There is an interesting article regarding the recent big ‘surge’ in women being diagnosed with osteoporosis based on a scan that determines ‘low bone density’ and the push for the pharmaceuticals. Here’s the gist of it:
A diagnosis of osteoporosis or osteopenia is a very frightening thing and there is little information available to help the consumer distinguish fact from hype before embarking on long-term drug regimes. Most of us are unaware that until it was re-defined as a measure of low bone mineral density (BMD) in 1994, osteoporosis was considered an uncommon disease of fragile bones afflicting mainly the very elderly. Everyone naturally loses bone density as they age, but the new definition does not account for that. The standard reference norm on the bone density machines is that of a young woman, making it almost impossible for an older person to have a normal diagnosis. The test categorises the disease from a single risk factor, yet it reveals nothing about the strength, micro-architecture, rate of remodelling, size or shape of bone-all factors that contribute to bone fragility.
Although extensive reviews of the evidence by independent academic organizations in Canada, the US, Sweden, Australia and the UK conclude that BMD testing does not accurately identify those people who will go on to fracture their bones, the new definition of osteoporosis as a widespread disease remains.
In reality, the vast majority of the population never break their bones. Remarkably, an examination of the effectiveness of BMD screening by the University of Leeds found that people with higher bone density go on to have 63% of all fractures! All bones are designed to break when struck in a particular way. Low or high bone density makes so little difference that it is simply not worth measuring.
Most people under the age of 80 remain unaware that they have low bone density because it has no symptoms. Some 12% of women aged 50-79 do experience spinal compression (vertebral fractures) but the majority are unaware of the fact. A small percentage do have symptoms, from which most make a full recovery. In the reassuring words of Californian osteoporosis expert Dr. Bruce Ettinger: "the osteoporosis that causes pain and disability is a very rare disease."
Debilitating hip fractures in the elderly are most likely to occur not as a result of low bone density, but because of dangerous home environments, immobility, dementia, medication such as corticosteroids, poly-pharmacy (effects of taking multiple medications), low levels of vitamin D, and existing conditions, such as hyperthyroidism, Crohn’s disease and celiac disease. In other words, the older a person is, or the more unwell they are, the greater the risk of falling and breaking a hip.
Television ads, magazine articles, and fact sheets in doctors’ waiting rooms greatly exaggerate the impact that osteoporosis can have on our lives. Even experts agree. Dr. Mark Helfand is a member of the US National Institutes of Health osteoporosis consensus panel. In his opinion, "I think even people who agree that osteoporosis is a serious health problem can still say it is being hyped. Most of what you could do to prevent osteoporosis later in life has nothing to with getting a test or taking a drug.
To me, all of this sounds like a note of common sense in the middle of the big scare that’s out there these days regarding osteoporosis that is based on these bone scans. It’s a very sad state of affairs when you can’t trust medical care anymore because big pharma controls so much of it. I think we all need to look out for ourselves here. Don’t be pushed into dangerous drugs.
I told my doctor that if I start breaking bones in the true sense of a ‘fragility fracture’, then we ‘ll talk again. Until then, I’m upping my calcium through diet, I will make and drink stinging nettle infusions that are very rich in calcium, and all the needed bone building vitamins and minerals ( plant based calcium being better absorbed than that in rock based supplements), and work on upping my exercise, for strength and to build bone, and continue with yoga for flexibility.
Written by
MiaLee
To view profiles and participate in discussions please or .
I do wonder about my age and Osteoporosis I have and that is very hard to try drugs for it do to my not breading side effect with Rx drugs and is it going effect my kidneys since I have kidney disease. When it comes to my bones I rely on home remedies.
I’m sure there is a lot of truth in the article, especially if you live in the US where scans are more available, because you are paying for them.
My experience living in the UK, is more a case of you don’t get a DEXA scan until you have already suffered fragility fractures. Therefore the fear of further OP consequences is more realistic.
I had a family history of OP and fell backwards indoors onto a carpeted floor, from a standing position and damaged my coccyx. I was refused both a X-ray and DEXA scan, until I then went on and broke both wrists at the same time.
Had I been diagnosed and had OP treatment after the first fall, it may have prevented further breaks a few yrs later. I will never know!
Indeed it's appaling how in the UK they wait till something drastic happens! It's a disgrace and inhuman! They have no conception of prevention! They utter the words from time to time but NO action. I think patients are not confident enough to speak their mind and request a decent treatment before any worse damage occurs. That should change.
Thanks so much for this post. The article cited was published in 2005. Has more been published along this line since? Do we have studies looking at differences in fracture rates between women who do or do not get DEXA screens or use drugs intended to address osteoporosis?
Yes, once you start looking, there is quite a bit out there regarding the scans and the rush to prescribe the drugs. Google it and take a look. There was another one I came across that talked about Merek ( I believe that’s the name of the’ bone drug ‘ pharmaceutical company, also being the developer of the scans. ) once I started looking, I had that familiar feeling of how sad it is that we can’t trust our medical care anymore because it’s driven by interest in profit, rather than health CARE.
There was also a recent article that talks about the most recent ‘push’ to diagnose ANY woman who breaks a hip as osteoporotic EVEN IF HER BONE SCANS ARE NORMAL. In the article they say these women are being “ denied treatment”. Translation; if they can classify her as osteoporatic than they can prescribe her the drugs ( and gain a lot more customers for life). Yes indeed. What does this tell us? They have a very vested interest in classifying as many women as possible as having osteoporosis. Sorry; I just don’t trust Big Pharma. Sadly.
I don’t know if I’m allowed to cut and paste an entire article here but here goes ( 2016):
Objective news story or “giant platform for propaganda”? The Times pushes pharma viewpoint with one-sided coverage of osteoporosis drugs
POSTED BYCATEGORIESBusiness of health, Conflicts of interest, Drug industry, Story sources/independent perspectivesTAGSNew York Times, osteoporosis, overdiagnosis
Alan Cassels is a drug policy researcher at the University of Victoria and a regular contributor to the blog. He is also the author, most recently, of The Cochrane Collaboration: Medicine’s Best-Kept Secret. He tweets as @AKEcassels.
Orthopaedic surgeon consulting pelvic x-rays for a hip replacement.A June 1st story in the New York Times, “Fearing Drugs’ Rare Side Effects, Millions Take Their Chances With Osteoporosis,” raises some provocative questions:
To what extent are patients’ perceptions of drug side effects preventing them from taking medications that might help?
And, further, are some journalists being used by those who sell medications to shape the public image of certain products?
Risks to patients or profit?
The catalyst for this front page story is the apparent decline in the use of bisphosphonate drugs, standard treatments used to prevent osteoporotic fractures, and the concern that patients are being misled about the safety of these drugs. Research shows that rates of bisphosphonate use, post-hip fracture, have “declined significantly from 40.2% in 2002, to 20.5% in 2011.” Such decline would obviously be a concern for two reasons: First, there may be dangers to patients who may be eschewing helpful, important treatments. Secondly, there may be dangers to the profit centers of major drug companies who make bisphosphonates and who are clearly concerned about the public image of these products in the minds of patients and prescribers.
You might wonder which concern gets the most media play.
The quality of the reporting of osteoporosis is a serious issue, given that it remains a controversial classification which some say is a classic example of selling sickness. In this case, selling the ‘risk’ of ‘low’ bone density as a bona fide disease in and of itself, as discussed in the BMJ, has no doubt added to the controversy. Since Fosamax, the first major bisphosphonate to hit the market, arrived just over 20 years ago, it is a good time to consider how well both the drug and the disease is being discussed in mainstream news reporting.
For starters, the safety of the bisphosphonates has always been a concern, even from the earliest days. Fosamax was linked to over 6,000 adverse event reports made to the FDA in 1996, the first full year it was on the market. It had the distinction of being associated with the most reported adverse events that year. The danger most reported was esophageal injury and what followed was stricter recommendations on how to safely take the drug. A number of me-too bisphosphonates arrived over the next few years and the warnings began to pile up. In 2011, two FDA advisory panels recommended stronger warnings on the drugs. At the time, the New York Times said the advice was “prompted by concerns over a relatively small number of long-term users who had suffered unusual thigh fractures or a serious jaw disease.” There was also the concern of longer-term use as FDA staffers said the benefits of the drugs have only been demonstrated for three to five years. There was a lot of news media coverage of the dangers of bones spontaneously breaking, osteonecrosis of the jaw and even kidney failure, yet the degree to which those stories would change patients’ behavior was unknown. Certainly it would be of interest to those who make the drugs and see their markets shrinking, as well as to the organizations and patient groups funded by the manufacturers of bisphosphonates.
Who’s putting out the ‘urgent calls’? ‘Clearly a pattern here’
Among those asking if this most recent New York Times article is an attempt to put some makeup on the declining image of bisphosphonates is Robert J. Davis, PhD– a veteran health journalist and author of The Healthy Skeptic–who’s based in Atlanta, Georgia. He said: “The groups that are pharma funded are the ones putting out ‘urgent calls’ around the safety issue. There is clearly a pattern here, a concerted effort to get the word out.” The groups he’s referring to include the American Society for Bone and Mineral Research, the National Osteoporosis Foundation and the National Bone Health Alliance, all of which receive funding from companies making osteoporosis drugs.
He particularly noted how the story seemed to downplay all the serious safety issues, “barely digging into the FDA warnings. There was no discussion of that.” In his opinion this was a “missed opportunity to talk about the legitimacy of of people’s concerns about the drugs.”
Professor Teppo Järvinen at the University of Helsinki and an expert in the research around osteoporosis echoes those comments. He said that “there are many things about the disease which are absolutely controversial: the drugs are targeting people to prevent hip fractures and while the studies might show some benefit, real-world studies can’t demonstrate any effectiveness of the drugs in preventing hip fractures.” He adds, “they don’t work in men or women over 80 and they can cause pretty serious adverse effects.” (Publisher’s note: you can hear much more from Dr. Järvinen in a podcast discussion we had with him in 2015.)
Trials show that magnitude of benefit is small
A review of all randomized controlled trials of bisphosphonates here found “no statistically significant reduction in hip or wrist fracture for women who have no prior fracture or vertebral compression at baseline. This represents the majority of women presently treated with bisphosphonates, most of whom are presumably being identified by bone mineral density measurements.” And for those women with previous fractures, “the incidence of hip and wrist fracture was decreased by bisphosphonates, however, the absolute magnitude of benefit is small, 1% for hip and 1.3% for wrist, and it is based on a potentially biased subset of randomized patients,” the review found.
Dr. Järvinen told me that there are major errors in even conceiving of osteoporosis as an important risk factor for fractures. “Blaming fractures on ‘bone weakening’, pumping the benefits of the drugs which are non-existent in many patients and downplaying the terrible adverse effects of those drugs” which he says aren’t as rare as many doctors are led to believe does a disservice to the Times’ readers.
It is clear that the very use of bone density as a predictor of fractures is controversial. As this BMJ commentary by Jarvinen and colleagues suggests, it may well be the patient’s age, not their bone density, which is the most relevant predictor of fractures. They note that the “Incidence of hip fracture in women rises 44-fold from the age of 55 to 85, and the effect of ageing is 11-fold greater than that of reduced bone mineral density.”
Sources’ drug company ties not disclosed
One thing that is most curious here is that much of the research and commentary in The Times story comes from osteoporosis experts who have who ties to drug companies. For example, the medical journal articles cited as news hooks by the Times — the ones “documenting” and “bemoaning” the abandonment of osteoporosis drugs by patients — are co-written by employees of drug companies and those with significant financial ties to drug companies. But those relationships are not mentioned by the Times. And Dr. Paul Miller, who laments the “fear factor” that keeps patients away from osteoporosis drugs, consults for companies that make osteoporosis drugs like Amgen, Lilly, and Merck. But again, Miller’s ties to those companies are not disclosed. Only when the Times quotes experts without current ties to drug companies (though many of these experts do appear to have past ties) does it alert readers that these sources “have no association with the makers of the drugs.”
Do the conflicts of interest matter? They do to Robert Davis. He tells me, “the story basically parrots the pharma industry line (which it is pushing through groups and the doctors it funds) that patients who worry about the drugs’ side effects are being irrational and that by not taking the drugs they ‘take their chances.’”
Perhaps the conflicts result in what Robert Davis thinks are the story’s key limitations: “The story fails to address some key issues such as the limitations of bone density testing; what “high risk” of fracture—the criterion for using the drugs—means exactly; the unknown risks of putting people on these powerful drugs for decades; and the seriousness of an FDA warning, which the drugs carry.”
We should acknowledge that the story did provide a graphic description of what it’s like to experience atypical fractures — from a patient who called the drugs “that wretched, dreadful stuff.” Perhaps coming 1,000 words into a 1,200 word story this comment is arguably too little, too late.
Reporters need to cover these kinds of stories, but they certainly need to do so with a heightened level of skepticism, and talk to more experts who aren’t tied to the drug industry view of treating osteoporosis. In that light, Robert Davis wondered to me, “Are the makers of the drugs trying to reverse declining sales by waging an informational campaign to stop docs and patients from questioning the drugs’ safety?” He adds: “Unfortunately, instead of reporting this angle, the article simply handed industry a giant platform for its propaganda.”
Note: Alan Cassels has written four books, including Selling Sickness with Ray Moynihan, the author of BMJ commentary mentioned in this post. Each of Cassel’s books have covered various aspects of the controversies around osteoporosis, its diagnosis and treatment.
The history behind Osteopenia and bone mineral loss is all based on a marketing plan concocted by Merck. They created the boards who arbitrarily came up with the levels of mineral density. Those have never been causal in actual fractures! These links expose the history of yet another fake disease:
A senior medical consultant at the University of British Columbia’s Centre for Health Services and Policy Research, Dr. Bassett’s research focuses on the systematic review of drug therapy and drug funding policy.
His paper called On Trying to Stop the Measurement of Bone Density to Sell Drugs (ISBN 0-88865-240-2) was presented at the 12th Annual Health Policy Conference held in Vancouver, B.C. in November 1999.
Interesting! I think this is important to keep in mind before rushing out to get medication. May I ask what kind of bone building vitamins and minerals you take?
I buy Stinging nettle herbs in bulk from Mountain Rose Herbs online and make infusions ( as Susun Weed recommends). If you don’t want to go to the trouble of making your own then take a look at ‘AlgaeCal ‘ ( you can buy from them online. ) They produce a supplement that has plant based calcium ( which is better absorbed than rock based calcium which is in the usual supplements. AlgaeCal was also the subject of 2 studies in which bone mineral was increased significantly within a year ( they have done their own research too, but I found two studies that were not initiated or produced by them). Their results are very promising and are very encouraging for anyone not happy with the pharmaceutical route. Certainly worth a look before going down that road anyway.
I have been looking into AlgaeCal but as I live in UK it works out very expensive. I have come across another product called VitaminCode Grow Bone which looks very similar and is available here. I have been in contact with AlgaeCal by email and was quite impressed with them but cost are an issue and import duties etc. Have you heard of VitaminCode Grow Bone. I realise you have to be so careful buying on the net.
Couldn't agree with you more, MiaLee!! I, too, refuse to take these horrible bone meds...the side effects can be debilitating and absolutely ridiculous! Thanks!
I quite agree. It seems extrodinary that my own grandmother lost height but I don't recall her complaining about pain...just high blood pressure and she was a thin woman and puffed cigarettes...not inhaled and lived until she was 82 and born 1900.
I got my two fractures L1 and L2 after I stopped taking Prolia injections on my dentist's advice as he wanted to remove an L4 tooth that had two abcesses. My bones regressed and compression vertical fractures diagnosed and I got stiff and very sore. The Pharma firms are making billions on our backs and fracturing our backs when we withdraw from the drugs. I have been put on Forsteo which is parthyroid hormone ...synthetic type.
Many thanks for posting this extract, it’s certainly thought provoking.
Like you, I’ve turned down conventional medicine and I’m working on ensuring I have a supportive diet. You may be interested to know that taking CBD can help build stronger bones (I’m taking it for pain).
Project CBD and Green aMed Info lists the relevant research articles, but this one has diagrams that show the role of cannaboloids in building bone. ncbi.nlm.nih.gov/pubmed/213...
I’m also taking turmeric capsules that have been shown to increase bone density by 7%. Turmeric has around 800 beneficial effects, so I thought it was worth taking!
Very interesting about the CBD! I will definitely look into this. I live in Canada and recently bought seeds for a CBD strain of marijuana to grow in my garden this coming summer.
Yes. I did grow some cannabis this past summer. I was growing it in view of a safe herb to use for anxiety and sleeplessness. I jumped the gun a tad, knowing it was a couple of months ahead of legalization, but I didn’t want to miss the time frame for starting the seeds inside. It was easy; like growing tomatoes. I bought books on when and how to cut and trim and dry, and cure it. Again not hard at all. We are allowed 4 plants per household; I grew 3, and that was tons; actually way too much. They were huge plants. So I also learned to make edibles, ( infusing the cannabis into butter for baking) not wanting to have to ‘smoke’ anything. Easy too. I bought a nice mild strain of cannabis seed, with very little ‘high’ effect, but just a very pleasant relaxing effect. It’s lovely for nights when I have some insomnia, or are stressed and have trouble relaxing. Way better than sleeping pills. No sleeping pill morning ‘hangover’ either. (Thank goodness the world is recovering from that silly demonization of a harmless herb, and realizing it can help people in a much safer way than so many of those damm drugs they hand out so freely’.)
It is indeed a harmless herb, because there are hardly any cannabinoid receptors in our brain stem. This is primitive part that controls breathing, heart rate and blood pressure. This means nobody has died from it, sadly, the same can’t be said about opioids.
Thank you for that article on CBD! Fascinating! I think now that all that silliness about marijuana is over with, safe medical applications will be developed with it. Here where I live in Ontario, the university has been given a mandate regarding research on applications for medical marijuana. It’s going to be interesting all right. No doubt Big Pharma is going to try to take control though and own it ( which is why I am happy that here we can grow our own legally in the garden).
More research will be terrific, as it’s much needed, then perhaps the government and the medical profession will be convinced. You’re sadly right about Big Pharma though. Have you seen the Sacred Plant series? John Malanca has presented 2 series now. I don’t remember anything about osteoporosis, maybe they will cover it next year.
Good luck with your plants, I can honestly say that CBD has changed my life . x
I broke an ankle in 3 places ten years ago, from falling from a standing height after slipping on black ice. After being handed a prescription for drugs with a dexa score of -2.5 in the spine, I googled information on them. At that time the only available info was from America. With much trepidation I refused the drugs. Now 63 I have had no further breaks despite a few falls. I am very active; dancing, hill walking, Pilates, swimming, gardening, some weight training and house work. I’ve recently bought a weighted vest and only now watch my diet and take supplements. It took me years to realise my ankle break was not a fragility break. Like you I’ve long ago decided I’ll take drugs when I do have fragility breaks. Horray for common sense! By the way have any of you read about the great improvements in bone density after a trial carried out with high intensity weight training. There is information about it in Dr Susan Brown’s blog on her website “Better Bones”
Just common sense would tell a doctor that ANYONE would break a bone given that scenario! I think normal breaks are becoming a reason to push a scan, a diagnosis, and then the drugs.
I deliberately never asked for a repeat dexa scan in the last ten years bar last year as I was doing weight training with a personal trainer and I thought we would both like to see if there were any improvements. The lady doctor, in her early 50', warned me that if the scan showed up a low bone density score she would be obliged to offer me bisophonates. I decided against it. I described my exercise regime or rather my way of living as I love all my activities with maybe the exception of the weight training! I did a charity "Strictly" last year! The doctor told me I was on the right path. I've been so lucky as 3 lady doctors in our practice, over the years, have backed me. Although I have to say it was not without a lot of soul searching as there was barely any support years ago.
I think we need to put the word out there. This corporate takeover of government and all things, is insidious. So odd that we can’teven trust our health providers because of lobbying by Big Pharma, and all those heartless tactics to increase their profits at the expense of our very lives. I think we all should have learned better from our encounters with the cigarette industries. Look at the lying just for profit. What has our world become? Surely things should be better than this. What a shameful outcome. Look at us all scrambling to try to protect ourselves from such rampant greed for profit that we are all so wounded, so heartlessly.
What kind of dangerous drugs are you talking about? The only thing I understood is Merak, but is Mirek so dangerous? Now there are enough studies of AlgaeCal, so this is a personal choice for each person. Doctors should tell patients about what they are prescribing. In my case, I was very often haunted by pain in my bones. This was a temporary problem and the doctor said that it was just necessary to be patient for about a month. This was standard practice. I used nuken strain online-weed.net/product/nuk... just to relieve the pain, because there were nights when I just couldn't sleep from the pain and medical marijuana was the only thing that helped me fall asleep at night.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Has anyone had sacral ala (pelvic) insufficiency fracture while on Prolia and/or a bisphosphonate? 
Anyone else have a -4.5 T-score?
Scared of meds trying natural but have fractures
In the spirit of sharing
Need Advice on Prolia vs Natural Osteoporosis Treatments
