Abstract
Osteoporosis is now being treated mainly with antiresorptive drugs, i.e. those inhibiting the production, maturation, and activity of osteoclasts and promoting their apoptosis (ERT, SERM, CT, bisphosphonates, and denosumab), and with osteoanabolic drugs, i.e. those enhancing the production of bone tissue de novo (parathormone, vitamin D, stroncium, antibodies against sclerostin). Any therapy of osteoporosis must be based on the supplementation of calcium.
The treatment needs to be long term, with dosages depending on the patient's age and on the severity of his/her illness. Calcium is one of the elements that are crucial for appropriate functioning of the organism.
In case we don't have normal levels of vitamin D, we are incapable of adequate calcium uptake from the gut and we have to obtain it alternatively from the bones, which is detrimental to their structure and firmness. The key effects of vitamin D are promotion of calcium and phosphorus absorption from the gut, stabilization of their levels in the organism through inhibition of parathormone secretion, and bone mineralization control.
Ninety per cent of total vitamin D amount are being obtained from the sunlight and from food. Elderly people have less functional skin enzymes (sunbathing not being very effective in them) and thus suffer from permanently decreased vitamin D levels.
Vitamin D3 has to be supplemented deliberately to ensure optimal concentrations. At the same time, adequate vitamin D level is associated with up to four fold increase in muscle strength - an effect of potentially crucial importance for prevention of falls in seniors.
The falls are, no doubt, the major cause of hip fractures.