Osteoporosis: an update.
Prevention is the therapy of choice for optimizing skeletal health and preventing osteoporosis. Attempts directed at increasing peak bone mass (e.g., good calcium intake during preadolescence, adolescence, and adulthood), reducing risk factors for bone loss such as menstrual abnormalities, thin body habitus, decreased physical activity or excessive alcohol intake, and slowing down bone loss and reversing any causes of secondary bone loss should be pursued vigorously. In practice, all patients should be encouraged to get regular exercise, as well as adequate vitamin D and calcium intake. In the absence of contraindications, estrogen is the mainstay therapy for the prevention and treatment of osteoporosis. Other antiresorptive agents are available as alternative therapies to estrogen. Of equal importance to elderly women with established osteoporosis is counseling on how to prevent falls. Therapies that increase bone formation (aside from fluoride), including growth factors, are not currently available. However, such interventions used in conjunction with an antiresorptive therapy, offer the potential to greatly enhance and therefore normalize bone mass and may hold a promise for the treatment of osteoporosis in the future.
el-Hajj Fuleihan
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Department of Internal Medicine, American University of Beirut-Medical Center.
D005260:Female; D050723:Fractures, Bone / Q000209:etiology; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D012307:Risk Factors