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New Cautions about Long-Term Use of Bone Drugs
In an unusual move that may prompt millions of women to rethink their use of popular bone-building drugs (known as bisphosphonates), the Food and Drug Administration published an analysis that suggested caution about long-term use of the drugs, but fell short of issuing specific recommendations.
The concern is that after years of use, the drugs may in rare cases actually lead to weaker bones in certain women, contributing to “rare but serious adverse events,” including unusual femur fractures, esophageal cancer and osteonecrosis of the jaw, a painful and disfiguring crumbling of the jaw bone.
The F.D.A. review analyzes only long-term use and does not address whether a woman should be prescribed a bone drug in the first place to reduce her fracture risk. Because serious complications are so rare, most doctors believe that for women with documented osteoporosis who are at very high risk for spinal fractures, the benefits of the drugs far outweigh the risks. However, some women with moderate bone density and no other risk factors continue to take the drugs for years even though they are unlikely to gain any benefits. The agency’s analysis, which found little if any benefit from the drugs after three to five years of use, may prompt doctors around the country to rethink how they prescribe them.
The F.D.A. report offered little specific guidance about long-term use, saying that the decision to continue or stop treatment should be based on an individual assessment of risks, benefits and preferences discussed between a patient and her doctor. The agency did say that women at low risk for fracture or with a bone density near normal may be good candidates to stop therapy after three to five years, but older patients at higher fracture risk and bone density “in the osteoporotic range” may benefit from continued therapy.
Dr. Iverson's Comment
Any drug that is taken for long term without sufficient studies to prove its safety is an area that I am quite cautious about. The drugs used for osteoporosis have long been a concern for causing osteonecrosis of the jaw and actually causing bone fractures—the  very malady they are supposed to protect against.   Unfortunately women are not given another alternative to use in their place.
In the clinic we see positive results after following a diet that it specific to their chemistry as well as taking the nutritional supplements that are specific to their chemistry. Bones are not just calcium or you would break like a piece of chalk!   Bones are also half protein—so the proper intake of proteinaceous foods will improve the strength of your own bones.
It’s long been understood that astronauts become temporarily osteopenic while floating weightless in space. Therefore to improve bone density we recommend lifting weights to increase the demands on the bone. Jump roping, walking with weight filled backpacks, squats, and pushups are all ways to do this.
As far as supplements we often recommend Nature’s foods of green superfoods—where does a cow get its calcium? Also calcium derived from bone, known as microcrystalline hydroxyapetite, as well as silica from plants and vitamin D from the sun are all vital for proper bone health. Cut back the coffee, alcohol and sweets and follow up with your doctor on your bone building progress
Be well!
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