Osteoporosis — what to take?

Medical body content is still in Romanian:

Risk factors

Menopause (oestrogen deficiency), age, female sex, family history, low weight, sedentary lifestyle, smoking, alcohol, calcium/vitamin D deficiency, chronic corticosteroid therapy, diseases (hyperthyroidism, Cushing's, coeliac disease).

Diagnosis

DXA bone densitometry — T-score ≤ -2.5 = osteoporosis. Between -1 and -2.5 = osteopenia. Fracture risk assessment (FRAX).

Treatment

Lifestyle:

• Calcium 1000-1200 mg/day (from diet or supplement).
• Vitamin D3 800-2000 IU/day, keep 25-OH-D above 30 ng/ml.
• Weight-bearing exercise (walking, dancing, tennis) 30-45 min/day.
• Balance exercises (fall prevention).
• Smoking cessation, limit alcohol.
• Adequate protein intake.

Medication (Rx):

• Bisphosphonates (alendronate, risedronate, zoledronate) — first line.
• Denosumab (Prolia) — monoclonal antibody.
• Teriparatide, romosozumab — anabolic agents, for severe cases.
• Raloxifene in postmenopausal women.
• Hormone replacement therapy — beneficial in those with menopausal symptoms.

Essential OTC

• Calcium (citrate form better absorbed) 500-600 mg twice daily.
• Vitamin D3 1000-2000 IU/day.
• Vitamin K2 (menaquinone) 90-180 mcg/day — directs calcium to the bones.
• Magnesium — important for calcium absorption.
• Hydrolysed collagen — emerging evidence.

Medical disclaimer: the information in this guide is for informational purposes only and does not replace advice from a doctor or pharmacist. For diagnosis and treatment, consult a healthcare professional.