Fosamax for Your Bones: A Cautionary Tale

November 14, 2016 2 Comments

Fosamax for Your Bones: A Cautionary Tale

On November 30, 2016, I interviewed Sandi Putnam via live webinar. Many years ago, Sandi was a very dutiful patient and followed her doctor’s orders, without question. She trusted her doctor and knew he had her best interests at heart. So, when her doctor told her that she had low bone density—“osteopenia” not osteoporosis—and that she needed to take Fosamax, she took the medication.

The result was a nightmare beyond imagining: Sandi had never broken a bone in her life, but after 7+ years of taking Fosamax, she suffered a fractured sacrum, vertebra and multiple pelvic fractures, not due to any traumatic stress, but simply from the weight of her own body. The excruciating pain incapacitated her for over a year, exacerbated by the failure of her health team to properly identify what was happening to her, despite outright evidence on x-rays and MRIs. The lesson here: long-term use of Fosamax (a bisphosphonate) can result in fragile bones that can fracture easily in a small percentage of people.

Her story is one that we can all learn from. Any time a medication is prescribed as a result of a test, that conclusion should be questioned. It doesn't mean that medications are always inappropriate; sometimes they can be lifesaving. In Sandi's case, however, it was not medically indicated. She was not in imminent danger of sustaining a fracture at the time of her osteopenia diagnosis. Her bones were probably pretty healthy. The video interview about her case is something everyone should see. I wish I could say this type of case is rare. Sadly, I see it frequently among my clients: people who come to me seeking another opinion, or because they, too have sustained these types of non-traumatic fractures.

NOTE: The diagnosis of osteopenia was never meant to be an actual diagnosis, and for some it can mean that their bone density is normal for them. Osteopenia simply means low bone density. It does not necessarily mean that any bone loss occurring. The bone density of women past menopause and men over the age of 50 are typically measured against that of an average 30 year old. If you have a small skeletal frame and small bones, this can result in a false-positive “diagnosis” of osteopenia, or even osteoporosis.

Another important note is that there are many people who have normal bone density or osteopenia who break bones easily (low-trauma fractures). When this happens we know that something else—other than bone density—is at play, and that is bone quality. This is why two people can have the same bone density, but one breaks bones easily, while the other has never broken a bone. Poor quality bone can be the result of poor nutrition, years of smoking or alcohol abuse, gastrointestinal disorders that result in malabsorption and, as mentioned above, prolonged use of some osteoporosis medications.


2 Responses

Lisa brott
Lisa brott

September 18, 2018

Help please, I was diagnosed with osteoporosis in 2016 from a dexa scan. A specialist I saw afterward did a urine 24 hour analysis and blood test which ruled out any other abnormalities or causes. I didn’t want to take drugs yet. I was 60 and oistmenopausal for 8 years and am small framed 5’5” and 112 pounds. I have lived my adult life with moderate exercise including aerobics, yoga and some strength training. Strength training only 1/2 times a week. Now I know o should have done all 3 types of exercise 3 towns a week and eaten more protein, more Vit D and more magnesium and weighed about 8 lbs more. I have also had a lot of stress since I was 50 including a 13 day hospital stay fighting for my life with a deadly strain of E. coli, sister choked to death, daughter moved to another continent forever and this year my mom was suddenly killed in a horrific car accident. And my company closed. I retested the dexa this summer 2 years after the first test and same great machine and am 5.4 % worse so doctor wants me on fosamax. I am afraid of gastrointestinal side affects and risks to femur, etc. the other choice he suggests is evista. Scares me for risk of blood clot or stroke. What to take. T scores are 2.77 and 3.1. I never smoked, don’t deink hardly at all and very little caffeine. Eat complex carbs and all the rest 90% great except for some sweets which I have reduced. What to take for this half bone loss and hopefully build some bone mass. I also take levothyroxine for hypothyroid and trazadone for bedtime. Also just started dhea 10 mg because my levels were very low in a saliva test. I have anxiety disorder and adrenals have been taxed. Starting at menopiaise I use bioidentical estradiol and progesterone cremes too so I was shocked and am depressed about getting osteoporosis. What to take? Thanks. Lisa Brott.

Marsha Wright
Marsha Wright

September 02, 2018

I have your book on Bone Health Guide. I have been “fighting” osteopenia and now osteoporosis for years. I have done aerobics for 46 years…weight lifting for 25 years and some yoga. Went to Endocrinologist with -2.6 & -2.8 in hip/spine respectively. He wants to put me on Prolia. He took a blood test showing I am losing bone (do not know the name but my score was at 800 and normal score is 400.) I will be having 24hr. urine/calcium test in few weeks. I eat super well, never broken a bone nor have any family members, etc. Am 5’6" and weight about 118 lbs., small bones like you Dr. Simpson. Don’t know who to go to from here? I live in Jacksonville, FL area. Do you have any specialists in this area you know of?

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