Drugs vs Nutrition again

Our Medical Industrial Complex — as I think of it anyway — is structured to profit from chronic illness, not from health.  The latest example of this phenomenon concerns osteoporosis drugs in the bisphosphonate class.  Fosamax, Boniva and Actomel are used by millions of women.  Bisphosphonates are chemicals originally used for water softening in citrus orchards irrigation systems (see History).  Yum!

Now bisphosphonates are widely prescribed for thinning bones, mostly to women.  The FDA recently issued a report suggesting that, while these drugs seemed to have some benefit in preventing fractures during the first 3 years of use, benefit beyond 5 years was questionable.

More worrisome: after long term use, many women report bizarre side effects, such as thinning jaw bones causing loose teeth, and unexpected femur (thigh bone) fractures.  The idea that a drug intended to strengthen bones and prevent fractures actually causes those problems is bizarre, and screams for research to clarify the reasons.  Unfortunately setting up such a study is problematic.  Who would participate, knowing they might lose teeth or have a sudden leg fracture?  Not to mention: who would pay for it?  Certainly not drug companies.  And who else has that much money?  Not our government.  The FDA bravely concluded:

“The safety of long-term bisphosphonate therapy continues to be unclear as study results are conflicting,”

The FDA simply wants to change the warning label, so that both doctors and patients will think hard about long term use of these drugs.  There are dozens of possible adverse side effects, in addition to jaw bone thinning and femur fractures.  Is that too much to ask?

Here’s what really bugs me: it’s all about drugs.  Doctors see a patient with thinning bones and immediately thing “drug prescription!”  They do not ask about intake of high calcium foods, vitamin D or exercise, all of which affect bone density.  They may check for vitamin D, and if it’s low, recommend supplements.  But instead of allowing nutrition intervention to work, they immediately go the drug route.  And unfortunately, many patients conclude: the drugs are more important; I don’t have to bother with that nutrition stuff.

The prescribing instructions for these drugs include recommendations for adequate calcium and vitamin D intake.  Here’s one example from the Fosamax prescribing recs:

Patients should receive supplemental calcium and vitamin D, if dietary intake is inadequate,

Let’s say the patient dramatically boosts calcium and vitamin D while taking a bisphosphonate.  A year later the doctor checks their bones.  They’re denser.  The doctor concludes: the drug is working.  There is no recognition of the effect of nutrition.  The patient is told to stay on the drug.  One thing is clear, if someone has low calcium intake and inadequate vitamin D status, taking a drug is going to have limited effect.   Our bones are not made out of drugs.  Bones are made from calcium and other minerals, as well as protein.  No drug can magically conjure up those nutrients inside the body.

I personally was prescribed Fosamax once, and I threw the prescription away.  Instead I got tested for vitamin D, and upped my calcium intake from both food and a supplement (a calcium citrate formula).  But bones are not just blocks of calcium.  There are many other nutrients involved in bone structure, so if you want to strengthen your bones the natural way, keep these in mind:

  • calcium (3-4 servings/day of a high calcium food, or some of that as supplements)
  • vitamin D (get checked, supplement accordingly)
  • magnesium
  • phosphorus
  • boron
  • protein – surprisingly, bone structure requires some protein.
  • vitamin K: the research on this is quite new, but there seems to be a connection between vitamin K and our ability to metabolize calcium for bone.  Where do you find vitamin K?  Green leafy vegetables.
  • exercise stimulates bone strength
By the way, nutrition intervention needs no warning label, other than:
Long term use of nutrition to prevent disease results in lower profits for drug companies.
Feel free to quote me on that.
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