Tuesday, March 16, 2010

Hoist a Beer for St. Patty—and Your Bones

If you’re contemplating a heavy Guinness-swigging session in honor of St. Patrick’s Day, hey, now you’ve got a great excuse. Beer is actually good for fending off osteoporosis. And isn’t beer just a little more palatable than osteoporosis drugs like Fosamax and Boniva, with all the side effects? (Naturally, it’s essential to ensure that a DUI isn’t the side-effect of beer therapy).

A study from the Department of Food Science & Technology at the University of California, Davis, recently found that beer is a great source of silicon with 50 percent bioavailability. And dietary silicon is, according to the National Institute of Health, apparently vital for bone and connective tissue growth, and also for slowing down the thinning of bones. This follows last year’s Tufts University’s epidemiological study of men and post-menopausal women, which found that moderate—emphasis: moderate—alcohol intake was associated with greater bone mineral density. Of course, it’s possible that all the study participants were just getting in extra weight-bearing exercise by walking to the pub, but that’s unlikely given that the study was done here in the US.

However, the news isn’t all good for Guinness drinkers. The study found that the beers with the highest levels of malted barley and hops, like pale ales, are the richest in silicon.

Thursday, March 11, 2010

Break a Leg in the Fosamax Show

Ouch. It would be pretty ironic if the drug you took religiously to strengthen your bones actually caused them to break, wouldn’t it?

Unfortunately, that may be the case for some people taking Merck’s osteoporosis drug Fosamax. There’s been an upswing in women suffering atypical breaks in the femur—the thighbone is normally a pretty strong bone—after several years of taking the drug; some of the women had merely been walking when their leg suddenly snapped. This unusual type of fracture is slow to heal and can lead to disability.

The FDA started looking into the issue in 2008 but has thus far found no conclusive link. However, a small study at Columbia University College of Physicians and Surgeons found that after four to five years, gains in the “buckling ratio” begin to reverse.

The study, by Melvin Rosenwasser, MD and a medical student, Anthony Ding, looked at 61 postmenopausal women with osteoporosis who had been taking oral bisphosphonates for at least four years and 50 controls who were taking calcium and vitamin D alone.

Other physicians speculate that long-term use of the drug may actually cause brittle bone disease; or that the bone growth driven by oral bisphosphonates like Fosamax is simply not as strong as natural bone.

Merck is currently being sued by some 900 Fosamax-users who have suffered jawbone deterioration apparently due to use of the drug.

Your takeaway: if you’re taking osteoporosis drugs of any kind, be cautious about using them for longer than a few years, be sure that you’re truly in an ‘at risk’ group rather than taking a drug your doctor just routinely prescribes, and discuss any concerns with your doctor.

And as always, report any side-effects or concerns about medications on RateADrug.com’s systematic survey, and email the results to your physician for a more productive office visit.

Wednesday, February 4, 2009

Triple Jeopardy: Risk of Dying Escalates After Osteoporotic Fractures

A new study has confirmed what we all know anecdotally.

“She broke her hip, and then…” You trail off, because we all know that many elderly people go downhill after a fracture—not always, but often enough.

And the study, published in JAMA (the Journal of the American Medical Association) on February 4, 2009, showed that indeed the risk of dying after a hip fracture more than doubles for elderly women, and triples for elderly men. This premature mortality risk lingers for about ten years after a hip fracture and about five years after a more minor type of fracture—a wrist fracture, for instance, which would increase the chance of dying by about 40 percent during those five years.

Dr Dana Bliuc and A/Prof Jackie Center, head of the Bone Clinical and Epidemiology Research Group at the Garvan Institute of Medical Research in Sydney, based their work on information gathered from the Dubbo Osteoporosis Epidemiology Study. Begun in 1989, this is a longitudinal, population-based study of men and women over the age of 60 living in Dubbo, Australia. 952 women and 343 men with fractures were followed for up to 18 years.

“Our study also looked at factors that drive the premature mortality after a fracture,” noted A/Prof Center in a press release. “Thigh muscle weakness and having a subsequent fracture were important factors in both sexes and low bone density was an additional factor in women.

“The interesting thing is that the increased mortality post fracture does not seem to relate to any other illnesses a person might have.

“Although for most fractures the actual cause of death does not appear to be directly related to the fracture, it appears in time close to the fracture.”

It’s enough to make us fifty-somethings head straight off to the doc for a prescription for Fosamax or Boniva. And then you think about all the side-effects of osteoporosis medications that are constantly hitting the headlines.

Uh oh.

What do you do to lessen the risk of osteoporosis and/or fractures? Medications, or lifestyle changes? If the former, have you noticed any side-effects and do you research the side-effects that other people suffer? If you rely on a healthy lifestyle, how effective has that strategy been for you?

Monday, January 5, 2009

Fosamax May Lead to Cancer for Osteoporosis Sufferers

Ouch. Brittle bones are bad, but are they worse than cancer?

If you have osteoporosis, you may well be scratching your head over the FDA’s recent report that 23 patients taking Fosamax have developed cancer of the esophagus and that eight of them have died. In addition, European and Japanese authorities have reported 21 cases of cancer in patients taking Fosamax and six in patients taking Actonel or Boniva.

Bisphosphonates such as Fosamax are known to cause espohagitis, inflammation of the esophagus, and patients are told to remain upright for at least half an hour after taking the drug. Diane K. Wysowski of FDA's division of drug risk assessment recommends that doctors not prescribe biophosphonates to patients suffering from esophagitis, which is a possible precursor to esophageal cancer.

The news comes especially hard for breast cancer patients who are taking the popular drug to offset the side-effects of chemotherapy.

It’s important to put this news in perspective. According to the National Institutes of Health osteoporosis currently affects nearly 10 million Americans: since 1995 more than two billion prescriptions have been written for bisphosphonates. 50 cases aren’t so many.

Statistically, the risk is small and patients may well be able to offset it by heeding the instructions to stay upright after taking the drug and by taking dietary precautions against reflux.

Share your strategies for avoiding Fosamax’ side effects.

Sunday, December 14, 2008

Osteoporosis Drug May Shrink Breast Tumors

The osteoporosis drug zoledronic acid (Zometa) seems to shrink breast tumors in patients who undergo chemotherapy, according to research presented at the San Antonio Breast Cancer Symposium.

In a study of 205 women undergoing chemotherapy, those who received Zometa in addition to chemotherapy were left with residual invasive tumors of 28.2 millimeters, while those receiving chemotherapy alone had residual tumors sized at 42.4 millimeters. Eleven percent of the women receiving combination therapy had no evidence of cancer in their breasts or lymph nodes compared with six percent of those who received chemotherapy alone.

Zometa is already approved as a treatment for breast cancer that has spread to the bone, and reportedly may lower the recurrence of breast cancer in pre-menopausal women with estrogen- or progesterone-positive tumors.

The study’s senior author, Dr. Robert Coleman of the University of Sheffield in England, expects that new trials will be designed to further test the hypothesis.

Zometa, like Fosamax,is a bisphosphonate and—also like Fosamax—has been linked to side-effects such as spontaneous osteonecrosis of the jaw, or “dead jaw.”

Medications can have unexpected benefits as well as negative side-effects. Have you experienced any such benefits while taking Fosamax? Please share your experiences with us.

Friday, November 28, 2008

Is Alkalinity the Key to Preventing Osteoporosis?

Side effects from popular osteoporosis drugs do not outweigh the benefits says Dr. Susan Lark, a women’s health practitioner and specialist in preventative medicine. Lark believes that all bisphosphonates like Fosamax and Reclast should be avoided because they can cause gastrointestinal side effects, chemical burning of the esophagus, infection and death of bone tissue in the jaw (called osteonecrosis), kidney toxicity, and atrial fibrillation.

The major problem she sees with bisphosphonates is that they don’t increase bone growth, but instead prevent the current bone from being reabsorbed back into the body. Normally bones are in a continuous state of recycling new bone in for the old bone. Drugs like Fosamax and Reclast halt this process, preventing further bone loss, but at the same time preventing bone growth. According to Lark, there are much safer, natural ways to prevent bone loss.

Dr. Lark believes the secret to preventing osteoporosis is maintaining alkalinity. Blood is typically alkaline with a PH of 7.35 to 7.45. Part of the way the body maintains this PH level is by releasing bone minerals like calcium, magnesium, potassium, and sodium into the blood. However as people get older, their PH-regulating system declines in efficiency causing their blood to become more acidic. Over the years, things like an acidic diet, stress, and pollutants all contribute to an acidic blood PH. Eventually body is required to break down more bone minerals to keep a healthy PH level, putting older people at a higher risk for osteoporosis.

To stay alkaline, Dr. Lark suggests four steps. First, cut out acidic foods like red meat, dairy products, alcohol, carbonated soft drinks, caffeine, refined sugar, and most artificial sweeteners. Also cut down consumption of acidic fruits, including citrus, apples, most berries, plums, apricots, pineapple, and raisins. Second, Eat more alkaline foods like green vegetables, whole grains, legumes, seafood, eggs, and non-acidic fruits. Third, build up extra mineral reserves by taking mineral supplements like calcium, magnesium oxide, zinc, silica, boron, and vitamins C, D, and K. Finally, you can increase the buffering capacity (alkalinity) of your water by adding sodium bicarbonate (baking soda).

What do you think? Please share your experiences and opinions about osteoporosis and the best ways to prevent it!

Wednesday, November 26, 2008

FDA Claims No Association between Fosamax and Atrial Fibrillation

The FDA recently released a statement saying that there is no connection between the drug Fosamax, used to treat osteoporosis, and an increased risk of atrial fibrillation. The FDA reviewed information for 19,687 patients who had taken a bisphosphonate like Fosamax and 18,358 patients who had taken a placebo. Each patient was monitored between 6 months to 3 years. They found that atrial fibrillation was rare (2 or fewer events per study) and that there was no clear link connecting these events to bisphosphonate drugs.

This FDA statement came after recent reports at the 74th annual American College of Chest Physicians conference suggesting that there is a connection between bisphosphonates and an irregular heart beat that can cause fainting, fatigue, heart failure, or stroke.

A study involving 16,000 patients at the University of Miami showed that patients taking Fosamax or Zometa (another popular bisphosphonate) could have a 68% increased risk of serious atrial fibrillation causing hospitalization or death. Yet, the total number of patients experiencing an irregular heart beat was small at 2.5 to 3.5 percent.

Another recent study published by the New England Journal of Medicine in May 2007 also suggested that bisphosphonates can increase the risk of this heart problem. Compared to the FDA data of 6 months to 3 years, this study lasted 5 years, ending in 1997. The results found that the risk for a serious irregular heart beat could be 50% higher in patients taking Fosamax compared to the placebo group.

With these conflicting reports it seems hard to know what to believe. One alternative is RateADrug.com where you can get a non-biased report of individual’s experiences with Fosamax. Please add to this growing database of community reported information and review Fosamax.