Ways to Keep Your Bones Strong

Medication. If you're at high risk for osteoporosis and your bone mineral density declines during treatment, there are medications called bisphosphonates you can take to strengthen your bones. The following bisphosphonates are approved by the United States Food and Drug Administration to treat osteoporosis:

• Fosamax (chemical name: alendronate sodium)
• Actonel (chemical name: risedronate)
• Boniva (chemical name: ibandronate)
• Reclast (chemical name: zoledronic acid)

Fosamax and Actonel are available as daily or weekly doses. Boniva can be taken once a month or injected once every 3 months. Reclast is injected once a year. Together, you and your doctor can decide if one of these medicines is right for you.

There are other bisphosphonates that are being studied to protect bones during breast cancer treatment. They are:

• Zometa (chemical name: zoledronic acid) (this is a different formulation than Reclast)
• Bonefos (chemical name: clodronate)

Bonefos is not commercially available in the United States, but is available in Canada and Europe.

Both Zometa and Bonefos are usually given as injections.

Bisphosphonates can sometimes cause a rare but serious side effect, osteonecrosis of the jaw, a condition in which the cells in the jawbone start to die. Researchers think that osteonecrosis of the jaw may develop because bisphosphonates stop the body from repairing microscopic damage to the jawbone that can happen during routine dental procedures or from everyday wear and tear. But it's still not clear why this happens in some people and not in others. If you're taking a bisphosphonate, tell your dentist right away. Together, you and your dentist can work out a dental treatment schedule that keeps your teeth healthy and minimizes your risk of osteonecrosis of the jaw.

Lifestyle changes you can make to keep your bones as strong as they can be during treatment:

• Get enough calcium. People older than 50 should get 1,200 milligrams of calcium each day. Make foods that are high in calcium part of your diet:
  • dairy products such as low-fat milk, yogurt, and cheese
  • calcium-fortified orange juice
  • dark green leafy vegetables such as broccoli, spinach, collard greens, and bok choy
  • tofu
  • almonds
  • vitamin-fortified cereal
  • calcium supplements
• Get enough vitamin D. Vitamin D helps your body absorb calcium. People older than 50 should get 400 international units (IU) of vitamin D per day. People older than 70 need 600 IU of vitamin D daily. Your body makes vitamin D when you're in sunlight, but if you're indoors most of the time or live in areas where sunlight is limited, add foods rich in vitamin D to your diet:
  • vitamin D-fortified milk
  • herring, salmon, and tuna
  • vitamin-fortified cereal
• Do weight-bearing exercise. Exercise makes your bones and muscles stronger and helps slow bone loss. Do 30 minutes of weight-bearing exercise 3-4 times a week for maximum bone health benefits:
  • walking
  • jogging
  • stair climbing
  • playing tennis, racquetball, or squash
  • dancing
  • lifting weights
  
  
  You can do your 30 minutes of exercise 10 minutes at a time during the day to make it easier.
• Limit or avoid alcohol. Heavy drinking increases the risk of bone loss.
• Quit smoking. Smoking weakens bones and can lead to osteoporosis.