Treatment of osteoporosis

Osteoporosis is not difficult to see in today's life. This common bone disease is a bone metabolic disease that often occurs in destitute female friends and middle-aged and elderly friends. It seriously affects the normal life and work of osteoporosis patients. This is still mild osteoporosis. If the symptoms are severe, patients may suffer fractures when participating in any minor activities, which seriously endangers the patient's life. The treatment of osteoporosis has now become people's most concerned issue.

The treatment of osteoporosis is divided into two methods: drug treatment and non-drug treatment. In our lives, bad living habits are the most fundamental cause of osteoporosis. Many young people develop osteoporosis when they are older due to some bad habits they develop when they are young. Today, I will tell you about several methods of treating osteoporosis:

Drug treatment for osteoporosis

Senile osteoporosis is caused by an imbalance of calcium-regulating hormones due to aging, which leads to bone formation disorders. Its treatment mainly involves the use of bone formation promoters.

(1) Calcium preparations: divided into two categories: inorganic calcium and organic calcium. The purpose of using calcium preparations is to supplement calcium, inhibit hyperparathyroidism, and improve the balance between bone absorption and bone formation. Increase calcium absorption, with Calcium D and Caesili D being the most effective. Organic calcium salts (calcium gluconate and calcium citrate) have minimal gastrointestinal reactions, but are contraindicated in patients with osteomalacia, severe renal failure, hypercalcemia, and hypercalciuria. Active Calcium, Gai Tianli and Long Mudan Bone Strengthening Granules are all natural biological calcium preparations and can be used to prevent osteoporosis in the elderly. The use of calcium supplementation in women before and after menopause has always been a controversial issue. Calcium supplementation is appropriate because the elderly's calcium intake and ability to adapt to a low-calcium diet gradually decrease with age. It is recommended to supplement elemental calcium 1200 mg daily, given in divided doses. A study suggests that elderly women should be given 1200 mg of calcium and 800 U of vitamin D daily. Giving patients high doses of calcium can cause several potential problems, including inducing or worsening constipation. Calcium supplementation and zinc absorption affect each other. Elderly patients should take multivitamin preparations containing zinc at the same time when receiving calcium supplements.

(2) Calcium regulators: Calcium regulators mainly include vitamin D, estrogen, and calcitonin.

1) Calcitonin: Calcitonin is a polypeptide hormone secreted by thyroid follicular cells. It can directly inhibit the activity of osteoclasts through osteoclast receptors, inhibit bone resorption and bone autolysis, reduce calcium release from bones, and increase calcium absorption. Calcitonin not only has the effects of relieving pain, improving activity function, and maintaining positive calcium balance, but also can prevent bone loss. Clinical observations have shown that calcitonin plays an irreplaceable role in the treatment of metabolic bone analgesia. Because long-term use of calcitonin can cause hypocalcemia and secondary hyperthyroidism, it is used in combination with calcium supplements and vitamin D.

2) Vitamin D: The main function is to promote the absorption of calcium and phosphorus in the intestine, inhibit the secretion of thyroid hormone (PTH), promote bone cell differentiation and increase bone mass. There are mainly two types of preparations: 1α-(OH)D3 and 1,25-(OH)2D3, both of which can effectively improve bone pain in patients with osteoporosis. Low doses of vitamin D (50μg/d) can cause toxic effects such as hypercalcemia in elderly patients, especially when used in combination with thiazide diuretics and calcium preparations. However, vitamin D deficiency is common in elderly patients. Vitamin D is required for calcium absorption and to improve muscle strength. A daily multivitamin containing 400 IU of vitamin D can be beneficial and will provide a normal vitamin D level even in hospitalized elderly patients. It is recommended to take 400-800U (10-20μg) of vitamin D per day. The main side effects are hypercalcemia and hypercalciuria. Therefore, serum calcium and creatinine should be monitored regularly during medication. The vitamin D absorption and metabolism (hydroxylation) function of the elderly generally decreases, which affects the absorption of calcium.

3) Estrogen: It can increase the activity of calcitonin, which inhibits bone resorption, and promote intestinal absorption of calcium. Appropriate administration of estrogen to women after menopause can delay postmenopausal calcium loss. Since long-term and high-dose use of estrogen can stimulate abnormal proliferation of the breast and endometrium and increase the risk of breast cancer and uterine cancer, the lowest effective dose should be used and supplemented with an appropriate amount of progestin. Livial has the combined effects of estrogen, progestin and weak androgen. It is currently the most ideal drug for the treatment of menopausal osteoporosis.

(3) Fluoride: It can mainly stimulate the osteogenic activity and bone formation ability of osteoblasts. In recent years, monofluorophosphates have been developed with better effects. In order to promote new bone calcification, this type of drug should be used in combination with calcium agents.

(4) Bisphosphonates: such as alendronate sodium and etidronate sodium can inhibit bone turnover and have a clear effect of increasing mineral density. The recently launched new formulation of alendronate sodium 70 mg/tablet is well tolerated and can be used once a week. It has a significant effect on enhancing bone mineral density and has been widely recognized since it was launched on the market.

Non-drug treatments for osteoporosis

(1) Phototherapy (2) High-frequency electrotherapy (3) Exercise therapy: Lack of physical activity can lead to disuse osteoporosis, while intense exercise can stimulate bone mass increase. It is generally believed that only load-bearing exercise has a positive effect on bones and can prevent the loss of bone mass in weight-bearing bones. (4) Nutritional therapy: Eat more calcium-containing foods, mainly dairy products and soy products. Three cups of milk can provide 900 mg of elemental calcium.

After reading the above introduction to the treatment of osteoporosis, I believe everyone has a deep understanding! In addition, osteoporosis is a stubborn disease that brings great inconvenience to the patient's life and normal work, and the treatment effect is relatively slow, so friends must develop good living habits in life and supplement calcium in time.