Osteoporosis treatment warrants consideration, and action
DEAR DR. ROACH: I’m a 61-year-old female, and my recent DEXA bone density scan resulted in measurements of -2.7 in the lumbar region and -2.1 in both femoral necks. My doctor recommended that I take bisphosphonates. I have read many negative things about this class of drug. My main concerns are that it slows the rate at which osteoclasts break down old bone, so old bone is not being replaced with new bone. This would result in denser, but more brittle, bone. Also, it is very corrosive and can cause damage to the esophagus; I already have issues with acid reflux.
Do you recommend bisphosphonates, or is there an alternative course of action I could take to build stronger bones, such as resistance training, walking, making my diet more alkaline and taking bone supplements (which supply other trace minerals and vitamin K, in addition to calcium)? — D.L.
ANSWER: It is appropriate to carefully consider your options for treatment, but osteoporotic fractures are a major cause of disability and death.
Both of the concerns you have about bisphosphonates are partially true. Bisphosphonates such as alendronate (Fosamax) and risendronate (Evista) work by slowing down the action of the osteoclasts, the cells that reabsorb bone. This allows the osteoblasts, which make bone, to increase the amount and strength of the bones. Taking bisphosphonates increases bone density, but it also reduces the risk of fracture, at least for the first three to five years of taking them.