please protect your bones
please protect your bones
If you have osteoporosis, or are at risk of developing osteoporosis, you want to do everything possible to keep your bones as strong as possible. In addition to following your doctor's advice on diet and exercise, you should also know that some medications are good for your bones, while others can have side effects that affect your bones.
Some medications for common health problems, such as heartburn or depression, may affect your bone health.
"That doesn't necessarily mean you should stop them," says Harold Rosen, director of the Center for Osteoporosis Prevention and Treatment at Beth Israel Deaconess Medical Center in Boston.
Instead, "it's important to weigh the pros and cons: the benefits of the drug versus the effects on the bones," he said.
The benefits of the drug may outweigh the risks. Or your doctor might prescribe a "bone maintenance" drug to offset the risk, Rosen said.
Corticosteroids and bone health
This type of steroid medication helps suppress inflammation. Doctors prescribe it for conditions including rheumatoid arthritis, asthma, and ulcerative colitis.
Some examples include:
1. Cortisone
2. Prednisone (Deltasone, Meticorten, Orasone, Prednicot)
These steroids hinder bone formation and increase bone resorption, increasing the likelihood of fractures, says Ann Kearns, MD, an endocrinologist and consultant at the Mayo Clinic in Rochester, Minnesota.
However, some people need these drugs, she said. "For most people, short-term risk isn't a big deal," Rosen said.
How you take your medication may also be important. Pills or injections are the most effective, but those you inhale or apply to your skin are "less worrisome," Kearns said.
GERD medications and bone health
If you have GERD (gastroesophageal reflux disease), your stomach acid can back up into your esophagus. You may be taking a drug called a proton pump inhibitor (PPI), which may or may not require a prescription. PPIs include:
1. Esomeprazole (Nexium)
2. Lansoprazole (Prevacid)
3. Omeprazole (Prilosec, Zegerid)
In 2010, the FDA warned that long-term use of high-dose PPIs may increase the likelihood of hip, wrist and spine fractures. FDA Orders Changes to Drug Labels to Pay Attention to Risks
Other drugs called H2 blockers suppress the production of stomach acid. H2 blockers include:
1. Cimetidine (Tagamet)
2. Famotidine (Calmicid, Fluxid, Mylanta AR, Pepcid)
3. Ranitidine (Tritec, Zantac)
According to Kearns, the drugs may be more bone-friendly, but that's not certain.
Bone Maintenance Drugs
Bisphosphonates are an osteoporosis drug. They include:
1. Alendronate (Binosto, Fosamax)
2. Ibandronate (Boniva)
3. risedronate (Actonel, Atelvia)
4. Zoledronic acid (Reclast)
Some studies have linked their long-term use to an increased likelihood of uncommon fractures of the thighbone.
If people who take bisphosphonates long-term suffer from this rare thigh fracture, their doctor should switch them to another osteoporosis drug, Deal said.
The following drugs are bisphosphonate replacements used to treat or prevent osteoporosis:
1. Denosumab (Prolia). This is a biological drug that slows bone loss.
2. Raloxifene (Evista)
3. Teriparatide (Forteo). This is a parathyroid hormone that increases bone formation.
hormone replacement therapy
If you've been taking bisphosphonates for five years, Deal says your doctor may check to see if you should continue, stop, or switch to another bone-maintenance drug.
Hormone replacement therapy (HRT) - estrogen alone or a combination of estrogen and progestin - is used to prevent and treat osteoporosis. The drug Duavee (estrogen and bazedoxifene) is a HRT approved for the treatment of hot flashes associated with menopause. Duavee also prevents osteoporosis in high-risk women who have already tried non-estrogen therapy.
Studies have shown that hormone replacement therapy increases the risk of breast cancer, heart disease and stroke in some women. Therefore, while HRT is known to help protect bones and prevent fractures, it is currently not generally recommended for the treatment of osteoporosis because the health risks are believed to outweigh the benefits.
In women who had menopausal hormone therapy in the past and then stopped taking it, the bones began to thin again -- at the same rate as during menopause.
In addition, with the Biophilia Tracker, we can better understand the effects of various drugs on our bones and thus better protect our bones.