It is expensive and requires parenteral administration. The mechanism by which anabolic steroids increase bone mass remains uncertain. These agents increase lean body mass and reduce fat mass. Changes in bone density are more consistent at peripheral sites than spinal sites and may be due to effects on soft tissue composition. Their use is limited by androgenic side effects including adverse lipid profiles.
Further evaluation is required, including study of their effects on fracture rates.
Fluoride Bone formation is stimulated by fluoride. Higher doses of fluoride may cause abnormal bone structure and increased spinal bone mass. On this basis clinical trials are needed to evaluate the doses and duration of treatment with fluoride and other factors before it is either abandoned or used routinely in the treatment of patients with osteoporosis. An ideal treatment for established disease is yet to emerge but several therapeutic options are now available and improved therapies will probably result from ongoing clinical trials. However, prevention strategies directed at the community and at high risk individuals hold the greater hope in controlling this major health problem.