title: Complementary and Alternative Medicine for Osteoporosis.
abstract: BACKGROUND
  A systemic skeletal disease is characterized by low bone mass and micro-architectural deterioration with a consequent increase in bone fragility and susceptibility to fracture. Asia has the highest increment in the elderly population; therefore, osteoporotic fracture should be a noticeable health issue. The incidence rate of hip fractures in Asia could rise to 45% by the year 2050. Complementary and alternative medicine (CAM) is a group of various medical and health care systems, practices, and products that are not presently considered as part of formal medicine. CAMs have been described as "diagnosis, treatment, and/or prevention which complements mainstream medicine as a holistic, subjective and various natural approaches to medical problems by contributing to a common whole, satisfying claims not met by orthodoxy, or diversifying the conceptual frameworks of medicine".
  
  
  METHODS
  Peer-reviewed publications were identified through a search in Scopus, Science Direct, Cochrane, PubMed, and Google scholar using keywords "osteopenia", "osteoporosis", "menopause", "CAM", "phytoestrogens", "phytotherapy" and "herbal medicine". The search was completed in July 2015 and was limited to articles published in English. Relevant articles were identified based on the expertise and clinical experience of the authors.
  
  
  RESULTS
  We categorized our results in different classifications including: lifestyle modifications (cigarette, alcohol, exercise and food regimen), supportive cares (intake supplements including vitamin D, C and K), treatments synthetic (routine and newer options for hormone replacement and none hormonal therapies) and natural options (different types of CAM including herbal medicines, yoga and chiropractic).
  
  
  CONCLUSIONS
  Established osteoporosis is difficult to treat because bone density has fallen below the fracture threshold and trabecular elements may have been lost. Antiresorptive agents can be used to prevent further bone loss and stimulation of new bone formation by the use of anabolic steroids or fluoride may increase the overall amount of bone.
authors.affiliation: Traditional Iranian Pharmacy Department, Faculty of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Zahra Alsadat
authors.initials: ZA
authors.lastname: Hejazi
authors.affiliation: Pharmacognosy Department, Faculty of Pharmacy, Ahvaz Jundishapur University of Medical sciences, Ahvaz, Iran.
authors.forename: Forough
authors.initials: F
authors.lastname: Namjooyan
authors.affiliation: Pharmacognosy Department, Faculty of Pharmacy, Ahvaz Jundishapur University of Medical sciences, Ahvaz, Iran.
authors.forename: Marjan
authors.initials: M
authors.lastname: Khanifar
keywords: Complementary Therapies; Menopause; Osteoporosis; Phytoestrogens; Phytotherapy