Our bones continually renovate through a process called bone turnover. Here, old bone is broken down and removed by cells called osteoclasts, and then the new bone is laid down by another group of cells called osteoblasts. The rate between these two processes should be balanced so that there is no significant loss in bone density. As you get older, the rate of bone removal will be higher than that of new bone formation. If this is left unchecked, it ultimately leads to osteoporosis. In this article, we will investigate the diagnosis methods and medications used for treating osteoporosis.
If your doctor suspects that you have osteoporosis, they measure the density of bones in the hip and spine. For this, they use dual-energy x-ray absorptiometry (DEXA). The result of this test is expressed in T-score. This score compares the density of your bones with that of a healthy 30-year-old adult.
- A person with normal bone density will have a T-score of -1.0 or above.
- A T-score between -1.0 and -2.5 means that you have low bone density, and this condition is referred to as osteopenia.
- A T-score of -2.5 or below means that you have osteoporosis.
Note: The lower the bone density of a person, the lower the T-score. Also, a T-score of -2.5 is lower than -1.0.
Most osteoporosis medications slow down or reduce the loss of bone. Usually, doctors start with bisphosphonates if someone has a low T-score. Listed below are the different types of bisphosphonates:
- Pills like alendronate (Fosamax), or risedronate (Atelvia, Actonel), and ibandronate (Boniva) are taken daily, weekly, or monthly.
- Zoledronic acid (Reclast) is administered intravenously once a year.
- Ibandronate (Boniva) injections are given once every three months.
Of these osteoporosis medications, alendronate has been around for the longest time. According to doctors, it gives good therapeutic results. The choice between different types of medications depends on your convenience. For instance, sometimes people cannot stand upright or sit for 30 to 60 minutes, or experience GI issues like reflux after taking oral bisphosphonates. In such cases, doctors can use infusion or injection of these drugs.
The Risk With Bisphosphonates
Two of the risks associated with bisphosphonate drugs are osteonecrosis in the jaw (bone death) and the fracture of the femur (thigh bone). These are more common in women who take high doses of bisphosphonates in the long term, as well as in those who are taking intravenous bisphosphonates for treating cancer that spreads to the bones.