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Osteoporosis Message Board

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Re: Actonel
Jun 13, 2005
I would like to clarify a few of the points you made below.....
First, you are correct, that Fosamax and the other bisphosphonates do not build bone. They are antiresorptives. They simply prevent the oseoclasts from resorbing bone. They do this by binding to the active sites of resorption and prevent the osteoclasts from absorbing to much bone.

Actonel and Fosamax return bone turnover levels (ie: bone resorption and formation) to NORMAL premenopausal levels. They DO NOT lead to a build up of dead bone. Bone biopsies (taking a peice of the bone out of the body and then examining it under a microscope or doing micro-CT) after 3, 5, 7, and now 10 years show that people on bisphosphonates have good normal quality bone. If there was a build up of 'dead' bone, then one would expect to see micro fractures in the bone and an increased incidence in fracture in patients taking the drugs. This is NOT the case.

In regards to the T-score of -2.5.....Actually the NOF and other groups already have recomended going down to -2.0....and some even recommend treatment at -1.5 with other risk factors. This is based on the epidemiological data that shows the incidence of fracture and risk of fracture at each T-score cutoff. A 1.0 decrease in T-score means that you have lost approximately 10 to 15% of your bone mass density.

With the cholesterol........those decreases to lower levels are also based on many years of research and many published studies showing that the lower levels in cholesterol result is fewer CV events.

Of course the drug comapnies would like you to take their medicines.....and for some this is the only way to go. Once you have lost the bone and your turnover levels are to high, just taking calcium and vitamin D will not be enough. I almost all of the clinical studies with osteoporosis therapies the CONTROL/PLACEBO groups were ONLY on calcium and vitamin D and they continued to lose bone.

So, how can you avaiod taking these drugs? Some people can't because it is already to late for their bones and they need to take them in order to reduce their risk of having a debilatating and sometimes deadly fracture. The best things you can do is take plenty of milk and vitamin D when you throughout your life.....especially when you are young and certainly when you are in your teens, twenties, and early thirties. This will help you acheive your peak bone mass......Also, get plenty of exercise. Not only will this help your bones but it will help your cholesterol.

Good luck.....

[QUOTE=jacal5]Thanks for your response and good wishes. I have read several times that Actonel and Fosoma do not build bone. I have copied this paragraph from another poster who explains what I have read better than I could have:

"Fosamax and it's sister drugs do not build living bone. It is a poison acid in the same class as soap scum remover. It kills the osteoclasts that normally scrub away old, dead bone cells to make way for the osteoblasts to follow and fill in with new, living bone cells. So, Fosamax allows the dead bone to build up instead of being removed. That looks great on a scan, but after several years, this bone is very weak because it is layer upon layer of dead stuff."

This is why I decided to go against my doctor's advice and wait and see
if I develop osteoporosis, and if I do, maybe a better drug will be available.
It is controversial that these drugs are even effective if a person has osteopenia and does not have osteoporosis yet.

Another interesting item I read is that the bone density measurement for osteoporosis recently was pushed down to 2.5, from higher readings.
This means more people on the drugs, just like they are doing wth cholesterol measurements.

Last year my total cholesterol was 300 and my doctor gave me Lipitor. I did not take it and went to a nutritionist instead. She gave me natural supplements to reduce fats and I started to eat oat bran every morning and I cut out saturated fats and trans fats in my diet. Two weeks ago my total cholesterol was 172!

The same nutritionist gave me supplements and tips on dieting for bone health, so let's see if they work, I will keep you posted.[/QUOTE]

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