Osteoporosis

Faith

Can osteoporosis be reversed? Or stopped?

Just give a bit of hypothetical background information, say we're talking about a 56 year old woman, mid-menopause, very healthy, walks regularly and is only a couple of pounds over-weight. Also, let's just say she had chemotherapy a year ago. If osteoporosis was found in one of her vertabrae, and osteopena in the two surrounding vertabrae, can that be reversed with medication?

Finally, would walking a lot be bad for that kind of osteoporosis? I imagine it would jar the spine and lead to further degeneration. Is that correct?

GuanYin

The two main treatment approaches are calcitonin and parathyroid hormone (PTH).
PTH looks like the way to go and the FDA are currently reviewing it (mainly due to concerns about withdrawal and relapse) but evidence suggests that it replenishes bone mass, prevents fracture and thus far, bone is stable after withdrawal.

The only issues is delivery, both are delivered subcutaneously and alot of research funding has been invested in looking at oral delivery strategies.

DrIndy

PTH and Calcitonin are 3rd line agents.

Osteoporosis and osteopenia are measurements of bone density or lack of, all of which are predictors of fracture risk in the future. These can be reversed with treatment, some are lifestyle - others pharmaceutical. Steroids which are in some chemotherapy regimens accelerates osteoporosis.

First line treatment is usually a calcium/vitamin D supplement replacement, second line is a bisphosphanate such as alendronate, third line after a fracture has occured or in severe osteoporosis, you can use calcitonin, which has the added benefit of accelerating healing of collapsed vertebral fractures.

The choice of the treatment would be up to the clinician looking after her.