what is your experience with fosamax?

@humphreysbr
I am on 4th month of alendronate once a week. I’m ok the day I take it, but by the second day, my stomach not good and joints are hurting and just exhausted. Is this normal? I thought I’d get over this weekly misery after a few months, but I’m not sure that’s the case. Is this normal for this drug or maybe just making things worse? I get a little better by day 4,5 but then start dreading the next dose coming up. And it starts all over. Does this really help improve bones? Getting harder and harder to do my normal gardening and other chores…

@gracierose that is exactly what happened to me! I would feel great at first for the first couple of months but over time I developed palpitations, joint aches in my feet so bad I had to order different super wide shoes to keep the aching down and was exhausted all the time! I also experienced leg cramps, eyelid twitches and arch cramps when I stretched in bed. All classic signs of low magnesium and too much calcium. I would start to feel better by day 6 but on day 7 and the next dose I would go downhill again. After 7 months I said enough is enough and the doctor told me I could stop to see if symptoms went away. They did and I realized the drug had caused all my symptoms. It took several months off it to feel back to normal as I increased my magnesium and my calcium magnesium ratios balanced out again. My exhaustion left too. I was taking 3 hour naps! It is crazy what drugs can do to you! Now I supplement with calcium hydroxyapatite, vitamin Mk7, vitamin d 4,000 IU and powdered collagen with Fortibone. I improved all my DEXA scores, and I also do weight bearing exercises three times a week at the gym. My doctor pointed out walking alone won’t do it unless you use a weighted vest or ankle and wrist weights as you need the bones to feel stress to tell them to increase density. Best of luck to you! Many studies show Alendronate does not increase density very much or if any. Several folks have posted links on that topic or Google it.

@gracierose In answer to your question, does Fosamax really improve bones -- it slows bone loss but also slows the growth of new bone. So BMD will show improvement on your DEXA, but there are questions on how much fracture reduction benefits it offers.

There are many articles about studies done on this, here is one: https://www.amjmed.com/article/S0002-9343(24)00101-3/fulltext
"Perceptions of the benefits of bisphosphonates depend on how risk reduction is presented. In general, use of relative risk reduction leads to more favorable views of treatment benefits compared with other risk-based statistics like absolute risk reduction. When the baseline risk is low, use of relative risk alone is likely misleading. According to the review conducted by the ACP, the relative risk reduction of hip fractures with bisphosphonate treatment for at least 3 years is 36%; however, the absolute risk reduction is only 0.6%. Framed as number needed to treat, 167 patients need to be treated for 3 years to prevent one hip fracture. One study of patients attending an osteoporosis clinic found that presentation of treatment benefits as absolute risk reduction significantly decreased the number of patients who would consider treatment compared with use of relative risk reduction."

The last paragraph offers a summary of findings: "for patients with osteoporosis based on bone density alone, treatment benefits are less certain. Hip fracture risk reduction is modest and not supported in patients without a history of fracture. Reductions in vertebral fractures are substantial regardless of baseline risk, but whether these reductions correspond to less chronic pain and disability is unclear. Clinical evidence is weaker for newer agents. Future guidelines and reviews on osteoporosis treatment should clearly distinguish between primary and secondary prevention of fractures to best inform clinical decision-making. Despite guideline recommendations and calls for more screening and treatment, there are legitimate reasons for some clinicians and patients to opt out."

Another article by Consumer Reports: https://www.consumerreports.org/cro/2012/04/popular-osteoporosis-drugs-come-with-mounting-concerns/index.htm
From this article: "Bottom line. Bisphosphonates offer only modest benefits in building bone and preventing fractures, and that should be considered along with the risks."

Thank you for this information! It just seems you shouldn’t feel THIS bad for what MAY or MAY NOT produce any gains at all. I’m in my 70’s and would like to be able to still work in garden and enjoy activities with grandchildren. Seems like I keep doing less and less of these activities after only 4 months of this drug because of fatigue, joint pain and generally feeling so bad…thank you for the information.

@gracierose It's hard to balance the benefits vs risks. I think the big factors are your age, if you have generally good physical condition making you less likely to fall, and your DEXA score. I am 76 with a DEXA score of -4.1 in my spine, -2.7 in hips and in otherwise good health and fitness. My Dr recommended Fosamax but I refused because I have no fractures and don't believe the fracture benefits are that great. My Dr disagrees but respects my opinion.

With my reluctance to go on Fosamax, my Endo Dr said he would prescribe it at 1/2 the normal dose (35mg/week). He said that dose was still effective and would have less side effects than the normal 70mg/week dose. If you want to remain on Fosamax, you could ask your Dr about reducing the dosage to 35mg/week and see if your symptoms improve.