Thursday, March 11, 2010

Long Terms Use of Oteoporosis Drugs Results in more Hip Fractures

Drugs that millions of older Americans take to ward of the effects of osteoporosis have been shown to actually increase the prevalence of the problem they are trying to prevent.  Osteoporosis is a condition is which the bones become thin and brittle, occurring mostly as people age.  There are risk factors for it such as obesity, sedentary life style and smoking that can be controlled or avoided.

Most people end up on a class of drugs called bisphosphonates.  These are drugs that include the brand names Actonel, Boniva, Fosamax, Reclast.  It is estimated that 10 million Americans have osteoporosis and an additional 34 million have low bone mass called osteopenia.  The market for these drugs is huge and sales last year exceeded $3.5 billion.

New research is showing that after as little as 5 years of use can actually cause a type of hip fracture that is not seen in women who do not take this class of drugs.  This problem with hip fractures is that they can be lethal or at the very least, very disabling.

Approximately 15-20% of patients die within 1 year of fracture.  Many people point to this statistic and would say of course a large percentage of patients that fracture their hips die soon after – the largest portion of the population who sustain these injuries are elderly adults.  But consider the next finding.   Interestingly, morbidity and mortality in those older than 90 years sustaining a hip fracture were not found to be statistically higher than others in the same age group without such an injury.

Big Pharma only cares about the money brought in by this class of drugs

The fact that these drugs can have severe side effects such as increasing the rate of hip fracture is disturbing because I have many patients who are on this class of drugs and not all of them are elderly.  Some of there are in the 55-65 range who have been told they ‘must’ start taking these drugs to improve their bone density.  They are also told they will need to be on them for the rest of their life.  This puts these patients in grave danger and I don’t believe the benefit outweighs the risk.  The pharmaceutical companies have responded to these new studies in a typical way.

Merck spokesman Ron Rogers says the company has updated the Fosamax label to include information about “adverse events.”

A “causal association” has not been established between longterm bisphosphonate use and these atypical fractures, he says. “In our clinical studies with Fosamax, there have been no increased fracture risk at any skeletal site.”

Thanks for the warning label, but it may be too late for thousands of Americans.  Of course their clinical trials found no issues, but they never do.  Would you want to find out that your billion dollar money maker is dangerous and should be pulled from the market?

Terry Hurley, spokesman for Genentech, says Boniva’s “safety and efficacy” have been demonstrated in extensive clinical trials.

Again, the clinical trials mean nothing if these results are true.  The problem with drug research is that you can’t possibly know the long term effects of a drug until it has been used for years and the American public is used as your guinea pig.  Simply because it has been shown to be safe in some clinical trials does not mean it is safe forever.

Instead of offering more drugs to people for bone ‘health’ why not try something that works to slow bone loss that is not toxic and has very little side effect?  A great solution that works well for all of my patients is a combination of 4 things:

  1. A calcium/magnesium supplement – at least 1,500mg of calcium to roughly 600-800mg of magnesium per day.
  2. A vitamin D supplement – at least 4,000-6,000 IUs per day.
  3. A vitamin K supplement – at least 2,000 – 4,000 mcg per day.
  4. Weight bearing exercise.

The combination of the above works wonders to slow bone loss and the side effects are non existent.  There are so many drugs out there that are dangerous and can actually cause the problem they are designed to prevent.  It doesn’t make sense that these drugs are used so prevalently when safer and more natural alternatives are available,

[Via http://thevreelandclinic.wordpress.com]

Eating Disorders:Female Athlete Triad

Hello Everyone! Although i said we were done highlighting the eating disorders specifically there is still one specific aspect I would like to cover. This is known as the female athlete triad. This is a consequence of when girls who play a sports or are excessively active and don’t balance their bodies’ needs in comparison to the activities they are partaking in.  This condition involves disordered eating, amenorrhea, and osteoporosis. Amenorrhea is a medical term that means lack of menstrual cycle. Athletic individuals can have just one or any combination of the three.  This is all based on the relationship of bone mineral density, energy availability, and menstrual function.  Remember when I discussed that negative energy balance? That is part of the female athlete triad. If not here is what we highlighted. We said that individuals that don’t eat enough (food is energy) and then partake in excessive excercise have a negative energy balance because they are not putting in as much as they are putting out. This can lead to many serious problems such as all three factors of the female athlete triad. This is a tricky condition because most of the problems associated are pathophysiologically related to one another and makes it hard to treat. This condition also goes without detection easily. The best way to identify this problem is through regular screening exams. The next step, like any other eating disorder, is to break down the bad habits they have developed. This is often hard because they link these bad habits to success in their sports or athleticism. Nutrition counseling, support groups, and therapy can all be recommended treatment for this problem. It is important to note that just because you are an athlete and may have a lean body with little body fat you do not necessarily have an eating disorder. If you are eating healthy and practicing proper training and stress management you will be successful in a healthy manner!

Until next time!

Sources:

1) http://kidshealth.org/teen/food_fitness/sports/triad.html

2) Textbook, Concepts of Fitness and Wellness 8th Ed. By Charles B. Corbin, Gregory Welk, William R. Corbin, and Karen A. Welk. Published by McGraw Hill in 2009

[Via http://krystallee27.wordpress.com]