Those of you who read this blog and my articles regularly might think I’m against bone drugs altogether. That’s not truly the case. There are certainly people who have such catastrophic bone loss that it’s appropriate for them to use medications to slow or halt it — but these are usually people who have a serious health crisis going on. Cancer treatment, Paget’s disease of bone, those on long-term high dose prednisone treatment, and similar situations where bone is eroding rapidly are clearly circumstances where these strong medications can be beneficial. But my natural approach to support bones and overall health would be helpful in these patients as well.
Where I take issue with bone drugs is when they’re used to address low bone density without any effort to identify the reason for the bone loss — and that happens all too often. As most of my clients and some of my blog readers can attest, it’s not uncommon for physicians to simply hand out a script when they see a bone scan that indicates osteoporosis (or even osteopenia) without taking any steps to determine why bone is being lost, or even if bone is being lost!
Unfortunately, most physicians regard bone loss itself as a disease, when the vast majority of the time it’s really a symptom of some other, underlying health issue.
Treating the symptom with a drug doesn’t cure the disease — it simply masks the problem. The “problem masking” in turn often brings with it significant life-damaging side-effects. And most physicians’ don’t mention that these are very powerful medications with a profound impact on the body’s most fundamental processes.
• Bisphosphonates put a halt first to osteoclast activity and over time to osteoblast activity as well.
• Teriparatide (Forteo) stimulates osteoblasts to work overtime in building new bone, but it has worrisome long-term risks that we discuss elsewhere.
• Denosumab (Prolia), a drug slated for FDA approval this summer, goes even farther, interfering with immune factors to prevent the natural process of bone breakdown and renewal.
What it boils down to is this: if your doctor finds your bone health situation so serious that she wants you to take these very powerful drugs — medications that affect not just bones, but other systems in the body too, then your situation is serious enough to warrant a full osteoporosis medical work-up looking for the causes of bone loss. The case for bone drugs cannot be made on the basis of just one or even two DEXAs. The simple fact that a person is losing bone isn’t, in my opinion, reason enough to start someone on a drug as a knee-jerk reflex. If there is an identifiable underlying condition that is causing an individual to lose a lot of bone, rapidly, this should be uncovered and addressed.
When a comprehensive natural approach to halting excessive bone loss fails, then can you make the case for bone drugs. And when there isn’t an identifiable underlying health issue or an identifiable cause of bone loss, it still stands to reason that working to support bones by improving nutrient intake, getting more exercise, dealing with stress, and improving the body’s pH through an alkaline diet are much more sensible first steps than hauling out the “big guns”!
Postscript
Thank you all so much for telling your stories and adding your comments below. When I wrote this post, I did so out of concern that people who had significant health issues that resulted in bone loss would misunderstand my position on bone drugs and believe that I thought bone drugs serve no purpose. Your comments have shown me just how important it was to clarify that position! Many of you have exactly the kinds of health issues that cause rapid, catastrophic bone loss/weakening, so you fall into the category of people that I believe should consider medical therapies under a physician’s care and guidance. I don’t want anyone to feel that taking bone drugs to address this sort of bone loss is somehow wrong or incorrect, and certainly your physician is the first person to whom you should address any questions about medical treatment for bone loss — for the most part, it would not be proper for me to offer advice on whether someone should or shouldn’t use particular treatments, as I’m not familiar with your specific cases. At the same time, though, the alkaline diet and nutritional support that I recommend to all my clients is something that I encourage all of you to consider, as the more support you provide your system, the better it will respond to your treatment regimen. In my work with clients at the Center for Better Bones, I've found that these methods are a great support even to those patients who must use bone drugs to halt bone loss related to a medical issue. Best wishes to all of you, and thanks for reading my blog!
We created the Osteo Blast 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.