Bisphosphonates for bone health: Therapy or fracture risk?

Are you at risk for bone fractures? If you’re a woman, you most likely are.

Breaking any bone is painful and frightening. However, more than 53 million Americans age 50 and older are at risk for osteoporosis due to low bone density. Women are especially vulnerable to hip fractures, especially after menopause, and men, too, in older age.

You see the commercials about bisphosphonates that are supposed to reduce the risk, but is the drug safe and effective?

The goal of oral bisphosphonate medications is to slow down the rate of bone thinning resulting in stronger bones that are less likely to break. But then again, it comes with an increased risk of causing atypical femur fractures. Talk about scary. Imagine getting a bone fracture with little force or trauma after taking the drug for an average of three years. 

That’s why researchers are trying to determine how helpful or effective they actually are, especially for women using them long-term.

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Bisphosphonate therapy: How effective for how long?

A recent Kaiser Permanente study concluded women taking oral bisphosphonates beyond seven years gained no additional benefit against hip fractures.

The research was conducted in a retrospective cohort study of nearly 30,000 women who completed five years of oral bisphosphonate treatment versus women who continued treatment for two additional years.

Here’s what they found. The 5-year cumulative hip fracture incidence was as follows:

• Discontinued use after initial 5 years: 23.0 hip fractures per 1,000 individuals
• Took a 6-month break from medication, plus 2 additional years back on: 20.8 per 1,000 individuals
• Continued for 5 additional years: 26.8 per 1,000 individuals

The group with the slightly lower ratio of hip fractures appeared to be the patients who took a break from the medication before starting it back up for an additional two years.

Additionally, after the initial five years of treatment, 37 percent of the women were diagnosed with osteoporosis. In following up with those women five years after treatment, 507 had experienced hip fractures.

A Task Force of the American Society for Bone and Mineral Research recommended in 2015 that low-risk patients should consider a bisphosphonate “drug holiday” after five continual years of treatment. But on the other hand, women at high risk for fractures should continue with ongoing treatment.

But the researchers involved in this Kaiser Permanente study pointed out that benefits beyond five years of continued treatment remain largely a mystery.

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Natural ways to boost bone health

If you currently take these medications talk to your doctor about concerns. It can certainly be confusing to decipher the data from these studies. But what’s obvious is that researchers aren’t sure if any benefits go away and possibly contribute to fracture, depending on length of treatment with these drugs.

Fortunately, there are several natural ways to boost bone health, so let’s start there…

Regular exercise is critical for flexibility and healthy bones and doesn’t require a fancy gym club membership.

That’s because walking, jogging, hiking, dancing and even climbing stairs are weight-bearing exercises — and this kind of exercise has been shown to slow bone loss. Some studies have shown this kind of exercise can also build bone by stimulating extra deposits of calcium and nudge bone-forming cells, according to Harvard Health.

The right nutrition can help you increase bone density, support structural health and maintain your bone health as you age.

Here are foods and natural supplements that help build healthy bones…

• Eat plenty of green and yellow vegetables, one of the best vitamin C sources, to stimulate bone-forming cell production.
• Consume calcium through food sources, unless directed by a physician to supplement it. Here’s why it matters.
• Add blueberries to your diet to support skeletal health. According to my colleague, Dr. Issac Eliaz, research has found phenolic acids derived from polyphenols in blueberries have bone-building effects.
• Drinking green tea has been shown to prevent age-related bone loss in older adults, decreasing their risk of osteoporotic fractures.
• Vitamin D and Vitamin K2 help your body absorb calcium and phosphorus, critical minerals for bone health. Vitamin K2 is especially helpful at helping channel calcium to places in the body where it’s needed, like the bones, so less calcium is in the bloodstream where it can contribute to calcium buildup in arteries. You can read more about K2 here.

Sources:

Long- Term Oral Bisphosphonates Get Little Love in Study — MedPagetoday

Hip Fractures Among Older Adults — CDC.gov