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As you are unlikely to know you have osteoporosis until you have a break or fracture it is usually not diagnosed until this point.
If your GP thinks you may be at high risk of breaking a bone or you have broken a bone after a relatively minor fall, you may be sent for a bone density scan called a dual energy X-ray absorptiometry (DEXA) scan. DEXA scans can help to diagnose osteoporosis by giving a reading of your bone mineral density which is then compared with the average density of a young adult. This will generate a ‘T score’. A T score of -2.5 or less indicates osteoporosis is present. Your scan results are looked at alongside other risk factors such as your age and family history. This helps to indicate whether or not you are currently at a high risk of breaking a bone and whether drug treatment should be considered.
There are a number of different drug treatments you may be prescribed to treat osteoporosis. These include:
Bisphosphonates are usually given as a tablet or an injection and are the most commonly used drug to treat osteoporosis. Bisphosphonates slow the breakdown of bones to maintain bone density levels and keep them as strong as possible. Bisphosphonates can cause a number of side effects including irritation to the oesophagus (the tube that leads from the mouth to the stomach), difficulty swallowing and stomach pain. There is a more severe side effect that can occur from taking bisphosphonates called osteonecrosis of the jaw. This can result in damage to the jaw so if you experience pain, swelling or numbness in the jaw or surrounding area whilst taking these drugs you should tell your doctor.
Strontium ranelate can also help to prevent bone loss and help new bone form. It is often used if bisphosphonates are found to be unsuitable. Strontium ranelate is usually taken as a powder which is dissolved in water. The side effects commonly experienced when taking this drug include nausea and vomiting.
Raloxifene is taken as a tablet and has similar protective effects on bones as oestrogen. In women raloxifene can reverse the loss of density that occurs following the menopause and gradually increase bone density. Side effects sometimes experienced include hot flushes and leg cramps.
Parathyroid hormones are given by injection and help to increase bone density. Parathyroid hormones are only used in extreme cases where bone density is very low and other treatments have proved ineffective. Nausea and vomiting are common side effects experienced whilst taking this medication.
Calcitonin inhibits the cells that break down bone which prevents loss of bone density. Calcitonin is taken as a nasal spray or an injection. Side effects may include nausea, vomiting and diarrhoea.
Calcium and vitamin D are vital for healthy bones so supplements can help to reduce the risk of fractures and are often prescribed alongside other medication to treat osteoporosis.
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