If you are young, why risk a therapy that may be dangerous for more than 10 years when new therapies are coming? Don't buy in to the hysteria. My own doctor told me at 30 that the next time I fell I could break several bones. That was 7 years ago. My DEXA score is stable without bisphosphonate therapy. With ice & snow here in the winter, believe me I've had hard falls - and no new fractures.
Please comment - the following is an understanding I have built over five years of continuous web research on consumer, medical and journal sites. I am now at a stage where I educate my endocrinologist on new developments, to my advantage:
- Osteoporosis was never diagnosed prior to a bone's breaking without other injury before we had DEXA machines
- Osteoporotic breaks usually happened after age 50
- The World Health Organization, recognizing the high morbidity factor for broken hips in the elderly and the high cost of treatment and disability, set out an initiative to try to prevent osteoporotic fractures through pharmaceutical and other intervention
- Research on bisphosponates began both from this mission and due to the high population of potential patients (profitability for the pharma companies)
- Bisphosphonates were developed in conjunction with DEXA machines because the drug researchers had to have a way to measure a baseline density and any improvements
- DEXA results enable doctors to tell you your bone density at any age, GIVING A REASON to prescribe the drugs DEXA was developed to test
- Neither DEXA readings nor your doctor can say if you will suffer a fracture or when, creating an uncertain pool of lower bone density people with many years left to live
- Longest drug trials for bisphosphonates are under 10 years
- Bisphosphonates accumulate existing bone and decrease destruction of bone formed while you take them - they do not build bone faster or stronger (Shame on the FDA for allowing the Boniva ad with Sally Fields -- "builds strong, healthy bones" )
- Bone ages normally and older bone is replaced with new bone in a natural, daily process
- As you age the amount of new bone built decreases but old bone is removed at the same rate, causing loss in density and molecular stability, usually from age 30
- Anyone under 50 with a sub-optimal bone density reading does not necessarily have osteoporosis or osteopenia, these are diagnoses for post-menopausal women
- New drugs are coming to build bone
- If you are under 60 and have not had an osteoporotic fracture it may be best to wait for actual bone building drugs rather than begin the anti-resorptive therapies (boniva, fosamax, etc.) which are bioactive for years to follow, though usually at a sub-clinical level 1 year after stopping treatment
- Recombinant teriparatide is the only currently available bone building drug (Forteo) in the US and it retails at around $750 a month. You are advised to take it for 1.5 - 2 years.
- Recent journal studies suggest that vitamin D and calcium intake are the most critical factors and the cheapest regimens to follow
- In Europe, strontium ranelate has improved bone density but it is a heavier molecule than calcium and this skews the DEXA data, making it difficult to calculate the actual T-Score gain once therapy begins
- In America, you can purchase strontium citrate (a similar molecule with one Sr ion wheras strontium ranelate has two Sr ions) from health food stores but your doctor and radiologist will not know how to adjust the DEXA readings once you start this therapy
- Rare cases report increases in fragility fractures in patients taking the anti-resorptive therapies for more than 3 to 5 years
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