"Osteoporosis Drugs -- Cosmetic Surgery For The Bones?"
Really helpful piece blogged by Dr. Skeptic on osteoporosis drugs, with some fascinating information. An excerpt:
How Fosamax works Fosamax blocks bone resorption (bone breakdown). Bone continues to be laid down, but none is taken away. This makes the bone more dense, but it is no longer in balance and structurally, it is not the way the body thinks it should be.Bone density is not everything
Bone that is 10% more dense is not necessarily 10% stronger. To use an extreme example, consider people with "marble bone disease" - osteopetrosis; they have the ultimate bone density. Bisphosphonate drugs for osteoporosis stop bone resorption by bone-eating cells called osteoclasts, so the bone-making cells (osteoblasts) work unopposed. In osteopetrosis, there is a congenital loss of osteoclasts, so the patient's bones are extremely dense (see picture) and surgery on these patients requires special tungsten tip and diamond drills and is still almost impossible. Interestingly, these patients often sustain fractures because their bones are hard, but like concrete, they are also brittle.Also, the biggest risk factor for a fracture is not bone density, it's falling. Falling comes from confusion, poor vision, sedative medications, unfamiliar surroundings, or simply getting up at night and stumbling to the bathroom without a light, etc.
Does Fosamax work?
In any study looking at bone density, Fosamax increases the density. But because none of us can feel our bone density, that outcome is not patient-relevant. Does it prevent fractures? The answer is yes, but mainly in those who have a very high risk of fracture, i.e. those with osteoporosis who have already sustained a low-energy fracture, not for those who are healthy but happen to have low bone density....The upside
In patients with a previous low-energy fracture (like a hip or wrist fracture after a simple fall), Fosamax has repeatedly shown that it will reduce the risk of a hip fracture (probably the most important one to prevent) from 2% to 1% over 3 years. You can call that a 50% reduction, but I call it a 1% reduction. Still, multiply this number by the number of people at risk and you can save a large number of fractures with this drug, even though 100 people need to be on the drug for 3 years to prevent one hip fracture.The downside
If taken for more than 3 years, the risk of inducing a stress fracture of the femur rises. ...
This is serious. I've run into this w/my Mom and have taken her off of Fosamax.
The family doctors seem to ignore this but several oral surgeons have stopped operating on those who have taken these drugs. Catch-22.
"Studies have long shown that patients who use the drug Fosamax may develop a jawbone problem known as osteonecrosis of the jaw (ONJ or dead jaw). However, while past researchers have called the risk "negligible," a recent report in the Journal of the American Dental Association suggests that Fosamax might actually cause dead jaw in a much higher percentage of patients."
http://www.anapolschwartz.com/practices/fosamax/ada-fosamax-jaw-problems.asp
Bob in Texas at June 1, 2014 10:22 AM
I was going to post the issue my Mom had with her jaw, and then I saw Bob in Texas' post. Thank goodness it was not necrosis! She developed a painful bone spur in her jaw. She has a little bit of hunched back, but no fractures, and was diagnosed with osteoporosis and put on Fosamax. Once she made the connection between the bone spur on her jaw and the drug, she stopped taking it. It's not worth the risk, to her. I will share the study Bob posted, with her. Thanks for that link.
flbeachmom at June 1, 2014 5:08 PM
Amy Alkon
https://www.advicegoddess.com/archives/2014/06/osteoporosis-dr.html#comment-4710690">comment from flbeachmomHorrible. Fosamax is pretty much doled out like candy.
Amy Alkon
at June 1, 2014 7:22 PM
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