The Surgeon General’s advice — work with nature
In one sense, I agree with pharmaceutical companies: prevention is best. But I don’t agree with their approach to prevention. Pharmaceutical medications, in my opinion, don’t work with your body. They work by suppressing or fooling it into doing something it wouldn’t do naturally. I know that in certain circumstances, bisphosphonates can be helpful, but for the most part they should remain a last resort.
In 2004, the Surgeon General studied osteoporosis in the United States and wrote a report over 330 pages long on the best ways to promote bone health and prevent osteoporosis and fracture. His advice, in essence, is to work with nature.
He provides an osteoporosis pyramid for prevention and treatment that starts with nutrition, physical activity, and fall prevention at the base. The second tier involves assessing and treating the underlying causes of compromised bone health. The very tip of the pyramid, and the last resort, is pharmacotherapy. The bottom line is that your bones are meant to last a lifetime. In most cases they don’t need drugs to keep them strong or prevent fracture. There are many, many natural ways to support your bones with proper bone nutrition and, many times, simple lifestyle changes to prevent osteopenia, osteoporosis, and needless fracture.
To learn more on the topic of osteoporosis and bone loss, read our additional articles here:
- Top 10 myths about osteoporosis
- About the diagnosis of osteoporosis
- Causes of osteoporosis
. Possible adverse side effects associated with osteoporosis medications (bisphosphonates)
- Ulcers of the esophagus
- Upper GI irritation
- Irregular heartbeat
- Fractures of the femur
- Low calcium in the blood
- Skin rash
- Joint, bone, and muscle pain
- Jaw bone decay (osteonecrosis) (rare)
- Increased parathyroid hormone (PTH)
If patients knew the reality of these numbers and the dangerous side effects that come with taking bisphosphonates (see chart at left), I’m sure they would reconsider the merits of taking a prescription for low bone density for the rest of their days. This information is hard to find, and many practitioners don’t have the time to analyze the statistics of each and every study that comes across their desk.
I would advise patients to ask their providers what the absolute risk reduction is for a drug before taking it. Or you can also ask about the number needed to treat (NNT). This figure gives you a sense of how many people would have to take the medication for one person to receive a benefit, and the lower the NNT, the better the chance that the drug will benefit you.
For example, the above information tells us that Fosamax reduces fracture risk by about 1% (absolute risk reduction), so 100 people would have to be treated for one to benefit from fracture risk — the NNT is 100, in this case. In essence, the NNT is telling us that for every single person who is benefiting from these drugs, 99 more are getting no benefit at all!
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