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The following drugs (called bisphosphonates) are all in the same chemical category and have similar effects on the bones in your body:
Fosamax alendronate
Didrone etidronate (not approved by FDA for osteoporosis)
Boniva ibandronate
Actonel risedronate
Actonel with Calcium risedronate with calcium carbonate
Reclast zoledronic acid
It's important to note the potential side effects of these drugs, which include…
• pain or trouble with swallowing
• chest pain
• very bad heartburn or heartburn that does not get better
• ulcers in your stomach or esophagus (the tube that connects your mouth and stomach)
• diarrhea
• pain in extremities (arms or legs)
• dyspepsia (upset stomach)
In addition to these side effects, new research findings show that while these drugs can strengthen bone in the short-term, there appears to be little further improvement in bone building after three years of use...
After four to five years, they may actually cause weakening of bones--making you even more susceptible to fractures!
It takes 10 years to remove these drugs from your system after discontinuing their use.
Healthy perimenopasual women who merely have below average bone density may wish to consider natural means for building bone. With regard to nutritional supplementation, calcium can be helpful. Calcium in the form of “microcrystalline hydroxyapitate" is the only proven type of calcium supplement that can actually add to bones after age 35 -- and even after menopause! There are several formulas containing this ingredient, but I usually reoommend "Bone Up" by Jarrow Formulas, which contains several potentiating vitamins and minerals which also build bone. With regard to vitamin D, since your total ideal vitamin D intake should be about 5000 units per day, extra vitamin D3 supplementation is strongly advised. This is especially true for persons who do not receive adequate weekly exposure to sunlight. Strontium Citrate is also a very good non-prescription supplement for building bone, and 700 mg/day is usually recommended.
For the treatment of osteoporosis, dietary changes should also be included, such as insuring the intake of adequate amounts of greens (high in magnesium and vitamin K), protein, as well as fruits and vegetables. Decreasing one’s sugar intake, minimizing caffeine to one serving a day at most, and decreasing ones intake of high sodium foods also helps preserve bone density. Weight bearing exercise, such as cardiovascular conditioning and light resistance exercise for the upper and lower body, stimulates bone growth naturally. These good health habits are far superior to insure proper bone re-mineralization, without all of the dangers and side effects of the commonly prescribed drugs available today. If you do choose to take a natural approach to building your bones, be sure to schedule a bone density scan every few years to be certain your program is having the desired effect. An average increase of 1% to 2% in bone mass is all to be expected per year, even with the best natural therapy approaches.
For persons at high risk for bone fractures, parathyroid hormone therapy may be a better option than most other drugs, yet more research needs to be done on the long-term side effects of this treatment.
** Never discontinue prescribed drug therapy without consulting your medical doctor for more information! **
References:
1. Cummings SR, Black DM, Thompson DE, Applegate WB, Barrett-Connor E, Musliner TA, Palermo L et al. Effect of alendronate on risk of
fracture in women with low bone density but without vertebral fractures: Results from the Fracture Intervention Trial. JAMA 1998: 280(24):2077-
2082.
2. Pols HAP, Felsenberg D, Hanley DA, Stepan J, Munoz-Torres M, Wilkin TJ, Qin-sheng G, et al. Multinational, placebo-controlled,
randomized trial of the Effects of alendronate on bone density and fracture risk in postmenopausal women with low bone mass: Results of the
FOSIT study. Osteoporos Int 1999: 9:461-468.
3. Tonino RP, Meunier PJ, Emkey R, Rodrigues-Portales JA, Menkes CJ, Wasnich RD, Bone HG, Santora AC, Wu M, Desai R, Ross PD. Skeletal
benefits of alendronate: 7-year treatment of postmenopausal osteoporotic women. 2999. J Clin Endocrinol Metab 85:3109-3115.
4. Black DM, Thompson DE, Bauer DC, Ensrud K, Musliner T, Hochberg MC, Nevitt MC, Suryawanshi S, Cummings SR. Fracture risk reduction
with alendronate in women with osteoporisis: The Fracture Intervention Trial. 2000. J Clin Encocrinol. Metab 85:4118-4124.
5. Orwol E, Ettinger M, Weiss S, Miller P, Kendler D, Graham J, Adami S, Weber K, Lorenc R, Pietschmann P, Vandormael K, Lombardi A.
Alendronate for the treatment of osteoporosis in men. 2000. N Engl J Med 343:604-610.
6. Ravn p, Bidstrup M, Wasnich RD, Davis JW, McClung MR, Balske A, Coupland C et al. Alendronate and estrogen-progestin in the long-term
prevention of bone loss: Four-year results from the early postmenopausal intervention cohort study: A randomized, controlled trial. Ann Intern
Med 1999: 131:935-942.
7. Bone HG, Hosking D, Devogelaer J-P, Tucci JR, Emkey RD, Tonino RP, Rodriguez-Portales JA, et al. Alendronate and estrogen effects in
postmenopausal women with low bone mineral density. J. Clin. Endocrinol. Metab 2000; 85(2):720-726.
8. Lindsay R, Cosman F, Lobo RA, Walsh BW, Harrris ST, Reagan JE, Liss CL, Melton ME, Byrnes CA. Addition of alendronate to ongoing
hormone replacement therapy in the treatment of osteoporosis: A randomized, controlled clinical trial. J Clin Endocrinol & Metabol 1999; 84
(9):3076-3081.
9. Odvina CV, Zerwekh JE, Sudhaker Rao D, Maalouf N, Gottschalk FA, Pak CYC. Severely suppressed bone turnover: A potential
complication of alendronate therapy. J. Clin. Endocrinol. Metabolism 2005; 90(3):1294-1301.
10 .Ott SM. Editorial: Long-term safety of bisphosphonates. J. Clin. Endocrinol. Metabolism 2005; 90(3):1897-1899.
11. Jennifer P. Schneider. Should Bisphosphonates be Continued Indefinitely? An Unusual Fracture in a Healthy Woman on Long-Term
Alendronate. Geriatrics 2006; 61(1) :31-33,
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