Postmenopausal women and men 70 years are advised to

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Postmenopausal women and men >70 years are advised to take 800 IU (international units) of vitamin D daily as this dose apparently decreases the rate of fracture and bone loss in those with sufficient calcium intake. The primary dietary source of vitamin D is milk supplemented with vitamin D. Salmon is another good source. Protein supplementation may be required for some people, especially those already having an osteoporotic fracture. It is also important to avoid or limit the consumption of food or drinks that increase the risk of fractures such as caffeine, alcohol and salt. 4.3.2.2. Smoking cessation Smoking is known to accelerate bone loss, making it strongly recommended that those at risk of osteoporosis or fracture should quit smoking. 4.3.2.3. Exercise Exercise increases bone mass and helps maintain BMD in postmenopausal women and thus may help reduce the risk of fractures. It also decreases the predisposition to falls. 30-60 minutes of exercise, 3 times a week are recommended. 4.3.2.4. Moderating the use medications favoring bone loss The use of medications that increase bone loss (e.g. heparin, some antiepileptics, and glucocorticoids) should be monitored. The drug could be discontinued, the minimum effective dose could be used or the patient could receive calcium and vitamin D supplementation. 38
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4.3.2.5. Prevention of falls All possible measure should be taken to prevent falls in patients known or suspected to have fragile bones. 39
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5. Treatment of Osteoporosis and Osteoporotic Fractures 5.1. Conservative treatment This involves changes in diet, physical therapy and exercise, and the use of medications for the prevention and treatment of osteoporosis and its complications and also the treatment of curable causes of secondary osteoporosis. 5.1.1. Dietary measures For the prevention and treatment of osteoporosis, it is important (irrespective of age, but especially in childhood) to consume adequate amounts of calcium and vitamin D. The daily calcium intake recommendations by the American Association of Clinical Endocrinologists for all ages are: − 0-6 months: 0.2 g/day − 6-12 months: 0.26 g/day − 1-3 years: 0.7 g/day − 4-8 years: 1 g/day − 9-18 years: 1.3 g/day − 19-50 years: 1 g/day − >50 years: 1.2 g/day − Pregnant and breastfeeding women ≤18 years: 1.3 g/day − Pregnant and breastfeeding women ≥19 years: 1 g/day Both women and men between 51 and 70 years are recommended to consume 600 UI of vitamin D daily a value that rises to 800 UI after 70 years, but shouldn’t exceed 4000 UI. Calcium citrate and calcium carbonate are commonly used calcium supplements, with calcium carbonate (which is cheaper and requires fewer tablets) being recommended as first choice. Absorption of calcium carbonate is better with food, while calcium citrate is better absorbed a jeun.
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  • Fall '19
  • postmenopausal osteoporosis

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