Tag Archive | bisphosphonates

Believable Good News

A new Canadian study has followed a group of people just like me: those who are responding to osteoporosis purely with lifestyle adjustments, without taking bisphosphonate drugs. Medical researchers from the University of Alberta and University of Calgary prescribed six micronutrients and an exercise program, then tracked the results. I’m delighted to see that over the year of the study the bone density of the participants increased more than it would have with the standard pharmaceutical drugs.

Of course, one reason I like this study is because it seems to validate my approach. Another is that no drug company funded the work, and for me that adds credibility. The authors appear to be squeaky clean with regard to conflicts of interest that may have skewed the results.

On the negative side, the sample wasn’t entirely representative of the low-bone-density population; the authors worked exclusively with people the doctors call “non-compliant”, who had already decided not to use the recommended drugs. Some had abandoned the drugs after experiencing continued decline of their density while taking them. Others had explored their options and just wanted a non-pharmaceutical approach. To me that suggests a cohort that is more health-aware than the average population, more likely to do their own critical investigations, eat a better diet, and resort to fewer pharmaceutical products in general. Really, though, I’m not concerned about the non-representative sample: when it comes right down to it, all I want to know is what will work for ME and the people I care for! And with that prescription I will comply.

Lifestyle adjustments in the study

So what did the participants do? Here’s the list:

Table 1: Combination of micronutrients (COMB) Protocol for Bone Health.

COMB protocol for bone health

(1) Docosahexanoic acid or DHA (from Purified Fish Oil): 250 mg/day
(2) Vitamin D3: 2000 IU/day
(3) Vitamin K2 (non-synthetic MK7 form): 100 ug/day
(4) Strontium citrate: 680 mg/day
(5) Elemental magnesium: 25 mg/day
(6) Dietary sources of calcium recommended
(7) Daily impact exercising encouraged

In earlier posts I’ve already talked about vitamins D and K2, strontium, magnesium, and calcium. Although I take fish oil containing DHA for general good health, I hadn’t heard that it’s particularly helpful for bones. According to the study: “Both DHA and vitamin D are involved in the regulation of many genes and…associated with improved bone strength.”

As for the exercise component, the authors said: “Patients were also instructed to commence and maintain a regimen of daily impact exercises such as jumping jacks or skipping where possible as impact has been associated with prevention of bone density loss.

How much did it help?

The mean improvement in BMD (bone mineral density) was impressive: 3% in the hip, 4% in the neck of the femur, and 6% in the spine. That was contrasted with a continued decline in BMD among the study dropouts, and substantially lower improvements using bisphosphonate drugs. Unlike the drugs, the study protocol delivers no side effects.

What will I change?

I’m already taking the micronutrients suggested by the study, although in different amounts. My calcium is not exclusively from food sources, as I consume very little dairy food, and I’m not confident that I can meet all my requirements all the time with my diet. These days I take 200 mg of DHA, 6000 IU of D3, 100 micrograms of K2, 340 mg of strontium citrate, 420 mg of magnesium citrate, and 1000 mg of a calcium supplement. I plan to leave those as they are for now. At the moment I get impact exercise three or four times a week at the gym, with some walking in between, and heavy gardening all summer. That didn’t prevent osteoporosis in my case, but adding some jumping jacks into my non-gym days is worth a try.
Combination of Micronutrients for Bone (COMB) Study: Bone Density after Micronutrient Intervention


Why blog? It’s in my bones.

I was stunned. This wasn’t the news I was expecting. When my doctor’s office called me in for a non-urgent followup after my first ever bone mineral density test, I anticipated being told that the aging of my bones might lead one day to osteoporosis, and being urged to take a drug to prevent that.

“You have severe osteoporosis. A diagnosis of this begins at a T-score of -2.5 Your spine measures far worse than that – it’s -4! You’re at high risk of a spinal fracture. We have no choice but to prescribe bisphosphonates.”

She went on to warn me: “Make sure you don’t fall. You mustn’t do any activities that may cause you to fall. No more ice skating, no skiing, no climbing on ladders, no riding bicycles. Be careful. A fracture could happen at any time. Be very careful. Take lots of calcium.”

I left the office in a blurry fog of unreality, and stepped cautiously across the parking lot to my car, feeling like a piece of delicate crystal. How could I have felt so fit and healthy just a half hour ago, when my body really was critically frail?

As I tried to process the report, the doctor’s dark words hung over me, and I felt my confidence ebbing. Was it safe to lift a full laundry basket? To twist around to look in the back seat of the car? To bound up the stairs like I always had? My initial Google search just confirmed the worst: I have elderly bones in a 54-year-old body. No running, no jumping, no twisting for the rest of my life, or face cruel years of handicap and pain.

My first response

I cried. I fussed. I stayed home from the gym and wallowed in my mortality.

What about the prescription?

Then there was the drug. I already knew that taking bisphosphonates risked some serious side effects – atypical brittleness of the thigh bone, almost at its thickest point; and an untreatable necrosis of the jaw. And that a very high percentage of users suffered with digestive issues, joint pain, bone pain, and flu-like symptoms while on the drug. I did not want to ingest anything like that if there was an alternative.

As I looked into it further, I discovered that until around 1990 bisphosphonates were just industrial corrosion inhibitors. Then someone had the idea of having women take them internally to build bone density. The particular drug prescribed for me is called Actonel, and it was developed by Proctor and Gamble, the chemical company we’ve all heard of. The story of them getting it on the market includes a plot of intrigue and controversy, as the high level scientist whose name was used to publish the glowing research report complained that P & G had withheld the raw data even from him, only giving him access to the small subset that seemed to show benefits of the drug in bone density. He asked to have his name removed from the published paper.

It turns out that bisphosphonates work by killing off the osteoclasts in our bones. These are cells that function to break down old bone, effectively cleaning up the regular debris from wear and tear in our skeletal systems. Osteoporosis happens when these osteoclasts are too active, cleaning away old bone cells faster than new ones are built. The drug gives an initial increase to bone density, as no more bone is taken away.

The resorption work of osteoclasts is normally complemented by the work of osteoblasts. They serve to build new bone, repairing our frequent little micro-tears, and replacing elderly cells. Unfortunately, it seems that these osteoblasts eventually stop working in the absence of their clean-up partners. So after an initial increase in bone density while on bisphosphonates, the density levels off. Worse than that, repair of minor damage ceases, and old cells aren’t cleaned away. The bone that remains may be more dense than before, but evidence suggests it is also more brittle.

Was it true I had no choice?

It didn’t make sense to me that an industrial chemical taken internally, resulting in continuous pain and eventual bone failure, was a good solution. When it came right down to it, I thought I’d rather spend a cloistered life in a bubble but feeling healthy. Or face an early death from bone collapse after a life fully lived. I folded the prescription and hid it in the bottom of a drawer.

Wasn’t there another approach? Surely our bodies are created to heal, and optimum diets can provide what we need. What had gone wrong with my body that some cells were overperforming? What could I do to turn things around?

I began reading everything I could find on the subject, and that pointed to the reason I’m blogging: There is an astounding amount of information available on natural approaches to osteoporosis that have worked for real-life people! Since my diagnosis, my three sisters have followed up with their doctors – and ended up with the same label as mine: osteoporosis. Recognizing a genetic link, as our mother and her sister were also afflicted, I’m thinking ahead to the bones of our children as they age. Obviously, I’m not the only one urgently searching for answers, and it makes sense to me to consolidate what I’m learning and share it with others.