Osteoporosis treatment
Osteoporosis is a systemic disease in which the processes of destruction of bone tissue prevail over its ability to regenerate and strengthen. In this case, calcium salts are washed out of the bones, since they become unable to keep them inside. As a result, increased fragility of bones, a high tendency to fractures, which occur even with a slight external influence. It can be an ordinary bruise, careless movement, fall.
Osteoporosis is a dangerous disease that can cause death. More often than not, the death and disability of people occurs only due to cardiovascular pathologies, diabetes mellitus and cancer.
The insidiousness of the disease also lies in the fact that osteoporosis develops with a minimal set of symptoms. The patient begins to feel them when the treatment becomes ineffective - this is the stage during which fractures often occur.
Learn more: Fractures - types of fractures, healing phases
Content:
- Factors affecting the development of osteoporosis
- Diagnostic methods
- Osteoporosis treatment
- Symptomatic treatment of osteoporosis
- Home treatment of osteoporosis
- Preventive measures
Factors affecting the development of osteoporosis
The main factors contributing to the development of osteoporosis:
- Lack of calcium in the body due to inaccuracies in nutrition. This can be an unbalanced diet, adherence to a variety of diets, fasting, etc. Lack of calcium in the body often provokes disruptions in the absorption of vitamins and minerals.
- Physical inactivity. Prolonged lying, immobilized position leads to the fact that osteoclasts are activated in the body. They destroy bone tissue, disrupt its mineralization. Dangerous in this regard, a long stay in a state of weightlessness. Therefore, people who are diagnosed with osteoporosis must maintain a constant physical activity.
- Hormonal disorders. The disease can develop due to any hormonal imbalance - these are disruptions in the production of thyroid hormones, parathyroid glands, sex hormones and pituitary hormones.
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Secondary osteoporosis can develop with excessive consumption of alcoholic beverages, coffee, in the presence of such a bad habit as smoking, as well as against the background of blood diseases, against the background of rheumatism, renal failure, diabetes mellitus.
- If a person consumes too much carbonated water, then bone disease can develop in him even at a young age. Most carbonated drinks have been shown to contain substances that help flush calcium out of the bones.
- Another reason for the development of osteoporosis is disturbances in the functioning of the digestive system, in the functioning of the cardiovascular system.
- Spine diseases develop mainly in old age, after 60 years. Women suffer more often than men, the disease is detected in them after the onset of menopause. In the male population, calcium in the bones remains longer, its age-related loss occurs somewhat later.
The main symptoms of the disease are considered to be:
- Disorders in the structure of bones, which leads to their deformation.
- Stoop, loss of height due to curvature of the spine, periodontal disease.
- Joint mobility disorders, both large and small. Habitual physical activity leads to rapid fatigue.
- At night, the patient may be disturbed by cramps arising in the lower leg. Dull aching pains are possible, or sharp pains in the spinal column and in the joints. The painful sensations become especially intense during a change of weather.
It is impossible to stop the development of osteoporosis, it is an obligatory companion of the aging of the whole organism. It is possible to prevent the leaching of calcium from the bones only when it is caused by another pathology. However, this does not mean that the rate of development of the disease cannot be slowed down. A well-designed treatment regimen eliminates the development of complications.
Diagnostic methods
X-ray examination is the most common method for diagnosing a disease. However, it is informative only when more than 30% of bone mass has been lost. It takes a long time to treat such a patient, and the effect is not always achieved.
- CT scan. With the help of a tomograph, a disease can be detected at an early stage of its development. For this, the devices are equipped with a special attachment. An ultrasound apparatus also helps to identify the disease. But at once it is possible with the help of these devices to study the state of only one part of the body. While to assess the extent of the spread of the pathological process, it is necessary to examine several departments.
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Osteodystrophy. Modern medicine has X-ray densimeters, thanks to which it is possible to assess the mineral density of bone tissue in several parts of the body at once. Moreover, the accuracy of such a study is high. It is possible to track even 2% bone loss, as well as to reveal the level of muscle mass and body fat, calcium content in bones. These data correlate with the patient's age and gender. Densitometric examination is safe for health, it is carried out quickly and does not cause painful sensations. There are no side effects after the diagnosis, so you can do it as many times as necessary.
However, the reason for the loss of bone mass cannot be determined using these techniques. This can only be done by the attending physician.
In addition to interviewing and examining the patient, he will send him to the delivery of the following tests:
- Urine must be passed to determine electrolytes in it;
- Blood sampling allows you to identify the level of calcium, vitamin D and phosphorus in it;
- Determination of the level of osteocalcin is required;
- The excretory capabilities of the kidneys are being studied;
- Blood is donated for parathyroid hormone.
These studies, carried out in combination, allow you to draw up the most complete picture of the disease and prescribe the appropriate treatment.
Osteoporosis treatment
Osteoporosis treatment methods directly depend on the nature of the disease. If it arises as a secondary pathology, then it will be necessary to eliminate the root cause of the disease - this can be the correction of immune disorders, diseases of the cardiovascular and digestive systems, etc.
Primary osteoporosis forms due to aging of the body and most often occurs in women. Treatment requires a special approach, since the disease is most often diagnosed in the period after menopause. It is necessary to slow down as much as possible the leaching of calcium from the bones and increase its build-up. In this case, it is necessary to take into account what changes have occurred in the synthesis of sex hormones.
The therapy is divided into the following components:
- Basic treatment with medication. Its purpose is to correct metabolic processes in the bones. Treatment is long-term, continuous, step-by-step.
- Hormone replacement therapy.
- Symptomatic therapy.
The operation is performed for osteoporosis of the hip and knee joints. If conservative therapy is unsuccessful, then replacement of the worn out joint with an artificial one is indicated. This contributes to the improvement of the quality of life of patients, its extension, as it eliminates the risk of spontaneous fracture of the femoral neck.
The main treatment for osteoporosis
For the treatment of osteoporosis, regulators of calcium-phosphorus metabolism are prescribed.
These drugs replace the work of parathyroid hormones:
- Calcitonins (Miacalcic). The hormone calcitonin prevents the loss of calcium from the bones, it also takes part in the process of their formation, and has an analgesic effect. The drug is made from salmon calcitonin and acts similarly to a human's own hormone. For this purpose, drugs such as: Osteover, Alostin, Veprena can be used.
- Bisphosphonate preparations are aimed at inhibiting the process of bone loss, normalizing bone mineralization. Perhaps the appointment of the following funds: Risedronate, Alendronate, Ibandronate, Zoledronic acid (Xydiphon, Etidronate, Bonefos, Fosamax).
- The complex preparation Osteogenon prevents the destruction of bone tissue (inhibits the synthesis of osteoclasts and stimulates the work of osteoblasts), promotes the process of bone formation.
- Fluorine derivatives are aimed at stimulating the formation of bone tissue - these are Kaltsik, Fluocalcic, Osin, Coreberon.
- The parathyroid hormone teriparatide - Forsteo is used to stimulate osteoblasts. It needs to be injected.
All these drugs can only be prescribed by a doctor who will control blood and urine using laboratory diagnostic methods. This will assess the effectiveness of the treatment.
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| Bone tissue forms normally | The level of osteocalcin in the blood before the age of 50 is between 11 and 23 ng / ml. After the age of 50 - from 15 to 46 ng / ml. |
| Salt content rate (mmol / l) |
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Hormone replacement therapy
Therapy with hormonal drugs is used very often. It is prescribed for people with severe osteoporosis, with the disease in the early stages of its development, and even for those patients who have only prerequisites for the development of pathology. For a woman who has entered the menopausal period, certain estrogen receptor modulators are prescribed. These are drugs such as Raloxifene, Keoxifen, Evista, Droloxifen. Their reception helps to stop the process of bone destruction, or significantly slow it down. The risk of fractures is reduced by exactly half.
Perhaps the appointment of the estrogens themselves, for example, the drugs Femoston, Kliogest, in combination with calcium preparations. But it should be remembered that taking estrogen-containing drugs affects the risk of developing gynecological oncological diseases. To achieve the effect, you will need to take estrogens for at least 5 years. In parallel, the level of hormones in the blood is monitored. Cancellation of drugs is carried out in stages, reducing the dose slowly.
Do not take estrogens for those patients who are at risk for cancer, as well as those patients who have a tendency to thrombotic complications. In addition, estrogen hormone therapy is a maintenance therapy and is not able to replenish the calcium level in the bones.
Calcium supplements for osteoporosis
To stop the development of the disease, you need to use calcium supplements. They work much better than including foods rich in this micronutrient on the menu, or using traditional therapies.
To increase the effectiveness of therapy, calcium preparations are prescribed in combination with calcium metabolism regulators:
- The reception of multivitamins is shown - it can be Elevit, Kaltsinova, Komplevit, Nutrimaks. But since there are a lot of components in these funds, they are absorbed worse than mono-drugs. Therefore, they are used as a prophylactic and not as a remedy.
- Taking monovitamins with calcium salts. Calcium gluconate itself is poorly absorbed, so it is best to take drugs such as calcium glycerophosphate, calcium lactate, calcium chloride.
- Perhaps the appointment of combination drugs in which calcium is combined with vitamin D - it can be Calcium D3 nycomed, Orthocalcium in combination with calcium citrate, Vitamin D3 in combination with Vitrum calcium.
Learn More: Calcium for Osteoporosis: Which Calcium Is Better?
Only a doctor can pick up a remedy. If you take calcium supplements without medical supervision, it threatens the deposition of salts of the trace element in soft tissues, which will lead to damage to the kidneys, heart, blood vessels. The independent use of vitamin D for the treatment of children is especially dangerous. Incorrect dosages can lead to future health problems. The same applies to the irrational use of hormonal drugs.
Modern method of osteoporosis treatment
Doctors use a qualitatively new approach in the treatment of osteoporosis, it boils down to the following points:
- It is necessary to accurately identify all areas of bone tissue affected by osteoporosis.
- Then the lacunae of the bones are cleaned using the shock wave method.
- The next stage is the introduction of animal tissue extract and ionized calcium under the periosteum.
- Carrying out standard therapy.
This osteoporosis treatment regimen is applicable to patients of any age.
At the University of Auckland in New Zealand, research is taking place on a novel drug that should be a breakthrough treatment for osteoporosis. This is the drug Zometa, which is produced by Novartis AG (Switzerland) and is zoledronic acid. It is enough to enter it once a year, no more therapy is required. Based on the study, it was found that the breakdown of bone tissue after injection slows down by a year, and the bone itself becomes denser during this time. However, there are no data on the prevention of bone fractures, but trials are ongoing.
Symptomatic treatment of osteoporosis
- Taking analgesics and muscle relaxants for pain and muscle spasms, taking NSAIDs for arthritis. This allows the patient to avoid the progression of the disease due to physical inactivity.
- Treatment of fractures with surgery.
- Physiotherapy treatment, exercise therapy complexes.
- Compliance with the diet with the inclusion of foods rich in magnesium, calcium phosphorus in the menu.
- Refusal to use carbonated drinks.
Home treatment of osteoporosis
You definitely need to adjust your menu. To slow the progression of osteoporosis, you should include foods with vitamin D, calcium, phosphorus. These are not only dairy products, but also seaweed, spinach, broccoli, fatty fish, legumes, eggplants.
From the table it becomes clear how much calcium is contained in various foods. The calculation is based on 100 g of product.
The body absorbs calcium salts in youth only by 30-35%, and in old age by 10-15%. Additionally, chocolate, tea, coffee and alcohol interfere with this process.
If treatment with calcium preparations is carried out, then in parallel it is necessary to take vitamin D. If this is not done, then calcium will simply be excreted from the body by the kidneys. Being in the sun, you can enrich your body with this essential vitamin.
At home, you can do physical exercises that have been prescribed by the doctor, do an independent massage.
Traditional medicine recommends using eggshells infused with lemon juice. Nevertheless, any pharmacy preparations that are available on the market will be much more effective than chicken egg shells.
Preventive measures
Prevention of osteoporosis is reduced to the following activities:
- The mother must take care of the child's skeletal system while he is in her womb. To do this, she needs to take vitamins that the doctor recommends. During childhood, attention should be paid to the accumulation of bone mass, for which the child should be properly fed, make sure that he is engaged in physical education, dancing, gymnastics, etc.
- In adolescence and adulthood, you should avoid inhaling tobacco smoke, drinking alcohol, and sweet soda. Sex life should be regular.
- During menopause, you should seek qualified medical help, since in the first 10 years after the onset of menopause, calcium is washed out of the bones especially quickly.
It is important to understand that osteoporosis is a disease that cannot be cured on its own. You should not take the information provided as a guide to self-medication. It is designed so that people understand the danger of the disease and do not postpone a high-quality diagnosis. Only a doctor can treat osteoporosis.
The author of the article: Kuzmina Vera Valerievna | Endocrinologist, nutritionist
Education: Diploma of the Russian State Medical University named after NI Pirogov with a degree in General Medicine (2004). Residency at Moscow State University of Medicine and Dentistry, diploma in Endocrinology (2006).
