What is Bisphosphonate Medication?
Bisphosphonate medication is a class of prescription medications that prevents the loss of bone mass over time by preventing the action of a certain type of cell called osteoclasts. Medical doctors use bisphosphonates to reduce the risk of fracture in patients with bone diseases that weaken bone structure, such as osteoporosis and the bone metastases of cancer.
What Are The Fundamentals About Bone Health?
Interestingly, although we view our bones as the stable foundational structure of our body that stops growing when we do, it is actually still a living tissue. Bone tissue constantly renews itself to maintain structural strength. Osteoclasts remove old bone, while osteoblasts create new bone. These two processes are in delicate balance and should occur at approximately equal rates to ensure that we keep our full bone mass and density over time. Osteoporosis is a loss of bone density that can be caused by too much bone being broken down without enough being built in its place.
Osteoclasts
Bones contain and store many important nutrients and minerals that our body requires to maintain health and proper functioning. Osteoclasts help us access these nutrients by breaking down damaged and fractured bone. They’re destructive cells that are actually good for us. So good for us, in fact, that they are necessary for our survival. Bone breakdown releases minerals and nutrients into the bloodstream. Osteoblasts then repair and build new bone, improving bone density.
What is Apoptosis?
Bisphosphonates reduce osteoclast activity and trigger apoptosis, or programmed cell death. This can help patients with excessive bone breakdown. However, these medications may slow normal bone turnover. Reduced turnover limits the body's ability to repair daily micro fractures. This condition is known as adynamic bone disease. Over time, damaged bone can accumulate and increase fracture risk. Osteoporosis becomes concerning because it raises the liklihood of bone fractures. In some cases, bisphosphonates may contribute to the condition they aim to prevent. Osteoclast overactivity rarely causes bone loss. Low osteoblast activity more commonly reduces bone formation. Insufficient protein, calcium, vitamin D, or weight-bearing exercise can limit new bone growth.
Length of Bisphosphonate Medication Treatment
Although initially it would seem to be OK to use bisphosphonates in the short term, just to help people with acute problems like bone metastasis, it turns out these drugs hang around in our bodies. Research on pharmacokinetics has shown that bisphosphonates can remain in the bone for many years. Long-term bisphosphonate use may increase the risk of adynamic bone disease and bone necrosis. Use bisphosphonates for the shortest time necessary. Treatment beyond five years may provide fewer benefits and greater risks.
Side Effects of Bisphosphonate Medication
Oral bisphosphonates can cause a number of different side effects. The most common are: abdominal pain, bone pain, nausea, constipation, diarrhea, acid reflux, and headache. Another important side effect is atrial fibrillation, a disordered fluttering of the upper chambers of the heart. More recent research has found that women taking bisphosphonates have a higher incidence of fractures of the large leg bone called the femur. This is likely due to the lack of remodeling, as described above. More recent research has also found that prolonged bisphosphonate use is associated with a higher risk of esophageal cancer.
Safety Notes
Although bisphosphonates were originally seen as a revolutionary new way to treat osteoporosis, it is becoming clear that for the average person, the risks outweigh the benefits. This is particularly true for treatment proceeding for longer than 5 years. If you are currently using one of these medications or are considering going on one, you may want to discuss other options with your doctor. For less severe cases, it may be preferable to try some natural methods to increase your bone density first. One of the best things you can do is increase the amount of weight-bearing exercise that you do every day, such as walking, running, jumping, and lifting weights. Eating enough protein and getting enough of the bone-building minerals will also help you to improve your bone health. There are a number of different influences on bone density, which gives us a lot of different ways to approach treatment. Don't be afraid to speak with your healthcare practitioner about your other options, whether they be pharmaceutical or natural alternatives.
