Risk factors for osteoporosis include:
Advanced age
Female
Thin body habitus, small frame
Caucasian or Asian (although Black and Hispanic patients at risk as well)
Smoker
Estrogen deficiency, from menopause or surgically induced (ovaries removed)
Absence of menstrual periods
Vitamin D deficiency
Family history of osteoporosis
Certain medications (steroids, chemotherapy, anticonvulsants)
Low testosterone levels in men
Excessive alcohol use
Inactive lifestyle
Risk Prevention for Osteoporosis
Assure adequate intake of Calcium, at least a 1000 mg a day, and Vitamin D, at least 800 IU but may be as high as 2000 IU, or International Units per day
Weightbearing exercise
Exposure to sunlight (unless prone to skin cancers or housebound)
Add soy to the diet (contains plant estrogens)
Don't smoke
Consider hormone therapy (check with your doctor)
Avoid excessive alcohol
Limit caffeine
Treatment Strategies for Osteoporosis
Medications, as noted below, are usually prescribed by your internist, as each considered treatment option has factors for and against its use.
Bisphosphonates: these drugs inhibit bone breakdown, help to preserve bone mass, and sometimes increase bone density.
Examples include
Fosamax (Alendronate),
Boniva (Ibandronate),
Actonel (Risedronate).
Often useful for patients with steroid induced osteoporosis, like with chronic asthma.
Raloxifene (Evista): mimics beneficial effects of estrogen on bones without some of the risks associated with estrogen, like breast and uterine cancer. Should avoid if there is history of blood clots.
Calcitonin: a hormone produced by the thyroid gland, is usually administered as nasal spray, helps prevent bone loss. Less effective than the bisphosphonates.
Teriparatide (Forteo): currently under study, is similar to parathyroid hormone, which is can strongly influence bone metabolism by stimulating new bone growth. Long term effects as yet unknown.