Vitamins and Supplements: Osteoporosis

Overview

Osteoporosis is a condition in which the bones begin thinning and there is a loss of bone density and mass over time. This occurs when the body stops forming enough new bone tissue and/or excessive bone tissue is reabsorbed. Osteoporosis is the major underlying cause of fractures in postmenopausal women and the elderly. Fractures occur most often in bones of the hip, spine, and wrist, and can be permanently disabling, especially when they occur in the hip. It is the most common bone disease, affecting an estimated 10 million Americans, most of whom are women.

Signs and Symptoms

Osteoporosis is often referred to as a “silent disease” because there are often no symptoms during the early stages. An individual may not realize the condition is present until he or she has suffered a broken bone. Some of the later-stage symptoms include:

• Bone pain/tenderness
• Fractures with no trauma
• Loss of height (up to )
• Lower back pain
• Neck pain
• Stooped posture

Causes/Common Triggers

One of the key risk factors for osteoporosis is older age. As patients age, essential minerals such as calcium and phosphate are reabsorbed from the bones back into the body, causing bones to become weak and fragile. This gradual process occurs over a period of several years. The leading causes of osteoporosis are reduction of estrogen in women (at time of menopause) and reduction of testosterone in men. Other causes of osteoporosis include:

• Chronic kidney disease
• Rheumatoid arthritis
• Long-term use of corticosteroid medication
• Hyperparathyroidism
• Vitamin D deficiency
• Lack of muscle use (eg, individuals who are confined to bed)

Tests and Diagnosis

Diagnosis of osteoporosis initially involves examining the patient’s medical and family history. In addition, the following tests are used to help determine a diagnosis:

• Physical exam
• Computed tomography scans and x-rays
• Laboratory testing to determine levels of bone formation and breakdown
• Bone mineral density scans

Prevention

Maintaining a healthy lifestyle that includes a balanced diet and a sufficient amount of exercise can help prevent the onset of osteoporosis. More tips for staving off osteoporosis include:

• Consume adequate amounts of calcium and vitamin D
• Avoid excessive drinking of alcohol
• Avoid smoking cigarettes

Management

To help manage osteoporosis, individuals should make sure they are getting enough calcium, vitamin D, and protein in their diet. Regular activity that includes weight-bearing exercises is also recommended to reduce the likelihood of bone fractures.

Treatment and Care

Patients should consult with their physician for the best treatment plan for osteoporosis, as treatment should be based on severity of disease as well as individual specifications. In addition to bisphosphonates, which can be taken orally or by injection, a physician may prescribe estrogen or hormone replacement therapy.

Homeopathic and Alternative Remedies

Some alternative remedies may help in the treatment of osteoporosis, including:

• Herbal extracts to support stomach acid (helps calcium absorption)
• Sun exposure to increase vitamin D level
• Fish oil
• Vitamin and mineral supplements

Self-Care

A number of formulations of OTC vitamin and mineral supplements are available to help boost levels of calcium and vitamin D. It may be helpful to consult with a pharmacist before choosing a vitamin or mineral supplement. To prevent drug interactions or contraindications, pharmacists should be informed of all medications that the patient is taking.

Resources for Patients

• American College of Rheumatology
• National Osteoporosis Foundation
• International Osteoporosis Foundation
• National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center

Resources for Pharmacists

• National Osteoporosis Foundation Resources for Professionals
• National Association of Chronic Disease Directors