Heidi Powell, MD
Literature reviewed December 01, 2006. Updated April 22, 2009
A 65 year old woman with a history of hypertension returns to your clinic to discuss her screening DEXA study results. She had a spine T score of - 2.6 and a hip T score of -2.0. She takes atenolol, a multivitamin, and two 500 mg Tums daily. You discuss treatment options with her. She prefers calcitonin because she had a friend who developed severe esophageal erosions on alendronate and does not want to take that risk, even though it is small. She declines taking a SERM because she does not want to have hot flashes.
Click an answer under each question.
Is there any evidence that calcitonin reduces the risk of fractures?
- Option A Yes, it reduces hip fractures by 30%
- Option B No, but it increases bone density by 5% in 1 year
- Option C Yes, it reduces vertebral fractures by over 30%, but the evidence is weak
- Option D Yes, it decreases vertebral fractures by 15%
Is calcitonin a first line treatment option for osteoporosis?
- Option A Yes, as it reduces vertebral fracture rates
- Option B No, as it is not as effective as other available drugs
- Option C Yes, but only for men with idiopathic osteoporosis
- Option D Yes, but only in corticosteroid induced osteoporosis
Which form of calcitonin is most commonly used now?
She heard that calcitonin can be used for bone pain. Calcitonin is helpful in reducing bone pain in which of the following: