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Drugs Used to Enhance Bone

The efficiency of various drugs: calcium, vitamin D, calcitriol, hormone replacement therapy, selective estrogen receptor modulators (SERMS), bisphosphonates, and thiazide diuretics, calcitonin and fluorides.

Calcium

Calcium plays a very important role in metabolism and is involved in ensuring the work of several mechanisms, including the functioning of the nervous system, the transfer of muscle contraction, blood clotting mechanism.

In addition to his role - mechanical support, the bones are great reservoir of calcium. If insufficient intake of calcium from food the body begins to myself "get" calcium washing away it from the bone. As a result, bones become thin, become more brittle. That is why it is important to eat foods rich in calcium, or using food additives or medicines that contain calcium.

The bones are composed mainly of collagen protein fibers. Calcium and phosphate in the form of crystals are located between the fibers and give the bones strength and durability. The composition of the bone tissue is subject to change depending on the load in a state of dynamic equilibrium processes of formation and resorption (destruction) of bone are balanced. If calcium intake from food is not enough to provide all the vital processes in the body, activates the mechanism of bone resorption (removal) of calcium from bone into the blood.

Dairy products like milk, cheese, yogurt, ice cream (including foods low in fat), contain large amounts of calcium. As a rule, older people consume a diet of 500 mg to 1000 mg (1 gram) of calcium daily. But studies show that the additional intake of 500-1000 mg of calcium per day can significantly slow the loss of calcium from the bones. This requires at least use 4-6 servings of calcium-rich foods a day. Many older people feel uncomfortable with the use of such a large number of dairy products, and therefore prefer to take supplements or medications containing adequate amounts of calcium.

Older people with increased risk of osteoporosis are advised to take 500-1000 mg of calcium per day in the form of supplements or drugs. The range of pharmacies represented a large number of food additives and drugs that contain calcium in different forms. There are conflicting data that are proven or refuted the view that the calcium in a soluble form is absorbed more easily than in the form of sparingly soluble salts, for example, in the form of calcium carbonate.

Receive only the calcium may not completely stop bone loss, but it can slow down this process.

Vitamin D

A complete absorption and assimilation of calcium occurs only in the presence of sufficient vitamin D. Unlike other vitamins, the principal amount of vitamin D from food is not replenished, and is produced in skin exposed to sunlight. Most older people do not get enough vitamin D, as unable to perform the necessary amount of time outdoors, and their skin is not exposed to the sun. But, fortunately, the lack of vitamin D can make use of food additives.

The daily dose of 500-1000 IU (International Units) may be filled at the use of fish oil (cod liver oil or halibut fish) or multivitamin preparations. Alternatively, you may use one tablet per month containing 50 000 IU of vitamin D (calciferol).

If you are not sure whether a sufficient amount of vitamin D you eat, ask your doctor for a blood test that will show the levels of the vitamin in your body.

Calcitriol

Calcitriol is produced in the kidneys. This is the most active, which is formed in the body form of vitamin D. Calcitriol regulates the absorbance (absorption) of calcium from food. Previously, in some countries it has been used to treat osteoporosis.

However, the effect of calcitriol is low and inferior efficacy of other treatments: hormone replacement therapy (HRT) or bisphosphonates therapy. Yielded conflicting data on the incidence of fractures during therapy with calcitriol. It is more preferred are more developed in recent years, more effective therapies.

Hormone replacement therapy (HRT)

After menopause in women decreases the levels of sex hormones produced by the ovaries. The level of hormones in the blood is directly related to bone strength. Therefore, all the older women are subject to reduced bone density. Hormone replacement therapy (HRT) compensates for the lack of natural hormones and can restore the level of their content to a level corresponding to the period prior to menopause.

Estrogen is a hormone that affects bone density. However, in most cases, the preferred method is a combination of estrogen and progesterone, as Progesterone prevents the development of cervical cancer. If a number of years to use preparations containing estrogen alone may appear irregular bleeding and increased risk of developing cancer of the endometrium (lining of the uterus). Therefore, estrogen drugs usually prescribed for women with a uterus removed.

Home use of HRT during menopause to prevent postmenopausal bone loss and reduces fracture risk, which develops later in the next 5-10 years. However, even if HRT is started after a few years after menopause, the effectiveness of therapy is clear: increases bone strength and reduces fracture risk.

All preparations for HRT prescribed by the doctor after a thorough medical examination, since there are several contraindications to the use of this therapy. When HRT should strictly follow the instructions of the doctor and follow the instructions for use contained in each package.

Selective Estrogen Receptor Modulators (SERMS)

SERMS nonhormonal chemical nature, which selectively act on the cells, rendering the action, this action of estrogen. As SERMS do not have hormonal activity, they do not have the serious side effects, which are characteristic of estrogens. For example, they do not increase the risk of developing cancer of the uterus and mammary glands. Now for the therapy available SERMS drugs containing active ingredients as tamoxifen raloxifene, or toremifene.

However, the effect of SERMS on bone density is not as great as the actual effect of estrogen. Long-term study of this group of drugs in women with postmenopausal osteoporosis showed a reduction in vertebral fractures. But the risk of fractures of other bones (eg, hip) did not decrease. Drugs belonging to the group SERMS are not prescribed for menopausal women suffering from painful tides. This group of drugs prescribed by the doctor after a thorough medical examination, since there are several contraindications to the use of this therapy. While receiving SERMS should strictly follow the instructions of the doctor and follow the instructions for use contained in each package.

Bisphosphonates

Bisphosphonates salt of phosphorus, which activate the formation of bone tissue and help prevent its resorption (breakdown). Bisphosphonates not only prevent the subsequent loss of bone mass and reduce fracture risk, but during the first years of application, they do increase bone strength. Bisphosphonates are the most studied group of drugs for the treatment of osteoporosis.

Bisphosphonates, like other drugs to treat osteoporosis, prescribed by the doctor after a thorough medical examination, since there are several contraindications to the use of this therapy. While receiving bisphosphonates should strictly follow the instructions of the doctor and follow the instructions for use contained in each package.

We emphasize only one of the properties of this group of drugs and related warnings.

Bisphosphonates are poorly soluble, and therefore should comply with certain requirements for better absorption of the drug and reduce the risk of side effects. - Take the medication in the morning on an empty stomach, at least a half hour before meals with a full glass of water.
- Only need to drink water! Milk, tea, coffee, fruit juice inhibit the absorption of bisphosphonates.
- Necessary to maintain the upright position (sitting or standing) for at least a half hour after taking the pill. This contributes to a better passage of tablets through the esophagus and prevents irritation.

Thiazide diuretics

Thiazide diuretics are used for many years to treat high blood pressure. One side effect of taking reduced excretion of calcium in the urine. As a result, there is a slight increase in bone density. Thiazide diuretics are not effective enough for use as monotherapy for osteoporosis, but may be used in combination with other drugs.

Thiazide diuretics are prescribed after a thorough medical examination, since there are several contraindications to the use of this therapy. It should strictly follow the instructions.

Calcitonin

Calcitonin - a hormone produced by the thyroid gland.

As the drug can be given as injections or nasal spray, as destroyed by ingestion.

Calcitonin can be assigned to a physician only after a thorough medical examination, since there are several contraindications to the use of this therapy. It should strictly follow the instructions.

Fluoride

Fluoride salts used in the past for the treatment of osteoporosis. Obviously, they increased bone density, but this does not always lead to fewer fractures. It is known that taking large doses of fluoride can damage the normal structure and bone strength.

As a result, fluoride will not find wide application in the treatment of osteoporosis, but taking lower doses in combination with other drugs may be effective.

Fluoride may be prescribed by a doctor only after a thorough medical examination, since there are several contraindications to the use of this therapy. It should strictly follow the instructions.