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Sticks and stones...

Several medications can be used to increase bone strength, but a class of drugs called bisphosphonates is preferable in most patients. This along with calcium and vitamin D should be taken for at least five years and, in severe cases, forever. Bisphosphonates are effective either for prevention of osteoporosis or treatment with a 30-50 percent reduction in fracture rate. These medications are effective even after age 75 and usually have very few side effects with dosing convenience once a week or even once a month.

When bisphosphonates are not tolerated or show insufficient benefit after repeat testing, another effective treatment is daily injection by the patient of parathyroid hormone (Forteo) for a period of no more than 2 years. Estrogen hormone replacement after menopause can have benefits but also carries significant risk of increasing stroke or heart attack and even breast cancer and should be avoided if other treatment is available for menopause symptoms.

Foods high in calcium include all dairy products, leafy green vegetables, tofu and fish such as salmon or sardines. Calcium citrate (Caltrate) twice a day provides supplemental calcium and vitamin D. In the case of osteoporosis the old saying "an ounce of prevention is worth a pound of cure" certainly applies.

Dr. Josh Schwartzberg practices in Lake Placid, Willsboro and Burlington. He can be reached at www.docjosh.com or 518-963-4355

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