Friday, March 23, 2012

Re-Post from the Wellness Professor "Tim Dennehy" These osteoporosis drugs actually cause fractures

In October 2010 the FDA released a warning stating that Bisphosphanate drugs used for osteoporosis have been linked to atypical fractures of the thigh. These drugs include Fosamax, Boniva, Actonel and Zometa. This new adverse effect is one among many for these drugs.  

As I have talked about with statin drugs a barometer to establish how well a particular drug works is determined by the number needed to treat (NNT). The lower the NNT the more effective the drug.
So a drug with an NNT of one works for everyone. A drug with an NNT of one hundred works for one out of every one hundred people, etc. Let's look at the number needed to treat for these osteoporosis drugs.

A study out of the "Journal of Bone and Mineral Research" estimates that the number needed to treat for Bisphosphonates is anywhere from 100 to up to several thousands. This means that possibly thousands of people need to take the drug for one person to benefit. (1)  

These drugs do not work for the primary prevention of hip fractures (first fracture). They may work for a very small percentage of people with a low bone mineral density and a history of fractures, but are they worth the risks?

In addition to their lack of efficacy, these drugs can increase your risk of jawbone necrosis, kidney damage and esophageal cancer.

The incidence of esophageal cancer for Bisphosphanate users is 1 case per 1,000 people taking the drug (3). If the NNT of these drugs is 1,000 that means for every 1,000 people that take these drugs one fracture will be prevented, but one case of esophageal cancer will occur. Just like with statins, we are trading one disease for another. 

While there is still a great deal to learn about osteoporosis and how to prevent it, these drugs are not the answer. Here are some ways to limit the risk of osteoporosis and bone fractures in the elderly.

1. Osteoporosis prevention should start in childhood. Adequate Vitamin D levels and calcium intake are critical for strong bones. What is the right form of calcium? Here is a quick answer: it is not cow's milk or supplements. I will discuss why and the best ways to get calcium in my next newsletter.

2. Avoid excessive consumption of acidic foods like grains, dairy, meats, coffee, sugar, sodas, and carbonated beverages. The body has to maintain a PH balance. When the PH is too acidic calcium leaches from the bones to correct this. Eat foods that give you an alkaline PH. These include whole fruits and vegetables.

3. Exercise with weights. Weight bearing exercise is critical for bone health and should be done at least 3-4 times per week.

4. This one may sound obvious, but limit your risk of falling. Avoid drugs that increase this risk, particularly in the elderly, such as sleeping pills and anti-anxiety medications that may cause drowsiness and dizziness.

Until next time....

Stay healthy my friends,

The Wellness Professor 


1. J Bone Miner Res. 2008 September; 23(9): 1435-1441.
Published online 2008 April 21. doi:  10.1359/JBMR.080418

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