Managing and Treating Osteoporosis

Please note: This slide show is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult your doctor about any questions you may have regarding a medical condition.

I've been diagnosed with osteoporosis – now what?

If you've been diagnosed with osteoporosis, the first step is to talk with your doctor about a treatment plan that's tailored for you.

Treatment has two goals:

• To slow or stop bone loss
• To prevent fractures

What does an osteoporosis treatment plan include?

Medication may be part of your treatment plan.
Medication works best as part of a treatment plan that also includes:

• Eating a healthy diet
• Getting the right amount of calcium and vitamin D
• Staying active safely and exercising
• Preventing falls

What's a healthy diet for treating osteoporosis?

A healthy diet includes:

• Plenty of fruits and vegetables
• The right amount of calories for your age, height, and weight
• The right amount of protein
• The right amount of calcium and vitamin D

Calcium and vitamin D

Many foods contain calcium, but dairy products have the most calcium per serving.

If you find it hard to get enough calcium from food, take calcium supplements.
Your body needs vitamin D to help it absorb calcium. But it's hard to get enough vitamin D from food, so you may need to take a vitamin D supplement.

Talk to your doctor about the daily amounts that are right for you.

What's a safe way to be active with osteoporosis?

Being active helps keep your bones and muscles strong. Two kinds of activity can help maintain bone mass.

Activities that you do on your feet, with your bones supporting your weight, like

• Walking or jogging
• Climbing stairs
• Gardening
• Lifting weights
• Tai chi
• Yoga

What's a safe way to be active with osteoporosis?

Activities that strengthen your muscles, like push-ups and lunges, also help to maintain bone mass.

In addition, activities like tai chi and yoga can also improve your balance, which can prevent falls.

Preventing falls helps prevent fractures

Falling increases your risk for breaking a bone. Preventing falls helps prevent fractures. Some ways you can help prevent falls include:

• Wear shoes with nonslip soles
• Avoid slippery icy surfaces
• Keep floors free of clutter or objects that you might trip over
• Keep your home well lit
• If you need to get up at night, turn on a night light or use a flashlight
• Install grab bars in the bathtub or shower

Medications to treat osteoporosis

Studies clearly show that for older women with osteoporosis, medication can reduce fracture risk by about one-third.

Some medications work by slowing bone loss.

Medications to treat osteoporosis

Other medications work by building new bone. While others can both slow bone loss and build new bone.

Medications to treat osteoporosis

Your doctor may recommend medication if:

• You're at least 8 years past menopause and have a T-score of –2.5 or lower
• Your score on the FRAX tool indicates a high risk for fracture
• You have broken:
• A spinal bone
• A hip in a fall from a standing position

Medications to treat osteoporosis

Some medications are taken by mouth, while others are given by injection.

Talk with your doctor about your medication options and which medication might be the best choice for you.

What about medication side effects?

In rare cases, long-term use of some osteoporosis medications can cause harmful side effects like:

• A fracture in the middle of the long thigh bone that isn't caused by an injury
• Weakening and infection of the jaw

What about medication side effects?

If a thousand patients with osteoporosis take one of these medications for a year, one patient might have one of these side effects.

For most patients, a lower risk for fracture substantially outweighs the risk of a rare medication side effect.

What's a drug holiday?

With some medications – such as bisphosphonates – if you've been taking them for 4 or 5 years, your doctor may recommend that you stop taking them for a while. This is called a drug holiday.

The risk of harmful side effects may be higher after you've been taking a medication for more than 5 years. A drug holiday can reduce this risk.

What's a drug holiday?

A large study compared older women who took a drug holiday with those who did not.

If women had taken their medication regularly for at least 3 years before the drug holiday, their risk for a hip fracture was no higher than that of women who did not take a drug holiday.

Your healthcare team is ready to help

If you have questions about your osteoporosis treatment plan, talk with your doctor or another member of your healthcare team. By talking openly and regularly with your doctor, you can take an active role in your care.

References

1. American Bone Health. Bones Don’t Improve on Drugs Alone. Last reviewed 11/25/20. https://americanbonehealth.org/medications-bone-health/bones-dont-improve-on-drugs-alone/
2. American Bone Health. Taking a Medicine for Osteoporosis. Revised 02/19/20. https://americanbonehealth.org/medications-bone-health/bonesense-on-taking-a-drug-for-osteoporosis/
3. American Bone Health. What is a Drug Holiday? 2016 Sept. https://americanbonehealth.org/medications-bone-health/what-is-a-drug-holiday/
4. Curtis JR, Westfall AO, Cheng H, Delzell E, Saag KG. Risk of hip fracture after bisphosphonate discontinuation: implications for a drug holiday. Osteoporos Int. 2008;19(11):1613-1620. doi:10.1007/s00198-008-0604-4
5. Harvard Health Publishing. Osteoporosis drugs: Which one is right for you? Updated June 2014. https://www.health.harvard.edu/womens-health/osteoporosis-drugs-which-one-is-right-for-you
6. Kaiser Health News. Why Older Adults Should Eat More Protein (And Not Overdo Protein Shakes). 2019, Jan. 17. https://americanbonehealth.org/nutrition/why-older-adults-should-eat-more-protein/
7. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Living with Osteoporosis. Last reviewed October 2019. https://www.niams.nih.gov/health-topics/osteoporosis/advanced#tab-living-with
8. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Treatment of Osteoporosis. Last reviewed October 2019. https://www.niams.nih.gov/health-topics/osteoporosis/advanced#tab-treatment