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UAB Osteoporosis Prevention and Treatment Clinic
Step 1: Self Evaluation
Step 2: Bone Density Testing
Step 3: Specialist Examination
Step 4: Nutrition and Supplements
Step 5: Strength, Balance and Posture
Step 6: Personal Treatment Plan
Your Osteoporosis Treatment Worksheet

Use this treatment worksheet to outline your recommendations for calcium, vitamin D, medications, exercise, and other dietary recommendations. Your physician, physical therapist, registered dietitian, and/or patient educator should help you to fill this out.

  1. Calcium Recommendations:

    You need _____ milligrams (mg) of calcium per day (includes both diet and supplements).

    You are getting _____ mg of calcium from your diet each day.

    You need ______mg of calcium recommended from a supplement.

    Type of supplement: _____ Calcium Carbonate or _____ Calcium Citrate

    Each pill should have _____ mg of calcium and _____ mg of vitamin D

    Instructions:

  2. Vitamin D recommendations :

    You need _____ International Units (IUs) of vitamin D every day.

    Multivitamin (take with food) _____

    Calcium + vitamin D supplement(s) _____

    Other _____

    Other dietary recommendations:

    ___ Sodium Restriction ___ Caffeine Restriction

    Notes:

  3. Medications:

    ___ Hormone Replacement Therapy (HRT)

    ___ Evista (Raloxifene)

    ___ Fosamax (Alendronate)

    ___ 70 mg (once per week)

    ___ 10 mg (once per day)

    ___ Actonel (Resedronate)

    ___ 35 mg (once per week)

    ___ 5 mg (once per day)

    ____ Miacalcin (Calcitonin)

    ____ Forteo (PTH/Parathyroid Hormone)

    Medication Instructions:

  4. Exercise/Physical Therapy Recommendations:

    ___ Walking

    ___ Weight Training

    ___ Other

    ___ Physical Therapy Referral for:

    ___ Neutral Spine Training

    ___ Strengthening

    ___ Fall Prevention

    ___ Balance Training

    ___ Pain Control

    Notes:



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