Osteoporosis. Description of the disease
Osteoporosis is a disease of the skeletal system when the bones lose density, become brittle and become more prone to fracture. It is the major cause of bone fractures in older people, particularly post-menopausal women. Women are affected by the disease 4 times more than men. The risk of osteoporosis can be reduced by adequate nutrition, especially with calcium and vitamin D, regular weight bearing exercise, and by stopping smoking and avoiding alcohol.
History and facts about the disease
The International Osteoporosis Foundation has provided the following facts about the incidence and impact of this disease.
- Osteoporosis affects an estimated 75 million people in Europe, USA and Japan.
- 30-50% of women and 15-30% of men will suffer a fracture related to osteoporosis in their lifetime.
- Nearly 75% of hip, spine and distal forearm fractures occur among patients 65 years old or over.
- A 10% loss of bone mass in the vertebrae can double the risk of vertebral fractures, and similarly, a 10% loss of bone mass in the hip can result in a 2.5 times greater risk of hip fracture.
- By 2050, the worldwide incidence of hip fracture in men is projected to increase by 310% and 240% in women.
- In white women, the lifetime risk of hip fracture is 1 in 6, compared with a 1 in 9 risk of a diagnosis of breast cancer.
- In women over 45 years of age, osteoporosis accounts for more days spent in hospital than may other diseases, including diabetes, myocardial infarction and breast cancer.
- It is estimated that the lifetime risk of experiencing an osteoporotic fracture in men over the age of 50 is 30%, similar to the lifetime risk of developing prostate cancer.
- Approximately 1.6 million hip fractures occur worldwide each year, by 2050 this number could reach between 4.5 million and 6.3 million.
- Hip fractures cause the most morbidity with reported mortality rates up to 20-24% in the first year after a hip fracture, and greater risk of dying may persist for at least 5 years afterwards. Loss of function and independence among survivors is profound, with 40% unable to walk independently, 60% requiring assistance a year later. Because of these losses, 33% are totally dependent or in a nursing home in the year following a hip fracture.
- Vertebral fractures can lead to back pain, loss of height, deformity, immobility, increased number of bed days, and even reduced pulmonary function. Their impact on quality of life can be profound as a result of loss of self-esteem, distorted body image and depression. Vertebral fractures also significantly impact on activities of daily living.
- The incidence of vertebral fractures increases with age in both sexes. Most studies indicate that the prevalence of vertebral fracture in men is similar to, or even greater than, that seen in women to age 50 or 60 years.
Pharmaceutical Drugs used to treat this disease
Drugs used to treat Osteoporosis have been found to cause more problems for the bones! So paradoxically instead of the drugs improving the condition, they can actually make it worse!
The website Physorg published an article on15 January 2008 "Popular osteoporosis drugs triple risk of bone necrosis" .The article outlined a study undertaken by the University of British Columbia, and Vancouver Coastal Health Research Institute that found the most commonly used Osteoporosis drugs almost tripled the risk of developing bone necrosis, a condition that can lead to disfigurement and incapacitating pain.
The research was described as “the largest study of bone necrosis and bisphosphonates, a class of drugs used by millions of women worldwide to help prevent bone fractures due to osteoporosis”.
It was also said to be the first study to explore the link between bone necrosis and specific brands of the drug group bisphosphonates, such as Actonel, Didrocal and Fosamax. Researchers apparently found that all three brands had similar outcomes.
The online Journal of Rheumatology published the findings, undertaken following
“a recent USA FDA alert about bisphosphonates drugs that highlighted the possibility of severe and sometimes incapacitating bone, joint and/or muscle pain in patients taking the drugs”.
This is perhaps the reason why NHS Choices is extremely coy when it outlines the treatment for Osteoporosis!
“You may not need or want to take medication to treat osteoporosis. However, you should ensure that you're maintaining sufficient levels of calcium and vitamin D. To achieve this, your healthcare team will ask you about your current diet and may recommend making changes or taking supplements”.
Bisphosphonate drugs are the most commonly used medications used to treat osteoporosis. The DIEs of this treatment have been outlined above, yet they were approved, and continue to be approved by Drug Regulators throughout the world. They are used both for the prevention and treatment of the disease. They include the following:
- Actonel (risedronate)
- Boniva (ibandronate)
- Fosamax (alendronate)
- Reclast (zoledronic acid)
Other side effects for bisphosphonates taken orally include gastrointestinal problems such as difficulty swallowing, inflammation of the esophagus, and stomach ulcers.
Side effects for bisphosphonates taken intravenously include flu-like symptoms, fever, pain in muscles or joints, and headache.
Other drugs used by the Conventional Medical Establishment to treat osteoporosis include:
- Evista (raloxifene), which belongs to a class of drugs called selective estrogen receptor modulators (SERMs).
- Miacalcin and Fortical (Calcitonin), a hormonal drug.
- Forteo (teriparatide), another hormonal treatment which has a ‘black box’ warning from the FDA as it can increase the risk of developing osteosarcoma, a rare but serious cancer.
- Estrogen/Hormone Therapy (ET/HT). This treatment is is often known as estrogen therapy. It can increase a woman’s risk of developing cancer of the uterine lining (endometrial cancer), breast cancer, blood clots and heart attacks. Other side effects include vaginal bleeding, breast tenderness, mood disturbances, blood clots in the veins, and gallbladder disease.
Pharmaceutical Drugs that may have caused this disease
So what are the causes of the enormous rise in the incidence of Osteoporis? Several factors are usually mentioned in relation to osteoporosis. For instance, it has been shown to have a large genetic component; and body weight in infancy has also been associated. Physical inactivity and a sedentary lifestyle, smoking, high alcohol intake are also frequently mentioned.
Yet all these factors have not changed fundamentally over the decades that have seen the increasing incidence of the disease, certainly not enough to explain the increase.
As usual, the evidence that pharmaceutical drugs have played a role is rarely mentioned. The International Osteoporosis Foundation provides a long list of conventional medical drugs drugs contribute to osteoporosis by causing bone loss. This is what they say, followed by the list of medicines implicated.
“Some medicines can be harmful to your bones, even if you need to take them for another condition. Bone loss is usually greater if you take the medication in high doses or for a long time.
- Aluminum-containing antacids
- Antiseizure medicines (only some) such as Dilantin® or Phenobarbital
- Aromatase inhibitors such as Arimidex®, Aromasin® and Femara®
- Cancer chemotherapeutic drugs
- Cyclosporine A and FK506 (Tacrolimus)
- Gonadotropin releasing hormone (GnRH) such as Lupron® and Zoladex®
- Medroxyprogesterone acetate for contraception (Depo-Provera®)
- Proton pump inhibitors (PPIs) such as Nexium®, Prevacid® and Prilosec®
- Selective serotonin reuptake inhibitors (SSRIs) such as Lexapro®, Prozac® and Zoloft®
- Steroids (glucocorticoids) such as cortisone and prednisone
- Tamoxifen® (premenopausal use)
- Thiazolidinediones such as Actos® and Avandia®
- Thyroid hormones in excess
Yet perhaps there are three types of Big Pharma drug are the worst culprits. The first is Proton Pump inhibiting drugs, such as Nexium, Prilosec, Prevacid, Tagamet, Zantec, Pepcid, which can reduce the absorption of calcium from the stomach. Long-term use (a year or more) of these drugs can increase the risk of hip fracture by up to 60%.
Then there is Steroid, or Corticosteroid drugs. It has been estimated that between 30-50% of patients on long-term Corticosteroid drugs will experience fractures, with a 2-fold increased risk of hip fracture in women, and 2.6-fold increase in men. Yet Steroid drugs are regularly prescribed for a variety of conditions, including rheumatoid arthritis, asthma, Crohn’s disease, lupus and allergies. They are often prescribed to relieve inflammation. They are also used along with other medicines to treat cancer and autoimmune conditions and to support organ transplants.
Yet perhaps the biggest culprit in the rise of Osteoporosis is conventional medicine’s meddling with our hormones, and in particular, the hormones of women. Large numbers of women were, until relatively recently, prescribed hormonal treatments (HRT), particularly for menopausal symptoms. Add to these numbers the huge number of women who have taken the contraceptive pill over the last 50-60 years, the it become undeniably that conventional medical drugs have played, and continue to play, a large role in the disruption of normal hormonal balances within our bodies, and thus in the rise of Osteoporosis. Perhaps it is little wonder that Osteoporosis mainly affects older women, who have suffered most of the abuse caused by these drugs.