Osteoporosis and Drug Risks

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The following three articles on adverse drug reactions and bone health are intended to support informed choice only. Always speak to a health professional before changing how you use your medications.

Warning for use of Actonel and other Bisphosphonate drugs

Fosamax, Didrocal, and Actonel, part of the drug class known as bisphosphonates, are well known for their ability to improve bone density in individuals with osteoporosis. These drugs cleverly slow down the cells that break down bone, called osteoclasts. Research indicates that extended use of these drugs can actually lead to an increase in certain types of rare leg fractures caused by simple activities like walking. This may be because the bone, while under the influence of the drug, is unable to break down and repair mini bone injuries that accumulate on a daily basis. This side-effect is considered rare, but serious. The key to minimizing this risk may come from supporting the cells that build new bone, known as osteoblasts. Speak to your health professional if you experience chronic bone pain or deep thigh pain when standing while taking one of these medications.

Antidepressants may Increase Risk of Bone Fracture

Recent studies suggest that elderly people taking anti-depressants that increase the brain chemical serotonin, such as Prozac and Effexor, may experience more bone loss than people not taking the medication. At least one study also suggests that people taking other classes of anti-depressants have normal levels of bone loss, further suggesting that it’s not the depression alone causing the decreased bone density. Researchers aren’t sure why this happens, but it may have something to do with the increased availability of serotonin forced by the drug that stimulates bone to break down. This idea comes from a study in which a researcher reversed osteoporosis in mice by using an experimental drug to block serotonin production in the digestive tract.

Few people know that 95% of the body’s serotonin is produced in the digestive tract. In other words, your intestinal health significantly impacts your bone health. Interestingly, probiotics play a role in this pathway and may support healthy bones.

Antacids may increase Bone Fracture Risk

Drugs used to treat acid reflux and stomach ulcers, such as Nexium, Prilosec, and Prevacid, may increase risk of hip, wrist, and spine fractures. This might be because stomach acid, which is intentionally blocked by these medications, is required for optimal absorption of calcium and many other minerals critical for bone health. Calcium carbonate pills for example, are poorly absorbed in a low stomach acid environment, and the subsequent calcium deficiency may cause a decrease in bone density. Please speak with your healthcare provider about the possibility of healing underlying acid reflux so that discontinuation of medication is possible. Alternatively, a knowledgeable health practitioner can help you determine which mineral supplements are best absorbed despite medication.

Prevent Bone Fractures

In addition ensuring good bone health with an adequate diet, supplements when needed, and weight-bearing exercise, spend some time learning about how to prevent falls. Evaluate the quality of lighting in your home, sturdiness of your hand rails, and security of rugs on your floor. Engage in yoga or tai chi exercises that improve balance and core strength. An Osteopathic Manual Practitioner, Registered Massage Therapist, Chiropractor, Occupational Therapist, or Physiotherapist, can help you adjust your posture, muscle imbalances, and gait, to reduce risk of falling.