Osteoporosis is a reduction of bone mineral density (statistically, it is defined as bone density T-score less than 2.5 standard deviations below the mean), leading to increased risk of fracture and weakness. The precursor is called osteopenia. Causes include lack of estrogen or testosterone, lack of exercise, alcohol and cigarette consumption, and use of glucocorticoids.
A DXA bone scan is recommended to track bone mineral density changes. Over-the-counter supplements are the mainstay method to prevent disease progression.
First-line recommendations:
Calcium supplements: Calcium is essential for bone fortification and mineralization. Aim for 1,000–1,200 mg of calcium daily through diet or supplement.
Vitamin D supplements: Vitamin D is essential for calcium absorption. Dose: 800–1,000 IU daily.
Weight-bearing exercises: Activities like walking, jogging, or resistance training improve bone strength. We recommend walking with adjustable ankle weights and at-home resistance bands.
Prescription medications:
Bisphosphonates (e.g., alendronate): May be considered in patients with high fracture risk but require prescription.
Selective Estrogen Receptor Modulators (SERMs): Can help maintain bone density in postmenopausal women.
Citation:
Cosman F, de Beur SJ, LeBoff MS, et al. Clinician’s Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int. 2014; 25(10): p.2359-2381. doi: 10.1007/s00198-014-2794-2
