Osteoporosis

Overview

Your body constantly remodels its bone tissue. You have osteoporosis when your body does not produce enough new bone or it reabsorbs too much existing bone.

Aging normally results in some bone loss but osteoporosis can cause the bones to become so weak that they break even due to a minor fall. Such fractures can significantly affect quality of life and day-to-day functioning.

In addition to advancing age and menopause, risk factors for osteoporosis include:

• Family history of osteoporosis
• Certain medicines, including corticosteroids
• Low body weight and size
• Low intake of calcium and vitamin D
• Certain thyroid and adrenal gland disorders
• Smoking
• Heavy alcohol use

Osteoporosis does not cause symptoms for most patients. You may not know you have it until you fracture a bone by a bump or fall. Some people develop back pain or stooped posture.

At IU Health, physicians use dual-energy X-ray absorptiometry (DXA) to assess bone health, risk of fractures and evaluate bone mineral density (BMD).

IU Health physicians offer therapies to slow bone loss and help you maintain an active, fulfilling lifestyle. Your physicians will work closely with you to address your specific symptoms and concerns with an individualized care plan.

Your team’s partnership with the Indiana University School of Medicine means that your physicians can offer you the most advanced options for diagnosis and treatment. If you need additional care from other specialists, they connect you with highly trained experts in their system.

With one of the country’s leading research programs in metabolic bone disease, your physicians investigate ways to provide even better care. You may access innovative new therapies by participating in clinical research studies.

Treatment

Your team will provide treatment for osteoporosis based on your specific needs. Options include:

• Antiresorptive medicines. These drugs work by slowing your rate of bone loss. They do not rebuild bone, but they can reduce your risk of fractures. Antiresorptive medicines include alendronate, risedronate, ibandronate, zoledronic acid, raloxifene and denosumab. You can take some of these drugs once or twice per year, making therapy more convenient.
• Anabolic medicine. This type of medicine helps your body generate new bone tissue. Forteo (teriparatide), the only available anabolic therapy, has U.S. Food and Drug Administration (FDA) approval for use in postmenopausal women and in men at high risk of bone fractures. This medicine also treats patients with osteoporosis resulting from use of steroid medicines. Teriparatide increases bone mineral density and has been shown in research studies to reduce the risk of broken bones. You take teriparatide as a daily injection for up to two years.
• Estrogen replacement therapy (ERT) and hormone replacement therapy (HRT). These therapies help in both prevention and, to some degree, treatment of osteoporosis in women after menopause. They replace hormones that decline as a natural part of aging. Estrogen replacement therapy (ERT) involves taking estrogen alone. This therapy comes in pills and skin patches. Hormone replacement therapy (HRT) involves taking both estrogen and progesterone. Women who have not had a hysterectomy (meaning they still have a uterus) generally take HRT because estrogen on its own increases the chance of uterine cancer.
• Rehabilitation. A personalized exercise and nutrition plan can help slow the rate of bone loss, prevent fractures and maximize daily functioning. Physical therapy may involve improving your posture and balance and modifying the way you carry out routine activities.