Lara Pizzorno is the author of “Your Bones: How You Can Prevent Osteoporosis and Have Strong Bones for Life – Naturally” and a member of the American Medical Writers Association with 29 years of experience specializing in bone health.
Recently we asked Lara if she would help us provide a series of short, ongoing videos to help you (our customers and readers) stay up to date on the latest facts and science related to bone health and overcoming osteoporosis naturally.
In this latest video, Lara answers a question about a bisphosphonate drug, Fosamax and discusses the bone remodelling process with these drugs versus a natural alternative. Watch the video below (or read the transcript provided) and let us know what you think in the comments. 🙂
Hello, I’m Lara Pizzorno and I’m here to answer some question that were sent to me after we ran the first series of videos on bone health. I’m only answering one question per video because most of them are kind of complicated. So if your question was not answered in this video, don’t be faint of heart I promise to get to it in the next one. So the question I would like to reply to in this video is:
“Is it possible to get any results from AlgaeCal if I take Fosamax once again, I absolutely hate the thought of going back to taking a bisphosphonate medication but my doctor is putting pressure on me and I’m wondering if I’m making a mistake by not taking it.”
My reply is, Fosamax and all the other antiresorptive drugs, which include all the different bisphosphonates and denosumab – these drugs disrupt normal bone building metabolism.
The bisphosphonate drugs poison osteoclasts which are the cells that normally remove old, brittle and worn out bone so that this bone is retained. So what you get is a false sense of an increase in bone mineral density but what you’re retaining is not healthy bone.
And if old bone is not removed, there is no place opened up to lay down new healthy bone. You have to take out the trash before you can lay down new healthy bone.
This is the reason that these drugs have been found to actually increase your risk for osteonecrosis of the jaw and what is also called atypical femoral fracture, but is a very typical form of thigh bone fracture resulting from the use of bisphosphonates and denosumab and it can accrue in as little as six months. Although most bisphosphonate triggered fractures occur after 2-3 years or more of use of these drugs.
What you want is healthy bone remodelling, which is what our bones are programmed constantly to do to rebuild themselves.
Constant, balanced bone remodelling is essential for the maintenance of a healthy skeleton throughout your life. And the balance between the activities of osteoclasts which break down or resorb old damaged bone and the bone rebuilding activity of osteoblasts, which form new bone, is the key to having healthy bones. The remodelling action of both types of cells, both osteoclasts and osteoblasts are required for the maintenance of a healthy skeleton. When osteoclast activity is prevented as it very effectively is by the bisphosphonates and denosumab, old damaged bone is going to accumulate and this will render your bones more and more fragile which will increase your risk of fracture over time.
Remodelling begins when cells trigger the formation of activity of osteoclasts, yes osteoclasts, they start the process of healthy bone remodelling. Once the osteoclasts resorbing actions are completed which typically takes about 2 weeks, the body will switch gears and will ready osteoblasts to take over which takes about 2 more weeks. After which, new bone formation, which takes about 13 weeks, begins. Together, the osteoclasts and osteoblasts work in tandem in any particular region of bone surface and this unit that accomplishes healthy bone remodelling is called the basic multicellular unit or BMU. That’s the unit you will see in research if you’re looking at this. The average lifespan of the BMU, osteoclasts and osteoblasts team is called the remodelling period.
And when all systems are functioning properly a full cycle of both aspects of the remodelling process will be completed in 3-6 months.
The building of new bone also requires that osteoblasts are required with all the nutrients that they must have and in sufficient amounts for you so that they can lay down new bone. These must be provided by a bone healthy diet and supplements to prevent any shortage of a needed nutrient. And they must be well absorbed or osteoblasts ability to create healthy new bone will be significantly impaired. Unfortunately, many factors in our modern westernized lifestyle, which I have discussed in “Your Bones” – many, many factors, can disrupt this healthy balance. Either by causing the cells that signal osteoclast activation to go on fast forward or by hampering osteoblasts ability to lay down new bone. Since it takes longer to build than to break down bone, the result is that bone removal can outpace bone rebuilding and this leads to bone thinning or osteopenia or osteoporosis (porous fragile bones.)
The solution however is to not inhibit all osteoclast activity as do the bisphosphonates and denosumab. But the lifelong solution for the maintenance of healthy bones is to restore balance in your bone remodelling process. This is done, first by identifying in each person the specific factors that are causing excessive osteoblast activation in that individual and they vary from person to person. And eliminating them or at least ameliorating them. And two, ensuring that the nutrients needs of the individual unique person, not just those of some mythical average person are met so that osteoblasts are provided with an optimal supply of all the nutrients they need to build new bone for you.
AlgaeCal is going to supply you with the key nutrients your bones have to have to rebuild and you really need these. But AlgaeCal can not makeup for the distortion in the remodelling process that is going to be caused in your physiology by Fosamax. Or any of the other antiresorptive drugs. I urge you to read “Your Bones” in full and with the help of a well informed integrative medicine physician, figure out what the causes are for you of the excessive bone loss. Why are you not some mythical person but you specifically, why are you activating your osteoclasts too much and losing too much bone. So that you can deal with these causes and regain the health of your bones. If your doctor is unwilling to help you, then you may want to look at the website for the Institute of Functional Medicine, which has a patient referral service to doctors that are very well informed and certified in cutting edge, functional medicine. These physicians are well versed in determining the true causes of an individuals’ dysfunctions and then correcting them, so then health can be restored.
I hope this information is of help to you. Thanks for a great question!
Pizzorno L. Your Bones, 2nd edition. Praktikos Books, Edinburgh, VA, 2013.
Das S, Crockett JC. Osteoporosis – a current view of pharmacological prevention and treatment. Drug Des Devel Ther. 2013 May 31;7:435-48. doi: 10.2147/DDDT.S31504. Print 2013. PMID: 23807838