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Osteoporosis Medications: How They Work

From the latest medications to daily supplements -- what's your osteoporosis medication doing for you?
By
WebMD Feature

Think your bones stopped growing by the time you finished high school? Think again. Bones constantly remodel themselves throughout life, growing here, thinning there.

In osteoporosis, though, normal bone remodeling goes awry. Bone loss exceeds bone growth, and bones become thin and weak. Osteoporosis affects 10 million Americans, leading to 1.5 million fractures every year.

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Living With Osteoporosis

If you're one of the 34 million Americans (women and men) who are at risk for the disease, you know that strengthening and protecting your bones is crucial. Osteoporosis means porous bones that weaken and can fracture with even minor incidents.   Some 55% of people 50 and older have osteoporosis or reduced bone mass.  But "you can live with osteoporosis for a long, long time and never have complications such as fractures -- if you take certain precautions," says Felicia Cosman, MD, osteoporosis...

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Osteoporosis medications and physical activity can tip the balance of bone remodeling, preserving bone strength. How does bone remodeling work? What can be done to slow down or reverse bone loss? Read on to learn what you can do to keep your bones healthy and strong.

Bone Remodeling: A Never-Ending Improvement Project

"People think bones are static, but in fact bone is constantly growing and being resorbed," says Mary Zoe Baker, MD, an endocrinologist and professor of medicine at the University of Oklahoma Health Sciences Center in Oklahoma City. "It has to, in order to heal damage and microfractures" that occur with normal wear and tear, says Baker.

The process of bone remodeling is a give-and-take between two opposing forces, replacing old bone with new bone.

  • Bone loss (resorption): Special cells called osteoclasts break down bone. They are like a demolition crew. When the signal comes, osteoclasts are recruited to enter the bones and secrete enzymes that break down collagen and minerals. Somehow, they know just when to stop to avoid damaging the bone. 
  • Bone growth:Special cells called osteoblasts line the surface of bones. In response to signals in the blood, the osteoblasts get to work. They lay down bone, by depositing calcium and phosphate crystals on a scaffolding of collagen.

In healthy bone, the processes of growth and resorption are equalized. Various hormones, including estrogen in women, help keep this balance.

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