Bisphosphonates Increase Fracture Risk

Julian Whitaker, MD

If you have osteoporosis, it’s likely that your doctor has talked to you about Fosamax, Actonel, Boniva, or another bisphosphonate drug. These medications, which rake in $8 billion annually in worldwide sales, are prescribed to prevent fractures. But they too often make matters worse.

Bisphosphonates have long been linked with degeneration of the jawbone, and in October, the FDA issued a warning that extended use is associated with “atypical” fractures of the thigh bone. In the same breath, however, the agency told consumers to “keep taking your medication unless you are told to stop by your health care professional.” (Translation: “Never think for yourself. Doctor knows best.”)

This is bad advice. In addition to causing the very problems they’re prescribed to prevent, bisphosphonates aren’t very effective. Your doctor may tell you that they reduce the risk of fracture by 50 percent, but that’s just a statistical spin. In a widely cited study, Fosamax decreased the likelihood of fracture from 2.2 to 1.1 percent. Yes, that’s a relative risk reduction of 50 percent. But in terms of absolute risk reduction—the far more important consideration—it’s only a 1.1 percent drop. The number needed to treat (NNT) in order to prevent just one fracture is 100. The other 99? They’d be better off—a lot better off—taking a placebo.

Equally disturbing, these medications are pushed on people who have no business taking them. The studies focus on older women who have already had an osteoporotic fracture. Yet Big Pharma has a much larger population in their sights: younger women with osteopenia (relatively, but not critically, low bone density) who’ve never had a fracture. Inexplicably, doctors go along with this sham, writing prescriptions for expensive drugs that these low-risk women will be taking for the rest of their lives—willingly exposing them to irritation and ulceration of the esophagus, bone and muscle pain, and increased risk of atrial fibrillation, to mention just a few of the adverse effects that have surfaced so far.

Fractures are serious business, but you can reduce your risk with weight-bearing exercise, bioidentical hormone replacement therapy, and bone-building supplements such as vitamins D and K, calcium, and strontium. 

Recommendations

• If you are currently taking a bisphosphonate drug for diabetes, work with your physician to replace it with safer alternatives such as bioidentical hormone replacement (requires a prescription), vitamin D 5,000 IU per day (or enough to bring blood levels into the 50–80 ng/mL range), vitamin K 150–300 mcg daily (talk to your doctor if you are taking Coumadin or other blood thinners), Ccalcium 1,000–1,500 mg per day, strontium citrate 680 mg per day, taken 2 hours before or 2 hours after eating or taking other supplements, especially calcium. These supplements may be ordered by calling (800) 810-6655.
• To schedule an appointment at the Whitaker Wellness Institute to review your medications and develop a program of safe, effective alternative therapies, call (866) 944-8253.

References

• Brown SE. Osteoporosis risks vs. benefits of osteoporosis drugs—spinning the numbers. Better Bones. 2009 June 24. http://www.betterbones.com/osteoporosis/risks-benefits.aspx
• Food and Drug Administration. Possible fracture risk with osteoporosis drugs.
• Consumer Updates. 2010 Oct 13. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm229127.htm

Modified from Health & Healing with permission from Healthy Directions, LLC. Photocopying, reproduction, or quotation strictly prohibited without written permission from the publisher. To subscribe to Health & Healing, click here.