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Prevention and Treatment

The best treatment for osteoporosis is prevention. While preventive measures cannot eliminate every case of osteoporosis, regular weight-bearing exercise (such as walking and resistance training), eating foods rich in calcium and vitamin D (and supplements as needed), quitting smoking, and moderating alcohol consumption can all help reduce the risk. The American College of Obstetricians and Gynecologists (ACOG) in a recent practice bulletin outlines recommended age-appropriate dietary allowances for vitamin D and calcium that women should take on a daily basis. To maintain healthy bones, a woman should have a vitamin D level of at least 20 nanograms per milliliter (ng/mL). The sooner these lifestyle measures are adopted, the more that they can help. Maximizing bone mass in the young and minimizing bone loss during aging can help prevent or minimize osteoporosis.

For those at increased risk of osteoporosis, those who have decreased bone mass, and those who have been diagnosed with osteoporosis (and who may have already experienced a bone fracture), there are a variety of treatments available, including antiresorptive medications and bone forming (anabolic) medications. They are used to help inhibit bone resorption, increase bone formation, maintain bone mass, and reduce the number of fractures. Some examples include bisphosphonates, estrogen, estrogen agonists/antagonists (also called selective estrogen receptor modulators or SERMS), calcitonin, and parathyroid hormone.

People with osteoporosis should work with their healthcare providers to determine which treatments are right for them as well as adopt lifestyle changes that will help them conserve bone mass and take measures to prevent falling, a common cause of osteoporosis-related fractures. Those who take medications that can cause bone density loss, such as prednisone or other glucocorticoids, and some anticonvulsant drugs should talk to their healthcare providers about their alternatives. It is important that they do this prior to stopping any medications.

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