Bones and Joints - Osteoporosis Treatment and Prevention - The Compounder, Aurora, IL
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PREVENTION AND TREATMENT OF OSTEOPOROSIS
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by Bob Filice, M.D.

Fosamax is a drug that has become very popular among traditional physicians for the treatment of osteoporosis. It is typically used in conjunction with estrogen replacement therapy. Estrogens' effect on bone is to inhibit the "osteoclast cells". These are the cells responsible for the breaking down of bone as a part of its natural life cycle.

Estrogen replacement is only effective in managing post- menopausal bone loss during the first 5 years after the menses end. After that, estrogen-replaced and non-estrogen-replaced women lose bone mass at the same rate.

Deficiency of estrogen (levels drop by 40% post-menopausally) therefore is not the main cause of postmenopausal osteoporosis. What is? It's the drastic drop in progesterone (to 1/120 of the premenopausal values) that is the crucial factor. Progesterone is one of the only substances we know of that stimulates the bone building cells called "osteoblasts". So how does Fosamax work? Its mechanism of action, like estrogen's, is as an inhibitor of osteoclast cells. There is less breakdown of bone when taking the drug. Does this produce new bone? Marginally so, but when osteoclasts are inhibited, the osteoblasts also become inactive. The end result is stronger appearing bone which is actually weaker and more brittle, and a diminished capacity to form new bone because of reduction in osteoblast cell numbers, and activity. 		 

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Although for the first 3 years there appears to be increasing density of bone in Fosamax users, the incidence of serious hip fractures actually increases after that, since the remaining bone is not of adequate quality. Therefore early "improvement" seen on bone density X-rays like DEXA scans can be deceiving, and does not justify a lifetime commitment to an expensive drug with rather notable side effects as well.

The proper treatment for osteoporosis is not osteoclast inhibitors, but rather osteoblast stimulation, mainly provided by natural progesterone (not Provera), testosterone, and human growth hormone.

Osteoporosis can also be caused by mineral and vitamin deficiencies, corticosteroid drugs, poor eating habits, lack of exercise, and too much cortisol. The major influence on age-associated bone deterioration, however, would appear to be a severe deficiency of ovarian-secreted progesterone. Our treatment programs at CMRS involve focused natural hormone replacement therapies and scientific monitoring of the degree and rate of bone loss in the context of a complete medical and life style evaluation. We take all these factors into account, and will be happy to work with you to help you treat or prevent osteoporosis.

Dr. Filice serves patients in the greater Chicago area