Alendronate Newbie

@aacatsaregreat I believe, and have been told, that the loss of estrogen at menopause is a major factor and the bone density loss is inevitable to some extent regardless of how well we eat, exercise and supplement with calcium and Vitamin D. Some people on this forum tell us they have maintained density with holistic approaches, but many of us need meds once our DEXA scores merit that help.

I hope someone can come on here to comment on your current treatment. My insurance covers DEXA scans every two years but some on here pay out of pocket or even get insurance to cover an annual scan. There are blood tests that most docs do my doc does calcium, D3, albumin, kidney tests, some do others), and some doctors do bone markers like CTX and P1NP (mine doesn't). CTX measures bone turnover and P1NP measures bone growth. Alendronate would affect bone turnover, is my understanding.

Resources: "Great Bones" a book by Keith McCormick that is very comprehensive. He also does consults in person or by phone.

A video I like: Dr. Ben Leder, YouTube, "Combinations and Sequencing Approaches to Osteoporosis."

@aacatsaregreat, I have been taking alendronate since October 2020. The various possible side effects you describe are not those typically seen with alendronate, to my knowledge. I have not had any side effects at all. The most common side effect that prevents people from continuing use is GERD. Your doctor may be waiting to see how well you are tolerating the med in that respect before prescribing more.

I have not had any special bloodwork or tests outside of my usual yearly comprehensive blood panel and I don't think that's necessary with alendronate. I've only had one other DEXA scan (in February of this year) since the initial one in October 2020. Most people get them every 2 years. I simply was unaware (my PCP at the time didn't suggest one) or I would have had it done sooner. My DEXA scores were unchanged. I still have severe osteoporosis of the spine (-3.9) and just barely osteoporotic in my hips. While in a way that is kind of a win (at least I'm no worse off than before), I am trying to get on a different type of drug that actually builds bone. I don't know if you know that there are two different categories of bone meds: anti-resorptive and anabolic. Only the latter build new bone; the anti-resorptives, of which alendronate is one, try to stop the loss of old bone. Because I had/have severe osteoporosis, I think I should have been on an anabolic from the get-go but I didn't know anything about them at the time. It seems most docs prescribe alendronate or another anti-resorptive rather routinely and don't discuss or even tell you there may be other options for you. Even if you and/or your doc would prefer a different drug, insurance companies often/usually require you to "fail" one of the lesser-tier i.e less expensive drugs and/or be at high risk of fracture before they will approve one of the anabolics.

It may be that alendronate will work perfectly well for you. Many people's DEXA scores do improve with it. If you have mild or maybe even moderate osteoporosis and can tolerate it well, it could be the best choice for you at this time.

What are your DEXA scores? Did you doctor tell you about or discuss other potential options?

Interesting, thank you as I too have recently begun taking weekly dose of Alendronate. Haven't developed any noticeable side effects after 2 months.

Am a bit concerned that this drug stops the lose of old bone - does that mean that it hinders/prevents new bone cells being developed?

Thanks for your reply!

I've done some studying since I posted and loss of estrogen does appear to be a major factor, as well as a sedentary lifestyle, smoking, various medications, etc. I suppose, just as with many other conditions, it's sometimes hard to pinpoint an exact cause from person to person. I've read about some of the holistic approaches. I've also seen some studies concerning a possible connection between caffeine and osteoporosis, so I'm making a change there after being a coffee-holic for all my adult life. My current container of ground coffee has enough for about two potfuls left and coffee will then be a thing of the past! It seems that added sugars can also be a problem, according to some studies, but I've already been cutting way back on those because my husband's A1C is suddenly high and his doctor told him to change his eating habits.

I appreciate the treatment information. I guess I'll find out what my doctor's routine will be at my next visit. I've found that Medicare apparently covers a scan every two years (or more if medically necessary). I don't know what "medically necessary" might entail.

I'll check out Dr. Leder's YouTube video. Thanks! And the book also. I've been looking for something that's informative but hopefully easy to understand.

Thanks you your response!

The information that came with my alendronate prescription didn't mention tiredness or dizziness among the possible side effects, but the alendronate pages on several medication websites I've looked at do indicate dizziness, lightheadedness, unusual tiredness or weakness on their lists as "incidence not known". So I guess they've been reported but may not be common? I'm guessing they're associated with the med as both began right after I began taking it, but not to the extent that they interfere with my life! Hopefully both will eventually go away.

I, too, was unaware of any possibility that I had osteoporosis, and I'd never been offered a scan prior to starting on Medicare last November. I've never had a fracture of any type. According to my scan my femur necks and spine are involved.

My doctor mentioned numbers but at the time I was so surprised that I didn't listen very well. I do remember that I was very slightly below the "below average" line on the results. I'll get more information when I see her again, or I may be able to go online and get the results. I'm aware of the different categories of meds, but don't know the details. My doctor did mention a yearly infusion if the alendronate isn't helpful. But that sounds kind of scary!

According to the websites I visited, alendronate works by "inhibiting osteoclasts (which are responsible for breaking down and reabsorbing bone). It strengthens bones by slowing down bone loss and allowing osteoblasts (bone-building cells) to work more effectively, improving bone mass."

So apparently it helps to slow down bone loss by inhibiting the cells that break down bone, thus allowing the cells that actually build bone to do their job better.

I look forward to finding out how well it works, which hopefully it does.

@jennifer28 this is a bit of an oversimplification but in essence the osteoclasts (the "killers) are working faster than your osteoblasts ("builder"), and alendronate and the other anti-resorptives are meant to slow down the chewing up of old bone to give the osteoclasts a chance to catch up.

Thank you for this, appreciated.

thank you, this is helpful.

@jennifer28 Alondronate prevents the reabsorption of your own bone by your body, it does not help grow new bone. At the age we are at we do not grow new bones.