By Robert Preidt, HealthSCOUT Reporter

SUNDAY, Sept. 17 (HealthSCOUT) -- If you're a woman taking medication to fight osteoporosis, you need to ensure you're getting enough calcium and vitamin D to bolster the bone-building process, experts say.

Participants at the World Congress on Osteoporosis 2000, held recently in Chicago, heard that about 70 percent of women taking the top three osteoporosis medications don't take a calcium supplement or get enough vitamin D to allow them to get the full benefit of therapy.

The recent Physician and Drug and Diagnosis Audit (April 1999-April 2000) shows that more than 3.5 million recommendations were made by physicians for the top three osteoporosis medications -- Fosamax, Evista and Miacalcin. But the overall treatment regimen in those cases included calcium less than 30 percent of the time.

"Sometimes people think, 'My doctor's put me on some pills and that's what I need.' But if you're not getting enough calcium in your diet, then the pills can try and stimulate your bone, but if you don't have the building materials for bone, then you can't go anywhere," says Dr. Robert Heaney, professor of medicine at Creighton University's Osteoporosis Research Center in Omaha, Neb.

Osteoporosis weakens bones and can lead to painful and debilitating bone fractures. Ten million Americans have the disease and 18 million have low bone mass, placing them at risk, says the National Osteoporosis Foundation (NOF).

The NOF says osteoporosis causes 1.5 million fractures a year and costs the U.S. health-care system about $14 billion annually.

Osteoporosis-related vertebral fractures may lead to stooped posture, loss of height and chronic pain and disability. It also may cause compression of the lungs and stomach. Hip fractures can be life threatening, with a 20 percent increase in mortality within a year after suffering a hip fracture.

The latest National Institutes of Health consensus panel determined that treatment of osteoporosis with any drug therapy also requires sufficient calcium and vitamin D to get the most benefit.

Experts suggest that women on osteoporosis medication take 1,200-1,500 milligrams of calcium per day. Many women get only about 600 milligrams of calcium in their diet.

Heaney says most doctors are aware that patients on osteoporosis medication need to get enough calcium and vitamin D.

"But I'm not sure how much of that gets transmitted over to the patient. Doctors are so busy in their offices today with two minutes per patient per visit, or something like that, that it's extremely difficult to communicate this," Heaney says.

The best way to get calcium is through foods, but Heaney says that food usually doesn't provide the necessary amounts so most people have to rely on supplements.

"There are lots of good calcium supplements out there. Whereas the manufacturers would like you to think one is better than the other, they're all pretty good," Heaney says.

Jeri Nieves, an epidemiologist at Helen Hayes Hospital in West Haverstraw, N.Y., has reviewed the studies and agrees calcium is important for women on osteoporosis medication.

"It makes sense because if you think about it, one of the building blocks of bone is going to be the calcium. So if you have these drugs that are trying to stop [bone] loss and replace a little bit of the loss that occurred, it's hard to do that without the basic building blocks," says Nieves, who was one of the speakers at the World Congress on Osteoporosis.

She notes that younger people produce enough vitamin D through skin exposure to sun. But the ability to make your own vitamin D declines with age. Nieves says there are a wide range of fortified foods and supplements that provide vitamin D.

What To Do

The National Osteoporosis Foundation says a comprehensive program that can help prevent osteoporosis includes:

　　a balanced diet rich in calcium and vitamin D;

weight-bearing exercise;

a healthy lifestyle with no smoking or excessive alcohol use;

bone density testing and medication and when appropriate.

(From Yahoo!)