Fosamax is one of the bisphosphonate drugs. It is a hormone (estrogen) blocker.

There are two kinds of cells in the body directly related to bone health.

Simply, the osteoClasts "Chew" holes in bone. The osteoBlasts "Build" more bone into the holes.

Osteoclasts are activated by estrogen.

Osteoblasts are activated by progesterone.

As we age, our hormone levels decline. At menopause, women's hormones change dramatically. Men do not have that kind of rapid change. At menopause, progesterone levels fall much more (on a percent basis) than estrogen levels. That results in a relative imbalance between progesterone and estrogen activity. This is sometimes referred to as estrogen dominance. It does not mean there is more estrogen, just that the effects of estrogen are more dominant.

In today's world, all of us are consuming excess amounts of chemicals that have actions in our bodies that are similar to estrogen. We are more estrogen dominant than our ancestors. Estrogen activity stimulates osteoclasts and increases the amount of bone destruction. Modern medicine has decided that the best way to maintain bone health is to halt the destruction. I disagree, especially when doing so means that there is nothing done to improve bone growth. Bone is a living material and it must constantly undergo rebuilding in order to be healthy.

Blocking estrogen blocks bone loss and does not encourage bone growth. Over time, bones look more dense on X-Ray, but they are actually more brittle - like chalk. "Dem bones, dem bones, dem dry bones".

Drugs like Fosamax block the estrogen activity and the result is density with brittleness. Instead of blocking estrogen activity, it seems more useful to stimulate bone growth with progesterone. We have seen dramatic improvement in bone health when progesterone is used as a supplement. It enriches the bone growing without blocking other hormone pathways.

I am in opposition to the use of bisphosphonates because they do not solve the underlying problem. Instead of encouraging normal bone breakdown and rebuilding, they halt the loss. The results are not as good as the drug sellers would want you to believe. Now, add to that the immense side effect profile from those drugs and you have a very dangerous situation.

Bisphosphonates EAT tissue. That's why you must remain upright for 30 minute or more after taking it. If you lie down, the pill may fall against tissue and erode it. You also need to drink plenty of water and make sure the pill is fully swallowed. If it gets caught in the throat, it can begin eroding the tissue there.

Healthy bones are built by modest weight-bearing exercise, a good diet, and a balanced hormone profile. It does not require estrogen blocking drugs. 

We can all benefit from daily vitamin supplements.

Fish oils are very helpful. Glucosamine has been shown to be helpful. I can't say the same for chondroitin (unless it is injected).