Ways to Manage HPP SymptomsManagement of HPP will depend in part on how significant your (or your child’s) symptoms are, but in general, these steps can help:1. Work with a team of specialists. Because HPP has myriad symptoms and complications, treatment requires a multidisciplinary team. This can include a mix of the following: pediatrician, endocrinologist, geneticist, rheumatologist, orthopedic surgeon, periodontist or oral surgeon, genetic counselor, and pain management specialist.Regular dental care beginning early on is recommended, too. As kids with HPP become adults (around age 18 to 21), Simmons says, “Transition programs are important from a pediatric clinic to an adult clinic, so they learn how to manage their disease on their own.”2. Take advantage of physical and occupational therapy. Depending on how much mobility is affected by HPP, devices such as a cane, walker, or wheelchair can help, as can home modifications such as a wheelchair ramp. “It’s crucial to work with a specialized physical therapist or occupational therapist to help you identify what your needs are and also to work with a physical therapist on strength and conditioning,” says Dahir. “I really can’t underscore [enough] the importance of working with a skilled physical therapist throughout your entire life.”3. Take steps to protect bone health. While it may seem like calcium or vitamin D supplements would be important with HPP, Simmons says this is not necessarily the case. “Those with HPP need to consume a normal amount of vitamin D and calcium, just like somebody without hypophosphatasia,” she says.Recommendations are generally 1,000 milligrams (mg) per day of calcium and 600 international units (IU) of vitamin D. For women after menopause, the calcium goal increases to 1,200 mg a day. In addition, doing weight-bearing exercises as much as you (or your child) can tolerate helps strengthen bones, too.While both calcium and vitamin D are important for bone health, if you have HPP, talk to your doctor before taking them as supplements to ensure that you get what you need without overdoing it, which can have negative effects.It’s also important to avoid a class of osteoporosis drugs called bisphosphonates, which may worsen HPP, according to the National Organization for Rare Disorders (NORD). This can be a problem in adults, because HPP is sometimes misdiagnosed as osteoporosis, Dahir says.4. Talk to your doctor about medications. If diagnosed before age 18, enzyme replacement therapy can be an option to lessen symptoms. Because bone pain is common in HPP, nonsteroidal anti-inflammatories (NSAIDs) may help as well, although they require caution and monitoring to make sure they’re not used too much or for too long.5. Seek out resources and support. There are several resources that Dahir and Simmons recommend. For education on HPP, visit NORD and the Genetic and Rare Diseases Information Center. The MAGIC Foundation is a nonprofit focused on support services for families affected by conditions that affect a child’s growth, including HPP. And Soft Bones offers community support for families affected by HPP. A genetic counselor or mental health professional may be helpful as well.While HPP is often a challenge for individuals and families, management, support, and working with a team of specialists can make a big difference.