<<Disclaimer: Verify this information before applying it to your situation.>> My original post was referring to the potentially dangerous long term side effects (bone death) of using a certain class of anti-osteoporosis drugs known as biphosphanates, namely Actonel & Fosamax. These side effects do not apply to over the counter dietary supplements such as calcium, vitamin D, etc. that are marketed to improve bone health. I saw my dentist again today. She re-emphasized that the greatest dangers reported in the article she had read came from long term use, especially IV administration of anti-osteoporosis drugs like Fosamax, Actonel. She said using these in very elderly women who aren't expected to live much longer probably wouldn't cause bone necrosis. But taking these drugs starting at age 50 may cause bone necrosis if these bones are disturbed by a routine tooth extraction, fracture or surgery. She promised to get me the references to the articles she read. I'll post them later for those of you who might be interested. The responses I received are parapharased or directly quoted below in no particular order. If any of you have responses that you wanted posted as part of my summary and you don't see it here, I apologize. It was not intentional to leave out any viewpoints. Soemtimes things just get lost in the shuffle. If you don't see your views represented, please post them. ~Valerie in Tacoma -------------------------- I have recently done a lot of research on these drugs and am amazed that doctors hand them out so willingly. WRT Avascular Necrosis of the Jaw - this is not a condition to laugh at. I have Avascular Necrosis (AVN) bilaterally in the hips, knees and shoulders plus the spine and suspected in the ankles, elbows and wrists). You have not had pain until you have experienced the pain of your bones dying and decaying in your live body. When your bones die the by products of necrosis (gas and water) have no where to go because the outer bone traps it. The pain this generates is nothing short of horrific. Western medicine has no cure for this disease (though there are docs in China who do). Mine is not as a result of biphoshonates but as a result of corticosteriods. What really upsets me is that for 10 years I battled chronic corneal rejection and iritis and the only way to doctors could control it was with massive doses of steroids. The steroids resulted in AVN. Last year I went to a new pain management doctor and when she took a full medical history she became convinced I had CD. Turns out I did. Within 2 months of of going GFCF every bit of corneal rejection and iritis/uveitis was gone. It doesn't bear thinking about how different my life would be today if just one of the gastroenterologists and rheumatologists I have seen over the last 4 decades had just even thought to test for CD (I had all the typical GI symptoms) Sherene in Norfolk, VA ======== This actually is an issue I've discussed with my doctor. It's a risk-benefit thing, like so much else in life: losing bone vs. making bone more brittle by keeping what's there, but interfering with the remodeling cycle. Neither thing is good, but keeping what you have has great benefits. Osteoporosis, in sum, is a really bad problem to which there is, as yet, no good solution. Mary B NYC ========== ...when I broke my shoulder, both my md and chiro told me to take TWIN LABS TRI=BORON PLUS....cal/mag with boron and vit D for absorption. Afterwards I had surgery on my foot and was off my feet for almost a year. Before, my bone density test was a plus 1.75 [very good]. A year of being off my feet and taking Tri-Boron plus, my bone density went UP to plus 2. I told my gp about it and he took his other patient off fosomax and put them on tri-boron plus. No side effects, either Ann ========== There was an article in the New York Times in the last six months or so regarding treatment for osteoporosis and it included anecdotal accounts of women on Fosamax and related drugs for a long time (I don't remember the number of years) who broke bones in response to minor trauma such as the bumpy ride on NYC subways. The statements of your dentist provide a much clearer, though still anecdotal, account of the problem. To me, it is just common sense that if a drug stops the bones from remodeling, and you need remodeling to maintain the strength of the bone, then there is a big problem with the biphosphanates (sp?). I am just reading a book by John Abramson MD entitled, Overdosed America, The Broken Promise of American Medicine. In this book, the author briefly reviews osteoporosis research. According to his review, the published data fail to support the conclusions of the biphosphanates (Actonel & Fosamax) providing a substantial benefit in terms of preventing fractures. He also points out a study which demonstrates that BMD accounts for only 1/6 of the risk for fractures and that there are other much more effective things you can do, such as exercise, which have been empirically shown to provide a much greater reduction in hip fracture. The following is a long quote (pages 213-215): "...Randomized clinical trials of Fosamax published in medical journals show dramatic reductions in the relative risk of hip fracture for women with osteoporosis. In a study published in JAMA in 1998, for example, women with an average age of 68 and a T score of -2.5 or less who took Fosamax for four years were 56 percent less likely to suffer a hip fracture than women in the control group. "This sounds like very good news for women with osteopososis, but how many hip fractures were really prevented? With no drug therapy at all, women with osteoporosis had a 99.5 percent chance of making it through each year without a hip fracture--pretty good odds. With drug therapy, their odds improved to 99.8 percent. In other words, taking the drugs decreased their risk of hip fracture from 0.5 percent per year to 0.2 percent per year. This tiny decrease in absolute risk translates into the study's reported 56 percent reduction in relative risk. The bottom line is that 81 women with osteoporosis have to take Fosamax for 4.2 years, at a cost of more than $300,000 to prevent one hip fracture... A study published in the NEJM in 2001 showed that even women with severe osteoporosis (T scores of lower than -4, or lower than -3 with a major risk factor for hip fracture) derived only small bbenefit from these drugs. The study randomized women between the ages of 70 and 79 to receive Actonel (brand name of risedronate, cousin of Fosamax) or a placebo for three years. Hip fractures were significantly reduced only in the women who already had a spine fracture when the study began (40 percent of the women in the study). One hundred such women would have to take Actonel for about one year to prevent one hip fracture. For the other 60 percent of women in the study without a preexisting spine fracture, Actonel did not signicantly reduce the risk of hip fracture. Moreover, the drug appeared to have no beneficial effect on their overall health. There was no difference in the number of serious illnesses (causing death or hospitalization), including fractures, that occurred in the women who took Actonel compared with those who took the placebo. The same result was found in younger women, with an average age of 69, who had been diagnosed with osteoporosis and at least one spinal fracture: fewer fractures but no reduction in the occurrence of serious illness in the women who took Actonel. The net effect of drug treatment on the risk of serious illness in the highest risk women? Nothing--except the cost of the drug. ...the reality is that two out of three hip fractures occur in women who have reached the age of 80. With 90 percent of hip fractures resulting from falls, it makes sense that the oldest and frailest women would be at the greatest risk... Do the osteoporosis drugs protect these women from hip fractures? They don't appear to. The study of Actonel published in NEJM in 2001 included 3880 women over the age of 80 who had been diagnosed with osteoporosis or wo had at least one major risk factor for falls (approximately 80 percent of the women in the study had osteoporosis). "Treatment of these women with Actonel was reported in the article to have 'no effect on the incidence of hip fracture.' So it looks as though the women who have by far the greatest risk of hip fracture, and for whom the consequences of hip fracture are the most devastating, do not benefit from the drugs that are sold to help women with osteoporosis. "What about using these drugs to prevent osteopososis? Fosamax and Actonel were approved by the FDA to treat women with osteopenia based on studies that showed that they signigficantly increase the bone density of these women. It is important to remember, however, that bone density is only a surrogate end point: the real reason for taking these drugs is to reduce fractures, and hip fractures in particular. The study of Fosamax published in JAMA in 1998 (mentioned earlier) also included women with osteopenia. Did Fosamax reduce their risk of fracture? The results show that the risk of hip fractures actually went up 84 percent with Fosamax treatment. (Even though this is a large increase in risk, the number of hip fractures was low, so the difference did not reach statistical significance.) The risk of wrist fractures increased by about 50 percent (that figure may be statistically significant--but this can't be determined from the data as presented in the article)." --end of quote. Dr. Abramson goes on to discuss research results re: nondrug interventions, which, as it turns out, provide a much greater reduction in fracture risk than the anti-osteoporotic drugssuch as Fosamax. Since it has become abundantly clear that the pharmaceutical industry is not to be trusted and has a pattern of pushing drugs, claiming wonderful health benefits, in order to make big bucks when these drugs are actually dangerous--eg HRT, Vioxx, Celebrex--I see no reason at all to take the biphosphanates unless you want to contribute to the coffers of Big Pharma or want to damage your bones. Mary * All posts for product information must include the applicable country *