A recent study has found that the this common osteoporosis drug creates brittle bones with use ranging from three to five years and beyond. The class of drugs called bisphosphonates is the most commonly prescribed medication to treat osteoporosis. It is has been know for some time that there is a risk for atypical fractures with long term use of these drugs but this study included biopsying bone tissue in patients who took the drug more than 3 three years and up to 8 years. The study’s results should be cause for concern if you are currently taking or have been advised to take any drug in the bisphosphonate class.
There are two types of cells in our bone tissue; osteoclasts and osteoblasts. Osteoclasts break down bone tissue and osteoblasts build bone tissue. The bisphosphonate class of drugs basically works by turning off the osteoclasts which then does not allow for bone tissue to be broken down. On the face of it this seems like a decent way to treat osteoporosis, a disease in which we loose bone tissue making our bones weak. In reality turning off the function of osteoclasts results in old bone tissue not turning over as new tissue is grown creating “old bones.” What we have assumed is this old tissue causes the bone to become brittle. This study has confirmed it.
This study looked at the actual bone tissue of women who were taking bisphosphonates to treat a diagnosis of osteoporosis. What they found was that these drugs did create aged, brittle bones by not allowing for the normal turnover of old bone as new bone grew. They also found that these drugs caused “crack deflection” — the bone’s ability to stop a microscopic crack from propagating and resulting in a fracture. The atypical fractures that have been occurring due to taking these drugs are the result of stress fractures caused by fatigue loading. In people who are not taking bisphosphonates these stress fractures are healed through normal bone physiology. If you are taking the drug these stress fractures are not healed and instead worsen with time resulting in a major fracture.
My license does not permit me to make recommendations on whether or not you should or should not take any prescription medication. Based on what I have read on bisphosphonates over the years I ask patients to research the topic completely in order to come to a well informed decision. You should never base your decision on your DEXA scan number alone but also look at your FRAX score to determine your risk for future fracture. According to the literature I have read DEXA scans alone are not sufficient to make a determination on the need for pharmaceutical intervention. There are safe and effective means to improve your bone density score through strength training. We have had a number of patients who have improved their bone density through our BStrong4Life program. Most recently a patient brought in her DEXA score which showed a 5.6% improvement in bone density moving her from a diagnosis of osteopenia to having a normal or healthy bone score. Give us a call if you would like to know more about how we might be able to help you. 630-232-6616