Q: My doctor wants me to start taking a medicine once a week to strengthen my bones. How long do I have to take it?
Osteoporosis is a disease in which your bones become thin, weak and more likely to break. It directly affects 10 million Americans and threatens nearly 34 million more, according to Amy Porter, Executive Director and CEO of the National Osteoporosis Foundation (NOF), a health organization dedicated to preventing osteoporosis and broken bones though awareness, education and research.
“Osteoporosis now causes an estimated two million fractures each year and can result in immobility, pain, and other health problems”, says Robert Recker, MD, the president of NOF.
My mother died of complications of osteoporosis. She broke her left wrist when she was 73 years old from tripping in downtown Seattle trying to catch a bus. Four years later she broke her right hip in another fall getting up to go to the bathroom in the middle of the night. Her right leg ended up one inch shorter than her left, causing her discomfort and inconvenience for the rest of her life.
In the United States, one out of every two women and one in four men over age 50 will have an osteoporosis-related fracture in their lifetime. Twenty percent of seniors who suffer a hip fracture will die within one year.
May is National Osteoporosis Awareness and Prevention Month. The National Osteoporosis Foundation (NOF) is encouraging Americans to learn more osteoporosis and how to keep their bones strong and healthy, including getting enough calcium and Vitamin D, doing some weight bearing exercise every day, quitting smoking and asking their doctor or medical provider about bone density testing.
Although complications show up in old age, osteoporosis is a disease of thinning bones that starts in childhood. Up to 90 percent of peak bone mass is built before 18 years of age in girls and 20 years old in boys. At menopause bone loss accelerates; the thinner your bones are to start with, the more likely you’ll eventually experience a fracture.
If you have passed menopause or have taken certain drugs, especially prednisone or corticosteroids, you may have thin bones without knowing it. Testing your bone density helps determine how likely you are to have a bone break in the future. If you are at risk, your bone loss can be slowed with medicine. My mother never knew she had thin bones until she broke her wrist. With screening and bone-building drugs available today she may have avoided the hip fracture that shortened her life.
Bone building drugs like alendronate (Fosamax®), Actonel® and Boniva® are called bisphosphonates. These powerful medicines have complicated directions, which is why most women prefer to take them once a week instead of every day. They must be taken with a full glass of water on a completely empty stomach, and you must stay upright at least 30 minutes afterward, no leaning back or lying down allowed.
The reason you need to keep yourself upright and drink a full glass of water is to avoid irritating your esophagus. The empty stomach is also very important because even with the best conditions only 2-3% of the medicine in each tablet will get absorbed into your body.
But what does get in stays in. These drugs become part of your bone cells and continue to work to build bone for you even after you stop the drug. How long do you have to take this medicine? That depends, and you and your medical provider should decide together. The current evidence is that if you are taking them to prevent a future fracture, five years may be enough. Both alendronate (Fosamax®) and Actonel® are effective in preventing hip and vertebral fractures for up to ten years, even after you have stopped taking them.
To find out more about osteoporosis and how you can prevent it from the National Osteoporosis Foundation stop by their website at www.nof.org.
