Osteoporosis And Drug Treatments
Talk to your doctor about the use of treatments to prevent bone loss. You may need to see an endocrinologist who specializes in treatment of osteoporosis.
Talk to your doctor about the use of bio-identical hormones such as testosterone, estrogen and progesterone, especially if you have had an early menopause, or if your blood level of testosterone is very low.
The class of drugs known as Bisphosphonates is the most used type of drug and work by stopping bone turn over – in other words they stop the breakdown and building of bone. I have never felt comfortable prescribing this class of drugs because Bisphosphonates can have irreversible side effects such as necrosis (death) of the jawbone and atypical fractures which do not heal well. It is generally accepted, but not always adhered to, that Bisphosphonate drugs should only be taken for a maximum of 5 years to avoid such awful side effects. Many people cannot tolerate the prescription drugs commonly used to prevent bone fractures, or they are too nervous about side effects caused by bisphosphonate drugs (e.g. Fosamax, Actonel, etc.).
Denosumab (brand name Prolia) is a drug used to treat severe osteoporosis, however I am seeing that it is being increasingly used to treat mild to moderate osteoporosis. Prolia works by stopping the natural process of breaking down and rebuilding bones and it is very effective at halting osteoporosis.
However, side effects can be quite severe. Prolia side effects can include weakness, fatigue, back pain, muscle pain, hypocalcemia, skin irritation, tooth loss, gastrointestinal problems and increased risk of infections which can be severe. Side effects may last only a few days or up to months because this drug remains in your body for up to 6 months.
It is hard to come off Prolia because patients who stop taking it have bone loss within the first year if they do not start taking a new osteoporosis treatment. Clinical trials have demonstrated after stopping Prolia there is a rapid decrease in bone mineral density (BMD) and studies have shown people who stop taking Prolia and did not start another drug, had more fractures in their spinal vertebrae in the 10 months after treatment than people who had been taking a placebo. It is not wise to pause treatment without planning for further different bone treatment, which must be closely monitored.
Over more than 40 years of practicing medicine I have adopted the approach of using natural therapies that help the body to heal itself before adopting drugs that may be problematic.
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