Osteoporosis meds: How do they work?

Posted by grandmabubblestwin @grandmabubblestwin, Nov 11, 2016

I've been reading about osteoporosis and this is what I've seen so far: An individual builds bone until about age 30 then they begin to lose bone. Osteo meds do not help you build bone, they may actually prevent the natural bone building process but they do help you retain the bone you have but can make bone brittle. Correct?

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

I came to the same conclusion as you, but based on user comments on a variety of sites, including Mayo Clinic Connect. I have not seen any reports in the media that can be called "bad reports" - the ones I've read have all said that more women with osteoporosis should be taking these drugs. Could you please tell me where you have seen these "bad reports" types of stories?

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Has any one seen reports for Reclast? That's the yearly infusion I've had once. Rescheduled for second one in march. I haven't seen any bad reports on it

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Hi all,
I thought you might appreciate reading the international Clinician’s Guide to Prevention and Treatment of Osteoporosis (2014) found online here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4176573/

The Executive Summary on page 1 provides some information things you have been discussing here like diet, the recommended intake of calcium and vitamin D, weight-bearing exercise, as well as pharmacologic treatment (medication) recommendations.

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@jaleen

I came to the same conclusion as you, but based on user comments on a variety of sites, including Mayo Clinic Connect. I have not seen any reports in the media that can be called "bad reports" - the ones I've read have all said that more women with osteoporosis should be taking these drugs. Could you please tell me where you have seen these "bad reports" types of stories?

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Colleen and jaleen they are all over. And as I mentioned before, I have two personal examples of very bad side effects. I realize there are lesser "side effects" but I don't handle medicine well so I don't plan to find out first hand.

This is from https://www.drugwatch.com/fosamax/side-effects/
Severe Side Effects
According to Merck, a defendant in litigation because of Fosamax, the more severe side effects include broken bones, jawbone deterioration, A probems, low blood calcium, and extreme bone and joint pain.

Femur Fractures
For those taking Fosamax, perhaps the most frustrating side effect is the drug’s propensity to cause fractures of what is one of the strongest bones in the body – the femur. These low-energy fractures, also called stress fractures, often happen when patients least expect it. Some patients reported breaking bones while they were doing normal, everyday tasks such as walking or sitting. Merck said the fractures usually come after weeks or months of groin or hip pain. Researchers are still trying to determine why Fosamax is linked to bone breaks, especially in patients taking the drug for five years or longer. Many scientists theorize the drug shuts down the body’s bone-renewing process and creates more brittle bones.

Dead Jaw Syndrome (Osteonecrosis)
Another alarming side effect of Fosamax is jaw osteonecrosis, also called Dead Jaw Syndrome. This happens when the blood flow to the jawbone, or mandible, is cut off and causes bone death. Usually onset following minor mouth trauma such as dental work, jaw necrosis (cell death) causes an antibiotic-resistant infection and swelling. The infection eventually takes over the tissue and causes bone to die and collapse.

Esophagus Problems
Some Fosamax patients develop irritation, inflammation and bleeding ulcers in the esophagus, which is the tube that connects the mouth to the stomach. In addition, recent studies point to these problems leading to esophageal cancer. Those who have pre-existing known upper gastrointestinal problems, such as Barrett’s esophagus and dysphagia, should not take Fosamax. In some patients, Fosamax leads to esophageal erosion with bleeding and esophageal perforation. Because of these potentially dangerous side effects, Merck recommends that patients sit upright or stand for a full 30 minutes after taking the drug and take it with a full glass of water.

Low Blood Calcium
Also called hypocalcemia, low blood calcium levels can lead to hand and feet spasms, muscle cramps and abdominal cramps. Since bisphosphonates hinder the natural breakdown of bone, less calcium is deposited back into the blood stream. As the tissues and cells get robbed of calcium, patients can suffer from soft bones, nausea, fatigue and muscle weakness. This can also lead to spasmodic movements and seizures.

Musculoskeletal Pain
The FDA has also found that Fosamax patients can develop severe bone, muscle and joint pains within days of starting the drug. For some people, this pain stops almost immediately after discontinuing it. For others, it is ongoing. Even though it is well documented that Fosamax causes pain, some physicians are known to ignore this side effect, instead prescribing painkillers. The FDA has alerted medical professionals about this problem to ensure Fosamax-related pain won’t be overlooked.

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Furthermore, I think that you'll find this page from the National Osteoporosis Foundation useful and relevant to this discussion.
Medication and Treatment Adherence https://www.nof.org/patients/treatment/medicationadherence/

On this page, you'll find easy-to-understand information written in plain English about:
- Medicines Approved to Prevent and/or Treat Osteoporosis
- Bone Remodeling Cycle
- Response to Treatment
- Monitoring Treatment
- Past Experience and Studies
- How Long to Treat
- Serious Side Effects
- Maximizing Your Treatment
- Taking Medicines Safely

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@jaleen

I came to the same conclusion as you, but based on user comments on a variety of sites, including Mayo Clinic Connect. I have not seen any reports in the media that can be called "bad reports" - the ones I've read have all said that more women with osteoporosis should be taking these drugs. Could you please tell me where you have seen these "bad reports" types of stories?

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Lanadee, It is important to do what is right for you. As the NOF article states "A medicine that is appropriate and effective for one person may not be the best choice for another person. People can respond differently to treatment with the same medicine."

Luckily there are lifestyle choices you can make to help https://www.nof.org/prevention/preventing-fractures/prevention-and-healthy-living/ I bet you look forward to being able to return to adding exercise to your routine. Good luck with the healing of your toe.

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Colleen, while reading the info you suggested I did find something of interest. You are right. Everyone must decide for themselves as to whether or not the medication prescribed is right for them. I found, amongst the reading, information regarding a supplement that is not FDA approved as yet. That is what I may try. Genistein: An isoflavone phytoestrogen which is the main ingredient in the prescription “medical food” product Fosteum® and generally regarded as safe by the FDA. Genistein may benefit bone health in postmenopausal women but more data are needed to fully understand its effects on bone health and fracture risk.
Thanks so much for sharing!

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Hi, I am new to this group and just got a bone density scan of -2.5. My doctor prescribed Fosamax but after reading about side effects, I decided not to take it but am interested in any kind of treatment that might build bone density. Any ideas or experience with this?

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@jeray

Hi, I am new to this group and just got a bone density scan of -2.5. My doctor prescribed Fosamax but after reading about side effects, I decided not to take it but am interested in any kind of treatment that might build bone density. Any ideas or experience with this?

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Hi Jeray,
I moved your message to this discussion about treating osteoporosis so you can meet others members discussing the exact things your asking about re Fosamax etc. Here you'll meet @lanadee @edieguinn @jaleen @cherriann @tessie @dolan @grandmabubblestwin
Jeray, I encourage you to click VIEW & REPLY in the email and read all the messages in this discussion. There are some good resources included to help your decision making.

You can also read more members' experiences with Fosamax in this discussion http://mayocl.in/2gm3GcW

What side effect do concerns you the most?

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@jeray

Hi, I am new to this group and just got a bone density scan of -2.5. My doctor prescribed Fosamax but after reading about side effects, I decided not to take it but am interested in any kind of treatment that might build bone density. Any ideas or experience with this?

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My doctor has me on yearly infusion of Reclast. No side effects. Next one March

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