Medicine to Move You

Surprise, surprise.  In the news this last week, another class of pharmaceutical medications is undergoing scrutiny by the Food and Drug Administration (FDA) for safety concerns.  Known as  ‘bisphosphonates’, this class include drugs such as Fosamax (alendronate), Boniva, Actonel and Reclast – meds used to prevent and/or treat osteoporosis.

The debate stems over the safety of the long-term use of these medications.  Specifically, it seems that a small group of patients who have been taking one of these medications for longer than 5 years are now experiencing one of three troubling conditions: (1) death of the jawbone tissue – ouch!, (2) unusual fractures in the thigh bone (isn’t that what they are supposed to treat?) or (3) increased risk and development of esophagus cancer.

While the FDA Advisory Committee (an independent expert panel commissioned by the FDA) is looking to the drug manufacturers to determine the best length of time a patient should receive these medications and include this information on the package insert, they themselves have not solidified any recommendations regarding the ‘safest’ timeframe.  The hidden truth- it takes approximately 10 (TEN) years to remove 50% of the this class of drugs from your body.  So, if you do the math…if you’ve been on a bisphosphonate for only 5 years (much shorter than how long most women take them), you will have the medication in your system for well over 20-25 years!

Without any clear guidance from any authoritative body just yet, this leaves the true decision-making in the hands of the physicians and their patients until we (the medical community) know more.

Here’s my take:  When working with my patients and pharmaceutical medications, it is always my preference to try to find the root cause of the condition and provide nutritional and lifestyle support to allow the body to return to a healthier state.  From time to time, the use of prescription medications makes good sense, but must always be evaluated from the vantage point of determining the lowest dose and length of time on a drug to achieve the most benefit to the patient.  From my perspective, bisphosphonates have become one of the most overly dispensed classes of medications this last decade.  This is due, in part, to the broad condition for which it is approved, mainly, “the treatment and prevention of osteoporosis in post-menopausal women”.   This is more easily interpreted by the industry as “all menopausal women”.  Truth is, not all post-menopausal women have the same risk for developing osteoporosis and likewise, there are many more non-pharmaceutical therapies that may be considered before jumping right into a 10+ year relationship with a medication.

So, while the FDA and pharmaceutical manufacturers sort themselves out, here’s an action plan to get you started on the road to a thoughtful, intelligently designed osteoporosis prevention plan:

1.       Watch “Them Bones, Them Bones” on for a comprehensive class on bone health and osteoporosis.  Learn how to read your bone density report (DEXA), understand how much calcium you really should be taking & what vitamin D really does for your bones, incorporate natural strategies for bone health and determine if  you should consider pharmaceutical medication as your best option.

2.       Get your bone mineral density tested if you are at risk – DEXA scans are the gold-standard (but have limits as discussed on LWU)

3.       Eat more green vegetables – they are a super source of healthy calcium, AND they’re alkaline to help prevent more bone loss

4.       Pump iron – Lifting weights or doing exercises that push your body to resist weight make your bones stronger

5.       Talk to your doctor about your risks and options – (especially after watching “Them Bones, Them Bones”,so you can really sit down and partner with your doctor to discuss the best plan for preserving YOUR bones and the rest of your body!)

If you’re interested in learning more about this topic, join our Education Beyond Medication online medical community.  Visit and simply register to watch the following Dr. Saxena Speaks! educational videos which also relate to this topic:

* Them Bones, Them Bones Part I
* Them Bones, Them Bones Part II
* The Anti-Inflammatory Food Pyramid
* Therapeutic Lifestyle Change

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