Q: I am a 58-year-old woman and have recently been told by my doctor that I have some osteoporosis. He discovered this after I had broken my wrist from a fall, and I later had a bone density test that confirmed the diagnosis.
I thought I was eating enough foods with calcium. I eat ice cream, cheese and yogurt, and I put milk on my cereal and in my tea every day.
The doctor has given me pills to take, but they are difficult because
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I have to not eat for half an hour before taking them and they have to
be taken several times a day. Are there any other ways I can put the calcium back in my bones?
A: Some people seem more prone to developing osteoporosis than others, despite a good diet. These tend to be women who are small with fine bones, Oriental women, or those who have had sedentary occupations where they have not done much weight bearing exercise.
Because you have been diagnosed with osteoporosis at a relatively early age, you should take this seriously and follow the doctor’s advice, otherwise you will
get more serious fractures and they could become incapacitating.
The Canadian Osteoporosis Society has a good website that includes a calculator to determine if you are getting adequate amounts of calcium. It can be found at www.osteoporosis.ca. Click on calcium calculator. This website will also give you detailed information about the types of drugs and treatments that are available.
The most common group of drugs used in Canada are the bisphosphonates. They include such name brands as Fosamax, Didrocal and Actonel.
Some of these medications also come combined with extra calcium or vitamin D. These medications work by binding with the surfaces of the bones. This slows down the bone-destroying cells known as osteoclasts and allows the osteoblasts or bone-building cells to do their job without restriction.
The pills are a little difficult to take because eating any type of calcium supplement or calcium-containing foods may interfere with the drug action. Therefore, they have to be taken at least half an hour before eating, with a full glass of water.
You must also not lie down for that time frame to make sure the pills reach the stomach and do not get stuck in the esophagus. If they did, they might cause erosion or ulceration.
Side effects in some people include nausea, stomach pains and mild diarrhea.
It sounds as though your doctor has prescribed you Didrocal, which has to be taken twice a day. I expect he gave you this because it is covered by provincial health plans.
Fosamax can be taken either once a day or once a week in a higher dosage. The brand name drug can be expensive, but there are cheaper, generic versions on the market.
Other ways of combating osteoporosis include hormone replacement therapy using a combination of estrogen and progesterone. The male hormone testosterone is usually used for men with this condition, but may also be used in smaller dosages for women. Taking parathyroid hormone is another possibility.
There is another group of drugs known as selective estrogen receptor modulators. One example is named Evista (Raloxifene). Although these medications are not estrogens, they have a similar effect in keeping the bones healthy and strong in post-menopausal women. These pills are taken once a day.
Clare Rowson is a retired medical doctor living near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.
