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Osteoporosis (cont.)

Which Doctors Treat Osteoporosis?

Osteoporosis may be treated by a number of different medical specialists. Endocrinologists, rheumatologists, family practitioners, generalists, internists, geriatricians, and gynecologists all treat osteoporosis.

Can Any Foods Help Prevent Osteoporosis?

Many foods can help prevent osteoporosis. A number of scientific studies have shown that eating more fruits and vegetables leads to stronger bones. Low-fat dairy products are high in calcium, and many are fortified with vitamin D and help strengthen bones. Fatty fish such as salmon, mackerel, tuna, and sardines are high in vitamin D. Canned sardines and salmon (with bones) are high in calcium.

What Foods Should Be Avoided With Osteoporosis?

  • Foods that are high in sodium (salt) cause the body to lose calcium and can lead to bone loss.
  • Drinking too much alcohol can lead to bone loss. Limit alcohol intake to two drinks a day or less.
  • Caffeine found in coffee, tea, and soda decreases calcium absorption and can lead to bone loss.
  • Soft drinks. The caffeine and phosphorous found in colas may contribute to bone loss. It is not clear if the link to bone loss is because people choose soft drinks over milk and other calcium-containing beverages, or if cola directly causes bone loss.

What Medications Treat Osteoporosis?

  • Estrogen: For newly menopausal women, estrogen replacement is one way to prevent bone loss. Estrogen can slow or stop bone loss. And if estrogen treatment begins at menopause, it can greatly reduce the risk of hip fracture. It may be taken orally or as a transdermal (skin) patch (for example, Vivelle, Climara, Estraderm, Esclim, Alora).
    • Many women past menopause also choose estrogen replacement therapy because of its proven usefulness in slowing the progression of, or preventing, osteoporosis.
    • Recent studies question the safety of long-term estrogen use. Women who take estrogen have an increased risk for developing certain cancers. Although it was once thought that estrogens confer a protective effect on the heart and blood vessels, recent studies have shown that estrogens cause an increase in coronary heart disease, stroke, and venous thromboembolism (blood clots). Many women who take estrogens have side effects (such as breast tenderness, weight gain, and vaginal bleeding). Estrogen's side effects can be reduced with proper dosing and combination. If you have had a hysterectomy, estrogen alone is needed. For women with an intact uterus, progestin is always part of hormone replacement therapy. Ask your doctor whether estrogen is right for you.
  • SERMs: For women who are unable to take estrogen or choose not to, selective estrogen receptor modulators (SERMs) such as raloxifene (Evista) offer an alternative. For example, many women who have first-degree relatives with breast cancer will not consider estrogen. The effects of raloxifene on bone and cholesterol levels are comparable to those of estrogen replacement. There appears to be no estrogen stimulation of the breasts or uterine lining, which reduces the risk profile of hormone replacement. Raloxifene may cause hot flashes. Its risk of blood clots is at least comparable to the risks with estrogen. Tamoxifen (Nolvadex), commonly used in the treatment of certain breast cancers, also inhibits bone breakdown and preserves bone mass.
  • Calcium: Calcium and vitamin D are needed to increase bone mass in addition to estrogen replacement therapy.
    • A daily intake of 1,200-1,500 mg (through diet and supplements) is recommended. Take calcium supplements (calcium carbonate, calcium citrate) in doses of less than 600 mg. Your body can only absorb so much at one time. The best way may be to take one supplement with breakfast and another with dinner.
    • A daily intake of 800-1,000 IU of vitamin D is needed to increase bone mass. Vitamin D is available over the counter as vitamin D2 and vitamin D3 (cholecalciferol).
Medically Reviewed by a Doctor on 8/30/2017

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Patient Comments & Reviews

The eMedicineHealth doctors ask about Osteoporosis:

Osteoporosis - Symptoms

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Osteoporosis - Treatment

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Read What Your Physician is Reading on Medscape

Osteoporosis »

Osteoporosis is a systemic skeletal disorder characterized by decreased bone mass and deterioration of bony microarchitecture.

Read More on Medscape Reference »

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