Osteoporosis Drugs Linked to Fractures

Nutrition is a far safer and more effective support for your bones.

A 59-year-old woman—simply riding on the subway—suffered a fracture to her femur (thigh bone) when the train jolted suddenly. She had been taking the drug alendronate for 7 years to treat age-related bone loss.

A 65-year-old with osteoporosis stepped off a European tour bus and collapsed with a stress fracture to her femur. After taking alendronate for 9 years, she needed a rod placed in her leg.

Alendronate is a bisphosphate, a relatively new class of drugs that are heavily advertised—and almost universally prescribed—for osteopenia and osteoporosis. You’ll recognize names like Actonel, Boniva, Fosamax, and Reclast if you watch TV or read women’s magazines.

Fragility fractures of the femur are rare, writes Jennifer P. Schneider, MD, in Geriatrics. Or at least they were until recently!

“We are seeing people just walking, walking down the steps, patients who are doing low-energy exercise with snapped femurs just below the hip bone,” Kenneth Egol, MD, professor of orthopedic surgery at NYU Langone Medical Center, told ABC News a few weeks ago. This is “very unusual [since] the femur is one of the strongest bones in the body.”

Dr. Ann Louise’s Take:

Spontaneous fractures are not the only problem with highly advertised osteoporosis-fighting drugs!

They have also been linked to esophageal cancer, jaw necrosis (or death), and severe muscloskeletal pain. Anyone taking oral bisphosphates should discuss use of these drugs with a healthcare provider. And since the FDA is finally looking into problems with these drugs, you’ll also want to report any adverse effect—like thigh pain, which both the 59- and 65-year-old experienced for months before their fractures—to FDA’s MedWatch program, 800-332-1088.

Take Bone Loss Seriously

Approximately 10 million Americans have osteoporosis, bone loss that results in 2 million fractures annually. Alcohol, genetic heritage, diet, lack of regular exercise, and a number of other pharmaceutical drugs—from prolonged antibiotic use to aluminum-containing antacids and PPIs, antidepressants like SSRIs, corticosteriods, diuretics, Lasix, and excess thyroid meds—can weaken your bones.

Declining estrogen levels at menopause are a common cause of age-related bone loss in women. But hormone replacement therapy —in addition to taking a bisphosphate—didn’t prevent the 59-year-old from a fractured femur. Progesterone deficiency from adrenal exhaustion is an often overlooked factor.

Guys are at risk for osteoporosis too. The Osteoporotic Fractures in Men Study Group estimates at least 34% of white American males who are 65 and older—and almost half of those 75 and older have significant bone loss. Both dehydroepiandrosterone (DHEA) and testosterone have been found to promote bone growth.

Nutritional Solutions

Unlike drugs that block the body’s natural bone remodeling process, a number of supplements can strengthen the skeleton naturally. While most people turn to calcium, at least one study raises doubts about supplementing with only this mineral, as it may increase cardiovascular risk.

Because such a large body of research points to the bone-building—and so many other—benefits of vitamin D, I recommend taking 5,000 IUs daily. A new Dutch meta-analysis of leading research finds vitamin D3 most useful in preventing fractures in older women, who are most at-risk for osteoporosis.

And it’s hard to overemphasize the importance of balancing calcium with magnesium, which has been found to suppress bone turnover. In fact, I often recommend twice as much magnesium as calcium. Use bowel tolerance to find your own balance.

For daily osteoporosis protection, I like Osteo-Key, which contains magnesium, other bone-building minerals, vitamin K, and the most bioavailable form of calcium—microcrystalline hydroxyapatite. New research at North Dakota State University suggests that hydroxyapatite helps reform bone as part of the body’s normal breakdown and rebuilding process.

By contrast, long-term use of bisphosphates—even just for 4 years— can suppress bone turnover or reforming of bone tissue in postmenopausal women. Most doctors today recommend taking drug vacations—and 5 years on bisphospates is most researchers’ top limit.

Sources:
Hot Times
www.latimes.com/features/health/la-he-closer-20100322,0,1979825.story
https://latimesblogs.latimes.com/booster_shots/2010/03/bisphosphonates-osteoporosis-medications.html
www.niams.nih.gov/Health_Info/Bone/Osteoporosis/men.asp#a
https://www.ncbi.nlm.nih.gov/pubmed/20304741
https://www.ncbi.nlm.nih.gov/pubmed/19256578
https://www.ncbi.nlm.nih.gov/pubmed/20302551
https://www.ncbi.nlm.nih.gov/pubmed/20308116
https://www.ncbi.nlm.nih.gov/pubmed/20299227
https://www.ncbi.nlm.nih.gov/pubmed/20200971
https://www.ncbi.nlm.nih.gov/pubmed/20306435