The cost of osteoporosis in the U.S. is estimated at $22 billion per year.1 Bisphosphonates (such as Fosamax, Boniva, Actonel, and Reclast) are commonly prescribed by physicians to treat osteoporosis or to prevent osteoporosis in individuals with osteopenia. Unfortunately, bisphosphonates may actually increase one’s risk of mid-femur fractures (the femur is your upper leg bone).2-11 Bone tissue undergoes a continuous cycle of breaking down old bone and rebuilding new stronger bone. Bisphosphonates increase bone mineral density in the short term by reducing bone breakdown and turnover, reducing bone loss but not building new bone. However, this is not the same as building natural, healthy bone with exercise. When old bone is not broken down to create new bone, the old bone becomes brittle and fractures easily.
Bisphosphonates do more harm than good
In individuals with osteopenia (low bone density but not osteoporosis) who took a bisphosphonate for four years, these drugs did not decrease the risk of fractures.12
Long term (4-8 years) users of bisphosphonates have significantly higher risks of atypical hip and leg fractures. Most of these fractures are not the result of falls. They occur under minimal stress, often merely walking down stairs or low-energy exercise.2-11
An 8-year study of over 88,000 people found that taking bisphosphonates tripled the risk of developing bone necrosis. This means that bisphosphonates caused permanent loss of blood supply to bone, resulting in tissue death.13
The side effects of Bisphosphonates
Bisphosphonates have been linked with many other side effects, including esophagitis, esophageal cancer, osteonecrosis of the jaw, and atrial fibrillation. They can also negatively affect the musculoskeletal system, gastrointestinal tract, and kidney function.11,14,15
Exercise and nutrition for prevention and treatment
Prevention and treatment of osteoporosis does not need to involve potentially dangerous drugs. Instead, osteoporosis should be prevented and treated through physical exercise and proper nutrition, which have been shown to be more effective than drugs and have no negative side effects.16-19
Blume SW, Curtis JR. Medical costs of osteoporosis in the elderly Medicare population.Osteoporos Int 2011, 22:1835-1844.
Cermak K, Shumelinsky F, Alexiou J, Gebhart MJ. Case reports: subtrochanteric femoral stress fractures after prolonged alendronate therapy.Clin Orthop Relat Res 2010, 468:1991-1996.
Capeci CM, Tejwani NC. Bilateral low-energy simultaneous or sequential femoral fractures in patients on long-term alendronate therapy.J Bone Joint Surg Am 2009, 91:2556-2561.
Ing-Lorenzini K, Desmeules J, Plachta O, et al. Low-energy femoral fractures associated with the long-term use of bisphosphonates: a case series from a Swiss university hospital.Drug Saf 2009, 32:775-785.
Lenart BA, Lorich DG, Lane JM. Atypical fractures of the femoral diaphysis in postmenopausal women taking alendronate.N Engl J Med 2008, 358:1304-1306.
Sayed-Noor AS, Sjoden GO. Case reports: two femoral insufficiency fractures after long-term alendronate therapy.Clin Orthop Relat Res 2009, 467:1921-1926.
Somford MP, Geurts GF, den Teuling JW, et al. Long-Term Alendronate Use Not without Consequences?Int J Rheumatol 2009, 2009:253432.
Neviaser AS, Lane JM, Lenart BA, et al. Low-energy femoral shaft fractures associated with alendronate use.J Orthop Trauma 2008, 22:346-350.
Kwek EB, Goh SK, Koh JS, et al. An emerging pattern of subtrochanteric stress fractures: a long-term complication of alendronate therapy?Injury 2008, 39:224-231.
Pazianas M, Cooper C, Ebetino FH, Russell RG. Long-term treatment with bisphosphonates and their safety in postmenopausal osteoporosis.Ther Clin Risk Manag 2010, 6:325-343.
Cummings SR, Black DM, Thompson DE, et al. Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial.JAMA 1998, 280:2077-2082.
Etminan M, Aminzadeh K, Matthew IR, Brophy JM. Use of oral bisphosphonates and the risk of aseptic osteonecrosis: a nested case-control study.J Rheumatol 2008, 35:691-695.
Bhuriya R, Singh M, Molnar J, et al. Bisphosphonate use in women and the risk of atrial fibrillation: a systematic review and meta-analysis.Int J Cardiol 2010, 142:213-217.
Sellmeyer DE. Atypical fractures as a potential complication of long-term bisphosphonate therapy.JAMA 2010, 304:1480-1484.
Howe TE, Shea B, Dawson LJ, et al. Exercise for preventing and treating osteoporosis in postmenopausal women.Cochrane Database Syst Rev 2011:CD000333.
Sacco SM, Horcajada MN, Offord E. Phytonutrients for bone health during ageing.Br J Clin Pharmacol 2013, 75:697-707.
Cashman KD. Diet, nutrition, and bone health.J Nutr 2007, 137:2507S-2512S.
Nieves JW. Osteoporosis: the role of micronutrients.Am J Clin Nutr 2005, 81:1232S-1239S.
Joel Fuhrman, M.D. is a board-certified family physician, seven-time New York Times bestselling author and internationally recognized expert on nutrition and natural healing, who specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term “Nutritarian” to describe his longevity-promoting, nutrient dense, plant-rich eating style.
For over 30 years, Dr. Fuhrman has shown that it is possible to achieve sustainable weight loss and reverse heart disease, diabetes and many other illnesses using smart nutrition. In his medical practice, and through his books and PBS television specials, he continues to bring this life-saving message to hundreds of thousands of people around the world.
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