During the last few months a couple of news stories have caused me some major concern. I’ve always been one to avoid pharmaceuticals whenever at all possible, and every time that I’ve caved into a doctor’s insistence, I’ve regretted it and I haven’t been long getting off the prescription.

I’ll talk about the first one today.

I’m not sure that I was even yet fifty when my GP sent me for a bone mineral density test, the only reasons being that I was approaching “that age”, early menopausal and small boned. I’d never broken a bone in my life. I was very skeptical, and was even more so when the results came back that I had osteopenia! (osteopenia is a condition in which bone mass is lower than “normal”, but not low enough to qualify as osteoporosis) When I asked my doctor how that could be, since I’d spent the last twenty-five years of my life doing all the things recommended to avoid such a thing, her response was, “Well if you hadn’t done those things I guess it would have been worse!” I agreed to take calcium and Vitamin D supplements, and started a daily walking routine. I refused to take the pushed “hormone replacement therapy” and was happy when it was temporary taken off the market. However five years later,  the Nurse Practitioner  at my new doctor’s office told me the results of my latest bone density test (I’d been having them yearly since the first one) had not improved since I was moved into the osteoporosis category after my second test several years earlier. I gave in to taking the newest “natural” supplement and my bone density increased to the osteopenia category. I still felt something wasn’t right, but I was without evidence to protest. Then, a couple of months ago, while sitting in a waiting room, I came across an article in Vogue Magazine that made me sit up and take notice.

The story, written by Patricia Morrisroe, initially sounded like my story. She too had been urged to have a bone mineral density test when she reached age fifty, and had been diagnosed with osteopenia.  She too accepted, reluctantly, a prescription for a bone building medication.  She later stopped taking the drug due to resulting other health issues.  Her subsequent research gave me reason to give up on my weekly dose of such a drug.  After reading the article, even my partner, normally a firm believer in following any doctor’s suggestions without much question,  had no arguments for me.

I’ll leave it to you to go to the link where I found it and read the full article.  Here are  the five main points that determined my decision:

1.  Osteopenia is no longer viewed as a problem that automatically warrants medication, except in rare cases. People with osteopenic bones have such a low fracture rate that it doesn’t make sense to put them on a drug to prevent something that may not happen for several decades, if at all.(1)

The definition of Osteoporosis has evolved over the years and was once diagnosed only after someone had sustained a fragility fracture. In 1994, after the World Health Organization convened a meeting of experts, osteoporosis was defined by bone mineral density, the one measure of bone health available.  ‘Normal’ bones were those of a 30-year-old woman(2), and anyone who deviated 2.5 or more below that standard had osteoporosis, anyone in between had osteopenia.

2.  Doctors are now questioning the  long-term safety of the current drugs, and how often a woman should take the test, and if it is even valuable.

3. New data from the U.S. Preventive Services Task Force, an independent panel that develops recommendations for disease prevention, indicated no solid evidence that testing a patient’s bone density helped her avoid fracture…density is only one part of the picture; bone quality is determined by othe components, such as the micro-architecture of the bone and its capacity for self-repair.(3)

4. As a small-boned person you may have lower readings on the machines, but you may have perfectly good bone, just less of it.

5. While most doctors believe in treating osteoporosis with medication, giving them without accurate diagnosis (i.e. legitimate risk factors) can be dangerous. The drugs can  have significant side effects, most commonly gastrointestinal problems.  The U.S.  FDA recently ordered the makers of the most commonly prescribe osteoporosis drugs, to carry a warning label, following reports of atypical thigh fractures. The accumulation  of these drugs being deposited in the bones for years, could ultimately lead to bones that are more brittle. There appears to be no such warning in Canada yet.

6. Not enough is known about the effects of these drugs, because there have been no long-term studies done.

Pretty scary stuff! I think I’ll go for a walk in the sun. I need a break before telling you about my other discovery.

(1) (2) (3)Morrisroe, Patricia. “Breaking Point.(osteopenia and osteoporosis).” Vogue. 2011. Retrieved January 28, 2012 from accessmylibrary: http://www.accessmylibrary.com/article-1G1-249226931/breaking-point-osteopenia-and.html