Abstract

Our results demonstrate that the bone response to NaF treatment is a phase process: an increase in bone turnover is combined with an osteomalacia-like reaction during the first year of treatment. These metabolic observations are in close agreement with the histomorphometric data of Olah, Reutter and Schenk. By comparing the doses of NaF (50 and 100 mg), a 1:2 dose response relationship to the biochemical indices of bone formation and collagen turnover was observed.

Osteoarticular pains as major side effect were observed in both dose groups in about 60% of subjects, the peak of pains coinciding with the peak of alkaline phosphatase after six to twelve months of treatment. In one fifth of all subjects the NaF treatment had to be discontinued because of osteoarticular problems.

On sodium fluoride cortical bone decreased while an increase of cancellous bone, especially in the lumbar spine, was observed. After two years of treatment with 100 mg of sodium fluoride the mechanical stability of the lumbar vertebrae appeared to be improved. Therefore only a long-term treatment with sodium fluoride may be beneficial in osteoporosis.

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