Drugs to Build Bones May Weaken Them

Drugs to Build Bones May Weaken Them

Above link (click on it to read the original article) is NY Times News article on drugs that are used to treat osteoporosis may actually weaken them.

Osteoporosis is a serious health concern for American women. It is defined in women as bone mineral desnsity lower than 2.5 times the normal bone density. It is measured by DEXA. The main concern about osteoporosis is that it leads to increase risk of fracture. Hip fracture, especially, is traumatic to the patients, often requiring several months of rehab.

Osteoporosis is most common in post-menopausal women. It also is caused by the use of steroid medication. Osteoporosis can be prevented with lifestyle advice and sometimes medication, and in people with osteoporosis treatment may involve lifestyle advice, preventing falls and medication (calcium, vitamin D, bisphosphonates and several others).

There are a number of medications that are used to treat osteoporosis including fosamax. During my training at Dr. Andrew Weil's Program in Integrative Medicine, I was educated by my patients who researched about fosamax and was concerned about the possibility that fosamax actually may weaken the bone. The concern was a theoretical one at that time; it was thought that bone density increase was due to abnormal bone density growth that may not be as strong as normal bone. It seems that my patients may have been on to something.

Physicians at Weill Medical College of Cornell University are reporting that prolonged Fosamax—generically known as bisphosphonate alendronate—use may increase the risk of femur fractures, the large thigh bone that connects the leg to the hip. Continued evidence indicates that long-term alendronate use may overly suppress bone metabolism, which limits the repair of microdamage and increases fracture risk, Dr. Joseph M. Lane and colleagues report in the Journal of Orthopaedic Trauma. This report can be read by clicking following hyperlink http://www.newsinferno.com/archives/3443.

Meanwhile, earlier this year Canadian researchers issued a warning that bisphosphonates, sold under the names of Didrocal, Actonel, and Fosamax can lead to bone necrosis, a painful and disfiguring condition that results in bone death. The study found that such drugs almost tripled the risk of developing bone necrosis. The study was conducted by researchers at the University of British Columbia (UBC) and McGill University and is the largest study of its kind into the connection between bone necrosis and specific brands of bisphosphonates: Didrocal, Actonel, and Fosamax. Prior to that warning, the U.S. Food and Drug Administration (FDA) issued a warning about bisphosphonates and its link to a higher possibility of severe and sometimes incapacitating bone, joint, and muscle pain. “I think the study’s important just basically to let the public know if they do experience any severe, unusual pain they could tell their health professional,” said Dr. Mahyar Etminan, the principle investigator from the University of British Columbia. This report can be read by clicking following hyperlink http://www.newsinferno.com/archives/3443.

This puts many patients who are on Fosamax and related medicine at a catch 22. There are integrative approaches to slowing the bone loss using nutrition - calcium, magnesium, boron, and strontium. In addition, green tea extract, and ipraflavone can be useful. However, there is no documented study of strengthening the bone. From preventive point of view, the maximal protection comes from having had maximal bone density achieved in the teen years - which is affected by genetics, nutrition, and physical activity.

John Kim MD MPH
www.georgiaintegrative.com