Prevention and treatment strategies

A. A balanced diet including 1000-1500 mg of calcium, weight bearing exercise, and avoidance of alcohol and tobacco products should be encouraged. Daily calcium supplementation (1000-1500 mg) along with 400-800 IU vitamin D should be recommended.

B. Females who are not willing or incapable of receiving estrogen therapy and have osteopenic bone densities may consider alternative agents such as alendronate and raloxifene. After the age of 65, a bone density test should be performed to decide if pharmacologic therapy should be considered to prevent or treat osteoporosis.

Drugs for Ostioporosis






0.625 mg qd with medroxy-progesterone (Provera), 2.5 mg qd

Prevention and Treatment

Raloxifene (Evista)

60 mg PO QD


No breast or uterine tissue stimulation. Decrease in cholesterol similar to estrogen.

Alendronate (Fosamax)

5 mg PO QD 10 mg PO QD

Prevention Treatment

Take in the morning with 2-3 glasses of water, at least 30 min before any food, beverages, or medication. Reduction in fracture risk.


200 IU QD (nasal) 50-100 IU QD SQ


Modest analgesic effect. Not indicated in the early post-meno-pausal years.


1000-1500 mg/day


Calcium alone may not prevent osteoporosis

Vitamin D

400-800 IU QD


May help reduce hip fracture incidence

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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