<<Disclaimer: Verify this information before applying it to your situation.>> Dear Listserve, You are all amazing. I received at least 40 replies to my post concerning osteoporosis, proper treatment and the roller coaster I am on taking Actonel and calcium for BMD then adding Prilosec OTC to combat acid reflux caused by the Actonel. Your replies covered a range of suggestions from eating right to calcium supplements to Vitamin D. Many also offered helpful insights about Actonel and other bisphosphonates (Fosamax and Boniva). You told me what you thought of Prilosec and that was "not much." I can't list all of the comments here. However, I'll highlight the most important points. * We all agree that calcium is important and people take anywhere from 600mg to 2000mg. * Most everyone also agrees that we need vitamin D because we do not get enough naturally and the amount you suggested ranges from 400 IU to 1000 IU. As for bisphosphonates, the opinions were mixed. I felt the most balanced information came from a Medscape panel of doctors. It's difficult to download so here is a synopsis: (I'll give the link to anyone who wants it.) * ONJ is very rare and usually occurs in patients with cancer who are receiving IV bisphosphonates, although there have been a couple of reported cases where people took oral bisphosphonates and did not have any underlying health issues. * Bisphosphonates have been on the market since 1995. They referenced 36 cases of ONJ in 2003 - 35 from IV bisphosphonates. In 2004, there were 63 patients with bone exposure, 7 using oral treatment and 56 using IV. Nearly all were related to cancer treatment. * In the US, 33 million patients have been treated with oral bisphosphonates and the risk seems to be 1/100,000 for all forms of bisphosphonates. If you look at the risk of ONJ versus being in a fatal car accident, you are 10-15 times more likely to be in a fatal car accident. * In addition, they report that incidence and severity are much lower in the general population compared with those being treated for cancer. They do say that one factor to consider is your personal dental history. If one has periodontal infections and very bad teeth, they might need a lot of surgery- implants mostly and would not be a good candidate for bisphosphonates. But here's the big news, at least to me. We NEED TO TAKE MAGNESIUM. My husband uncovered a medical paper: "Magnesium deficiency: possible role in osteoporosis associated with gluten-sensitive enteropathy" which indicates that after 2 years, patients taking magnesium had a significant increase in bone density. Ron Hoggan makes the same point in an article that can be found at www.celiac.com. Magnesium was also mentioned in a talk given by Cathy Breedon PhD, RD, Clinical Nutrition Specialist at the GIG conference last June: "Magnesium is critical for over 300 processes in the body. And yet, according to a large national survey by the CDC, this important mineral is low in the diets of the majority of Americans. Because one of the most important dietary sources is the "germ" part of whole grains, there is an even greater likelihood of poor intake among people avoiding gluten. Other good sources include nuts and legumes, but many people do not eat much of these foods. Most multivitamins with minerals contain very little magnesium -- often only 10-25% of the recommended amount. For these reasons, some folks will need an additional magnesium supplement of 200-300 mg/day, and others can do well with just some diet adjustment." (Just a word of caution about magnesium. It can be a laxative so go slowly when adding it to your regimen.) * Several suggested natural treatments for acid reflux such as probiotics and iFLORA probiotic from www.sedonalabs.com . * A couple of people also suggested taking testosterone to help build bone. Thank you all for your comments. Let's all raise a glass of skim or soy milk to strong bones and healthy lives. Beth Hillson Founder, Gluten-Free Pantry V-P, Product Development & Consumer Information Glutino USA/Gluten-Free Pantry www.glutenfree.com 860-633-3826 * Please remember some posters may be WHEAT-FREE, but not GLUTEN-FREE * Archives are at: Http://Listserv.icors.org/SCRIPTS/WA-ICORS.EXE?LIST=CELIAC