteoporosis treatment.
Other types of estrogen and hormone therapy may help.
In the future, treatment may include stem cell therapy. In 2016, researchers found that injecting a particular kind of stem cell into mice reversed osteoporosis and bone loss in a way that could, potentially, benefit humans too.
Findings published in 2015 suggested that growth hormone (GH) taken with calcium and vitamin D supplements could reduce the risk of fractures in the long term.
Also in 2015, researchers in the United Kingdom (U.K.) found evidence that a diet containing soy protein and isoflavones may offer protection from bone loss and osteoporosis during menopause. Scientists believe that up to 75 percent of a person’s bone mineral density is determined by genetic factors. Researchers are investigating which genes are responsible for bone formation and loss, in the hope that this might offer new ways of preventing osteoporosis in the future.