Osteoporosis treatment: drugs, vitamins and minerals. What else will help?

Can osteoporosis be cured?

Yes, but only if it is secondary osteoporosis that has been diagnosed early and the risk factor for its development has been removed.

In other cases, the main goal of treatment is to slow the progression of osteoporosis and reduce the risk of fractures.

Treatment of osteoporosis is long-term and often lifelong.

The mainstay of treatment for all stages of osteoporosis, including osteopenia, is to maintain optimal levels of vitamin D3 (cholecalciferol), calcium and vitamin K2 in the body.

If their supplementation in the form of dietary supplements or medication is necessary, it is always necessary to follow the advice of the treating physician. In the case of calcium in particular, there is a risk of negative effects on the cardiovascular system if taken unwisely.

For more information on vitamin D3 and calcium, see our articles:
Vitamin D and its effects: Our health, strong bones or strong immunity
What are the effects of calcium? Symptoms of deficiency, excess + food sources

Along with vitamin D3, calcium and vitamin K12 are used in the treatment of osteoporosis:

• antiresorptive drugs that slow bone breakdown - alendronate, risedronate, ibandronate, zoledronic acid, denosumab
• Osteoforming drugs that help to partially rebuild broken bone mass - teriparatide
• dual-acting drugs that slow bone loss while helping to rebuild bone mass - romosozumab
• selective estrogen receptor modulators that replace the action of estrogen on bone tissue - raloxifene

The doctor selects the most appropriate combination of the above groups of drugs, which is tailored to the patient. The decision is based primarily on the type and degree of osteoporosis, the results of individual tests, age, gender and other associated diseases.

Regular exercise of a reasonable intensity, a balanced diet and sufficient drinking are important in the treatment of osteoporosis. Smoking, alcohol and excessive consumption of caffeinated and phosphoric acid-containing beverages should also be avoided.

Monitoring the effectiveness of treatment

During the treatment of osteoporosis, regular check-ups with the treating doctor are essential. These include monitoring the effectiveness of the treatment to assess whether or not the chosen treatment is working.

This is done by, for example:

1. densitometric examination
2. laboratory blood tests to check levels of the bone markers CTx, P1NP and osteocalcin

The treatment is effective if the bone density has not decreased by the values set by the radiologist since the last examination.

On laboratory blood tests, a decrease in CTx and an increase in P1NP and osteocalcin should be observed depending on the drug combination.

If the physician finds that the treatment is not working, he must look for the cause. Sometimes it also happens that the patient does not take the medication as it should. In some cases, the patient develops another disease that adversely affects the effect of the treatment. Once the cause is identified, the choice of treatment is then reconsidered.