Osteoporosis is a "quiet" disease, most patients have no symptoms in the early stages, and with the gradual loss of bone, there will gradually be generalized joint pain, and even a slight accident will fall into a fracture. Moreover, women are at higher risk of developing osteoporotic fractures throughout their lifetime.
Osteoporosis is a systemic bone disease characterized by low bone mass, destruction of bone microstructures, resulting in increased bone fragility, and susceptibility to fractures. For the elderly, low back pain, knee weakness, lower limb weakness and muscle spasms are often encountered, but to determine whether to suffer from osteoporosis, it is necessary to make a comprehensive judgment based on bone mass level, bone structure imaging performance and laboratory bone conversion biochemical indicators, combined with related risk factors.
What are the common medications for osteoporosis?
Bone metabolism is the process of continuous generation of new bone and continuous absorption of old bone, maintaining a dynamic balance between the two, so that bone tissue is constantly renewed to maintain the strength and elasticity of bones. With the increase of age and the aging of the human body and diseases and other reasons, the homeostasis of bone is destroyed, which will lead to bone loss and osteoporosis.
Based on the above physiological processes, drugs for the treatment of osteoporosis can be divided into three categories: drugs that promote bone formation, drugs that inhibit bone resorption, and other categories. Calcium and vitamin D are essential supplements for bone health.
Is calcium supplementation enough?
If the bones of the human body are regarded as a "bone building", then calcium is like the main raw material - bricks, although it is crucial, but there are bricks, no cement, steel and steel can not form a solid "bone building" of the human body.
To treat osteoporosis, daily calcium supplementation is not enough, but also vitamin D, bisphosphonate and other "cement, steel" to strengthen the "bone building".
So, for different people, is it the lack of raw materials to build a house? Or does "disrepair" need reinforcement? What drugs each person needs specifically, but also according to the test, examination, let the doctor prescribe. In other words, calcium supplementation should also vary from person to person.
In general, for people with osteoporosis, calcium supplements and vitamin D should be used, and bisphosphonate drugs can be selected if the bone resorption markers are high according to the laboratory indicators.
▷For patients with pain, calcitonin with analgesic effect can be selected.
▷For women within 5 years of menopause, estrogen or selective estrogen receptor modulators may be used, but their use is limited by adverse effects such as increased cardiovascular risk and breast tumors.
(Parathyroid hormone, which promotes bone formation, is less expensive.) ）
The six major categories of calcium supplements have their own advantages
At present, calcium supplements in China's pharmaceutical market can be summarized into six categories: calcium carbonate, calcium lactate, calcium ammonia phosphate, calcium citrate, active calcium, organic calcium.
Calcium carbonate: high calcium content, up to 40%, small side effects, cheap price, high absorption rate, is the main force in the current calcium supplements.
Calcium lactate: the calcium content is lower, containing 12.9% calcium, and the content is lower after making tablets. Its advantage is that it is easy to dissolve and is more suitable for infants and young children.
Calcium phosphate: Calcium content is relatively high, up to 23.3%. The disadvantages are that the tablet disintegration and absorption are difficult, the phosphorus content is high, and the kidney function is poor with caution.
Calcium citrate: calcium content of 21.1%, good water solubility, bioavailability is also better than calcium phosphate. Its absorption does not rely on stomach acid and is suitable for the elderly.
Active calcium: calcium content of 48 ~ 57%, is a biological calcium (shellfish) high temperature calcination and the formation of calcium mixture, its aqueous solution is strong alkaline, the gastrointestinal tract stimulation is large, not suitable for the elderly gastric acid deficiency.
Organic calcium: mainly includes amino acid calcium and protein chelated calcium, the absorption rate is relatively high, is the new favorite of the "calcium supplementation world".
The recommended calcium intake is 800 mg for adults and 1000 mg for postmenopausal women and the elderly. The current dietary nutrition survey shows that the average daily calcium obtained by the elderly in China is 400mg, so the average daily amount of elemental calcium that the elderly should supplement is 500 to 600mg.
The elderly and postmenopausal women are the main population of primary osteoporosis, due to the weakening of absorption in the elderly, it is recommended to use calcium citrate, chelated calcium, amino acid calcium, calcium carbonate and so on, which have a relatively high calcium content and bioavailability.
It should be noted that whether it is a domestic or imported calcium supplement, the body's absorption rate of calcium in calcium supplement products is about 30%, not the absorption rate of 95% as stated in some advertisements.
Editor: Connie Han