Bone density measures the mineral content of bone; calcium and phosphorus are the minerals most abundant in bone. Bone mineral density strengthens bone and helps prevents fractures. Bone is continually being broken down and resorbed. But as you age, more bone is resorbed and not replaced, so bone mass decreases, the Mayo Clinic states. Treatments for low bone density are aimed at inhibiting bone breakdown, decreasing the resorption of bone or building new bone.
Calcium and Vitamin D
Caclium and vitamin D are necessary to build adequate bone density. According to the National Osteoporosis Foundation (NOF), calcium and vitamin D supplementation may be required to bring the total intake per day to 1,200 mg of calcium and 800 to 1,000 international units (IU) of vitamin D. Calcium needs vitamin D to be properly absorbed. Many elderly people, who may have diseases that interfere with vitamin D absorption such as renal insufficiency and who may not spend much, if any, time in the sun, will need supplementation up to 2,000 IU per day of vitamin D.
Bisphosphonates
Bisphosphonates are medications that inhibit bone breakdown, preserving and in some cases even increasing bone density. Bisphosphonates reduce the risk of spine, hip and vertebral fracture in people with a previous fracture, the NOF reports. Bisphosphonates approved by the FDA for use in osteoporosis include alendronate, sold as Fosamax; ibandronate, sold as Boniva; risedronate, sold as Actonel and zoledronic acid, brand name Reclast. Reclast is given intravenously once a year; other bisphosphonates are taken daily, weekly or every three months, depending on the dose. Both men and women are treated with bisphosphonates.
Side effects of bisphosphonates include ulcers, difficulty swallowing and inflammation of the esophagus. Serious side effects include possible osteonecrosis, or bone death, of the jaw, which occurs more often in intravenous infusion of bisphosphonates as a cancer treatment but has also occurred after oral use for osteoporosis.
Calcitonin
Calcitonin is a hormone normally produced by the thyroid gland, which inhibits bone breakdown and promotes bone density build up. Calcitonin may also provide pain relief from spinal fractures, the Mayo Clinic states. Calcitonin is sold as Miacalcin or Fortical. Calcitonin is administered as a nasal spray or an injection, and may cause nasal irritation. Calcitonin is an older osteoporosis medication used mainly for people who can't tolerate other medications.
Raloxifene
Raloxifene, sold as Evista, is a selective estrogen receptor modulator (SERM). Evista is an estrogen agonist-antagonist, a drug that has many of the properties of estrogen and also some of the properties of an anti-estrogen. Evista has many of the positive benefits of estrogen on bone density without the increased risk of heart disease and breast and uterine cancer. Evista is mostly used in women, although it may be helpful in men, the Mayo Clinic reports. Evista may increase your risk of developing blood clots; hot flashes are the main side effect of the drug.
Teriparatide
Teriparatide, sold as Forteo, increases bone density by increasing production of new bone. Forteo is given as a once a day subcutaneous (under the skin) injection. Forteo is used to treat men and women at high risk of fracture. Leg cramps and dizziness are side effects of Forteo, which is used for a maximum of two years. People with other types of bone disease or malignancy of the bone should not use Forteo, which increased the incidence of osteosarcoma, a bone cancer, in rats, the NOF states.
