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What I think about the FDA's latest word on bisphosphonates

It’s now official and published in the prestigious New England Journal of Medicine (NEJM) — the Food and Drug Administration (FDA) cautions about the long-term use of popular bisphosphonate drugs for osteopenia and osteoporosis.

In fact, the FDA’s analysis showed that using these popular drugs for more than 3 to 5 years yields little benefit while carrying the risk of serious side effects.

Powerful statements about bone drugs (especially from the FDA, the government agency charged with protecting the public’s health) have left many researchers scratching their heads and even asking “Bisphosphonates for Osteoporosis — Where do we go from here?” in the NEJM.

Well, here’s where I think we should go:

1. Our bones were meant to last a lifetime. If they are not lasting — the first step is to find out why. This is done by means of a comprehensive “medical osteoporosis work-up” to identify any secondary causes of excessive bone loss.

2. Treat and correct any newly discovered, underlying causes of bone weakness

3. Implement a comprehensive lifestyle and nutrition program. That is, implement my groundbreaking Better Bones Program to rebuild bone health.

Of course, it’s possible that drug therapy may be helpful for certain individuals, and should be used alongside our Personal Program for Better Bones. But, drug therapy is a last resort when all else fails, not the first line approach. 


Reference: Whitaker, M., et al 2012. “Bisphosphonates for Osteoporosis — Where Do We Go from Here?” May 9, 2012 (10.1056/NEJMp1202619) URL: http://www.nejm.org/doi/full/10.1056/NEJMp1202619 (accessed 05.15.12)

We created the Better Bones blog as our forum to express opinions and educate the public about natural means of supporting and improving bone health and overall wellness. As part of this forum, we sometimes discuss medical issues and medications, and their effects on bone health in general. However, we cannot advise readers about specific medical issues in this forum. If you wish to obtain advice from Susan E. Brown, PhD, about your specific bone health and nutritional concerns, please visit our Consultations page. Other specific medical questions should be referred to your healthcare provider.

 

Comments

May 23. 2012 12:50

Thank you for writing this important piece. Several years ago, I discovered I had osteopenia, and my doc wanted me to immediately start on Boniva. After 2 treatments with horrible flu-like side effects I was convinced there had to be a better way to handle this. Thankfully, I found a new doc who is on board with your way of thinking (pharmaceuticals last) and I'm actually reversing my osteopenia through exercise and supplements. Heading over to your page on the personal program to see how it compares to what I'm doing now. THANK YOU!

Donna Ennis

May 24. 2012 09:44

Hi Donna, Glad to see you found a doctor who realizes that the strong bone drugs were never meant for those with simple lower side bone density.  Do check to see you are getting all 20 key nutrients in the correct doses and an alkaline diet in your bone program.  Best wishes, Susan Brown

Susan Brown

May 25. 2012 18:19

I took the so called wonderful fosomax and actinol for 8 years and did nothing to improve my bones, I have been off for 2 years and trying to do through excercise and food.  I had a dexa last month and my femoral head had improved from osteoporosis to osteopenia but my spine had not.  I just signed up to receive the better bone program.  I have also purchased your weight vest. Am really looking forward to hopefully improve or at least maintain.  Thank You.

Mary

Mary

May 27. 2012 09:44

Hi Mary,
Thanks for telling us your story.  You are not the first person to find that they went off the bone drugs and then actually gain bone with a natural program. The weight vest should help your exercise program and be sure to do the spinal exercises that I talk about in my blogs. You can actually wear the weighted vest while you do the back extensor exercise developed at the Mayo Clinic http://www.betterbones.com/blog/post/strong-back-muscles-decrease-fracture-risk.aspx.  Also, remember to follow are alkaline diet and make sure you had all the tests looking for hidden causes of bone loss. Best wishes, Susan Brown

susan brown

June 14. 2012 11:37

What you are doing is amazing.  I am so glad I found you, your book and your website.  I was in India so could not meet with you, but I followed your program to the best of my ability and have reversed Osteoporosis...I am so glad I told the endocrinologist I would not take Fosamax, Reclast, etc.  Keep up the great work...this world needs more people like you.

Louise A. Williams

June 14. 2012 12:56

I am so happy to report that after being off Fosamax for 6 years I have reversed my DXA readings significantly these past two years with supplementation including the 20 key nutrients and better diet.  I also implemented the 10 prunes a day you once wrote about and have gotten others off Fosamax (or similar) and onto your Better Bones site!  My Z-score readings went from minus 3.4 to minus 3.0 in 18 months.  I expect even better this year.  The unfortunate side is, I had a femoral neck fracture 6 years ago and a trochanteric fracture 4 1/2 months ago.  The half life of Fosamax is anywhere from 10 1/2 years to 15 years, depending on the research you read, so my bones still suffer from the 8 years on Fosamax!  Worst of all, my bones have a hard time healing, and I think this is Fosamax, too!  Doctors are unwilling to say but research would support it.  The key thing is getting woman educated.  That alone will be most helpful and get people to think for themselves, do their own research.

Tricia

Tricia Carusi

June 14. 2012 13:51

I am on the Better Bones program, trying to eat correctly and exercising.My dexa score was -4.5, so I was very distressed. But added the supplements, exercising with the vest and trying to eat correctly.  I suffer with sleep issues and know that this is so important for bones. You had mentioned in the past that you would post sleep helps. I haven't seen that. I have tried all the sleep hygiene techniques.  Any suggestions. Thank you for your very encouraging approach!!!

Mary Jane

June 14. 2012 20:16

I too am very interested in getting a better night's sleep.  I remember that you said in order to get
the correct reading with the ph test, you have to be able to sleep 6 hrs.  I wake up every three hours
to go to the bathroom.  Many of us would appreciate your advice on this problem.
I appreciate your research and your blog so much.  Thank you,   TJu

TJ Kessler

June 15. 2012 18:25

Hello, I was on Fosamax for at least 5 years. Last year ,I went off it. My Dexa scan revealed severe osteopena across the board. I did learn that I had an elevated PTH. Normal calcium and D. But the D dropped when I tried on my own to take liquid D and L by Douglas LAbs. So I went on 3400 I.U.'s of D. My last PTH test was 68.9 which is an improvement since my numbers were 100, 92, and 72. So it looks like I have to keep taking 3,400 I.U. 's of D forever. She is repeating the test in Oct. but ordering another Dexa scan including the forearm. She calls this time that I am off as a drug holiday. I have told the doctor no to Forteo and PROlia. She mentioned Actonel was an alternative but I asked her about the supplements put out by Dr. Wright, Osteo Mins. I showed her the supplement guide and told me strontium is a metal that stays in your system for life and the FDA does not regulate it. What are the downsides of strontium?

irene karas

June 15. 2012 19:08

Thanks to your guidance, I was able to reverse my osteoporosis without bisphosphonates. Thanks for having the courage to chart a bold, effective course for so many to follow.

Kate Murphy

July 18. 2012 20:28

Dr. Brown, I am 58 and have been on Synthroid for about 20 yrs and HTCZ for about 10 years.  I now have osteoporosis, a recent scan showed some crumbling of my jaw joint.  I have back and hip pain (mild at present).  Is it possible to reverse my osteoprosis and continue using Synthroid (I read it promotes thin bones)by using your methods? Also my vitamin D level is 33, but my calicum level is slightly high.

Sheila

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