Calcitonin (Fortical, Miacalcin) is less effective than bisphosphonates, but it slows bone thinning and could reduce the risk of spinal fractures.
Calcitonin may help reduce pain caused by spinal compression fractures. It can be injected or taken nasally (using a nasal spray). The most common side effects are nasal irritation (with the spray) and nausea (associated with the injectable form).
Parathyroid hormone is a naturally occurring hormone that stimulates new bone formation.
A synthetic version, teriparatide (Forteo), is approved for people who have severe osteoporosis and a high risk of fractures. The once-daily injection can be self-administered and is taken for two years, but is usually given only to people who don't respond to other medication.
At about $750 a month, it's pricey, Dr. Lyles says. Side effects include joint pain, headache, dizziness, and nausea. Many patients are also so tired after taking the shot that they discontinue use, Dr. Lyles adds.
Women would have great bones if they never hit menopause, Dr. Strickland says. If hormone therapy—usually estrogen taken by itself or in combination with progestin—were looked at strictly through the lens of bone strength, she adds, everyone should take it.
A wider lens has to be used, however. Hormone therapy is rarely prescribed to women unless they cannot take other medications because it can increase the risk of breast cancer and heart disease.
Friday, September 30, 2011