Osteoporosis secondary prevention: Difference between revisions
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==Overview== | ==Overview== | ||
Effective measures for the [[secondary prevention]] of [[osteoporosis]] include [[pharmacological]] therapy and also life style modification as soon as [[osteoporosis]] is diagnosed. | |||
==Secondary | ==Secondary prevention== | ||
=== | Effective measures for the [[secondary prevention]] of [[osteoporosis]] include [[pharmacological]] therapy and also life style modification. | ||
===Pharmacological therapy=== | |||
* | * The primary most important goal for treatment of [[osteoporosis]] is to reduce longtime [[fracture]] risk in patients. Increasing [[Bone mineral density|bone mineral density (BMD)]] in response to the treatment is far less important than improvement of clinical aspects of [[osteoporosis]], i.e., [[Osteoporosis|osteoporotic]] [[Bone fracture|fracture]]. Therefore, most of the [[drugs]]' efficacy are measured by the extend they improve the [[fracture]] risk, in turn of increasing [[Bone mineral density|BMD]].<sup>[[Osteoporosis medical therapy#cite note-pmid11893367-3|[3]]]</sup> | ||
* It has to explain for patients that treatment purpose is to reduce their [[fracture]] risk in the future. During the treatment, if a single [[fracture]] happened, it is not necessarily reflect of treatment failure; despite the major complicates [[fractures]] that may need to start alternative treatments or patient referral to [[specialist]].<sup>[[Osteoporosis medical therapy#cite note-pmid28761958-4|[4]]]</sup> | |||
* | * [[Calcium]] and [[vitamin D]] supplementation have been found to be effective in reducing the long term [[Bone fracture|fracture]] risk, significantly. In order to suggest the people to use [[vitamin D]] and [[calcium]] [[supplements]], first the [[physician]] has to become sure that patient is not able to obtain the [[nutrients]] through daily intake. The available supplemental ions of [[calcium]] include [[calcium carbonate]] and [[calcium citrate]]; and [[vitamin D3]] has various [[Dosage form|dosage forms]].<sup>[[Osteoporosis medical therapy#cite note-pmid24131178-5|[5]]]</sup> | ||
* [[ | |||
=== Life style modifications === | |||
* [[Exercise]]: Exercise promotes the [[mineralization]] of [[bone]], and [[bone]] accumulation particularly during growth. High impact exercise in particular has been shown to prevent the development of [[osteoporosis]], however it can have a negative effect on bone [[mineralization]] in cases of poor [[nutrition]], such as [[anorexia nervosa]] and [[celiac disease]]. | |||
* [[Nutrition]]: A [[diet]] high in [[calcium]] and [[vitamin D]] prevents [[bone loss]]. Patients at risk for [[osteoporosis]], such as persons with chronic [[steroid]] use are generally treated with [[vitamin D]] and [[calcium]] supplementation. In [[Kidney|renal]] disease, more active forms of [[vitamin D]], such as 1,25-dihydroxycholecalciferol or [[calcitriol]] are used; as the kidney can not adequately generate [[calcitriol]] from [[calcidiol]] (25-hydroxycholecalciferol), which is the storage form of [[vitamin D]]. | |||
* Quitting [[smoking]] helps prevent [[osteoporosis]], as well as other diseases. | |||
* Not drinking alcohol, or drinking only in moderation (1–2 alcoholic beverages/day) | |||
* Taking certain medications linked to [[osteoporosis]] ([[anticonvulsants]] or [[corticosteroids]]) only at the least possible dose and time needed.<sup>[[Osteoporosis life style modification#cite note-BuckleyGuyatt2017-1|[1]]]</sup> | |||
==References== | ==References== | ||
Revision as of 03:29, 16 August 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Raviteja Guddeti, M.B.B.S. [3]; Charmaine Patel, M.D. [4]
Overview
Effective measures for the secondary prevention of osteoporosis include pharmacological therapy and also life style modification as soon as osteoporosis is diagnosed.
Secondary prevention
Effective measures for the secondary prevention of osteoporosis include pharmacological therapy and also life style modification.
Pharmacological therapy
- The primary most important goal for treatment of osteoporosis is to reduce longtime fracture risk in patients. Increasing bone mineral density (BMD) in response to the treatment is far less important than improvement of clinical aspects of osteoporosis, i.e., osteoporotic fracture. Therefore, most of the drugs' efficacy are measured by the extend they improve the fracture risk, in turn of increasing BMD.[3]
- It has to explain for patients that treatment purpose is to reduce their fracture risk in the future. During the treatment, if a single fracture happened, it is not necessarily reflect of treatment failure; despite the major complicates fractures that may need to start alternative treatments or patient referral to specialist.[4]
- Calcium and vitamin D supplementation have been found to be effective in reducing the long term fracture risk, significantly. In order to suggest the people to use vitamin D and calcium supplements, first the physician has to become sure that patient is not able to obtain the nutrients through daily intake. The available supplemental ions of calcium include calcium carbonate and calcium citrate; and vitamin D3 has various dosage forms.[5]
Life style modifications
- Exercise: Exercise promotes the mineralization of bone, and bone accumulation particularly during growth. High impact exercise in particular has been shown to prevent the development of osteoporosis, however it can have a negative effect on bone mineralization in cases of poor nutrition, such as anorexia nervosa and celiac disease.
- Nutrition: A diet high in calcium and vitamin D prevents bone loss. Patients at risk for osteoporosis, such as persons with chronic steroid use are generally treated with vitamin D and calcium supplementation. In renal disease, more active forms of vitamin D, such as 1,25-dihydroxycholecalciferol or calcitriol are used; as the kidney can not adequately generate calcitriol from calcidiol (25-hydroxycholecalciferol), which is the storage form of vitamin D.
- Quitting smoking helps prevent osteoporosis, as well as other diseases.
- Not drinking alcohol, or drinking only in moderation (1–2 alcoholic beverages/day)
- Taking certain medications linked to osteoporosis (anticonvulsants or corticosteroids) only at the least possible dose and time needed.[1]