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There has
been reports of women developing liver damage two months after
starting Alendronate, the popular bone-resorption inhibitor, used
in the prevention and treatment of osteoporosis.
Some of the known side effects of Alendronate are gastric and
oesophageal inflammation, but renal failure, ocular damage, skin
reactions, and hypocalcemia have also been reported.
A case of
hepatitis that developed after treatment with Alendronate was
recently reported in a 77-year-old woman.
The authors admit that the mechanism by which alendronate may
cause liver damage is not known, although one possibility is that
the Alendronate inhibits the synthesis of cholesterol in the liver,
which may alter liver function.
Bone building
is a fine balance of a number of factors.
Fosamax is very similar to oestrogen's mode of action.
Oestrogen inhibits osteoclasts, while Alendronate actually kills
them.
Osteoclast cells in the bone remove the bone so it can be rebuilt.
If these cells are damaged, the bone gets much denser.
So, the idea believed is that by making the bone more dense, it
then will be stronger.
But, there are theories that this is actually false!
Even though the bones are denser, they may be weaker because they
have not been allowed to remould themselves, and readjust to the
constantly changing forces that are applied to bones.
This may actually increase the risk of fracture over time.
Natural progesterone
is normally required to stimulate the osteoblasts or the bone
rebuilding cells.
The synthetic version, such as Medhydroxyprogesterone, does not
provide this benefit.
Natural progesterone can be given in the form of a cream, troche,
or a capsule.
To make it in the form of a troche, progesterone USP (micronised)
can not be used because it will not dissolve easily enough and
reacts with the base used to make it into a sublingual tablet.
Wettable progesterone can be used, and has been shown to be just
as effective as progesterone USP.
This may sound
like the perfect treatment option but choosing the dose is critical.
If an abnormally high level of progesterone is produced in the
body, this can cause a reverse effect and stop it from working
at all.
The optimal
solution is to normalise the adrenal glands through a variety
of techniques.
If a woman still has ovaries they can normally be encouraged to
produce appropriate amounts of estrogens and progesterone to build
strong bones. The important tools for normalising the adrenal
glands include an optimal diet, getting to bed by 10 PM and mechanisms
for coping with stress.
Salivary hormone testing is a useful tool to monitor the effectiveness
of such therapy options.
Exercise and
large amounts of vegetables may also be important factors, and
should be encouraged. Studies have shown that calcium supplements
do not always increase bone density, highlighting the importance
of other ways to increase bone density.
I am not trying
to suggest that Alendronate should not be used in the treatment
of osteoporosis.
Still, I believe there could be better treatment options such
as natural progesterone.
If Alendronate was chosen, it would be wise to get your liver
function tested at regular intervals.
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