Lies My Doctor Told Me

1. Osteoporosis drugs can increase fracture risk over time

Out of 310 cases of atypical femoral fractures, task force researchers found a shocking 94% of them had been using bisphosphonates for at least five years, reported a study published by the Journal of Bone and Mineral Research.

Bisphosphonates' hidden danger. Osteoporosis drugs like Fosamax and Actonel, known as bisphosphonates, are commonly prescribed to increase bone density. However, long-term use can paradoxically increase the risk of fractures, particularly in the femur. These drugs work by inhibiting bone resorption, but this process is essential for maintaining bone quality and flexibility. Over time, bones become thicker but more brittle and prone to fractures.

Serious side effects. Besides increased fracture risk, bisphosphonates can cause other severe side effects:

• Osteonecrosis of the jaw (death of jaw bone tissue)
• Atrial fibrillation (irregular heartbeat)
• Esophageal cancer (in some studies)
• Kidney problems
• Severe musculoskeletal pain

The FDA has acknowledged these risks, recommending that patients reassess their need for these drugs after 3-5 years of use. However, many doctors continue to prescribe them long-term, unaware of or downplaying these potential dangers.

2. Calcium supplements alone may lead to arterial calcification

Taking calcium without Vitamin K2 leads to calcification of arteries.

The calcium paradox. While calcium is essential for bone health, taking calcium supplements without proper cofactors can lead to a dangerous condition known as arterial calcification. This occurs when calcium is deposited in the arteries instead of bones, increasing the risk of heart disease and stroke.

K2's crucial role. Vitamin K2 is the key to solving this paradox. It activates proteins that direct calcium into bones and teeth while preventing its accumulation in soft tissues like arteries. Without sufficient K2, calcium can end up in the wrong places, potentially causing more harm than good.

• K2 activates osteocalcin, which helps incorporate calcium into bone
• K2 activates Matrix Gla Protein (MGP), which prevents calcium from depositing in arteries
• Studies have shown K2 can reduce arterial calcification by 37-50% in just six weeks

3. Vitamin K2 is crucial for bone health and cardiovascular protection

According to the Archives of Internal Medicine, taking a daily dose of 45 mg of K2 in the form of MK-4: decreased all non-spinal fractures by 81%, decreased broken hips by 77%, decreased spinal fracture risk by 60%

K2's powerful effects. Vitamin K2, particularly in the form of MK-4, has shown remarkable results in improving bone health and reducing fracture risk. It works by activating osteocalcin, a protein essential for bone formation, and helps calcium bind to the bone matrix.

Beyond bone health. K2's benefits extend to cardiovascular health:

• Reduces risk of heart disease by preventing arterial calcification
• Improves elasticity of blood vessels
• May help prevent or reverse existing arterial calcification

K2 exists in two main forms: MK-4 and MK-7. While both are beneficial, MK-4 has shown the most dramatic results in clinical trials for bone health. The recommended daily dose for osteoporosis treatment is 45mg of MK-4, taken in three 15mg doses throughout the day.

4. Vitamin D3 and A work synergistically with K2 for optimal bone health

Vitamins D3 and A prevent toxicity for each other, so always take all three for optimal results.

The vitamin triad. Vitamins D3, A, and K2 work together synergistically to promote optimal bone health and overall well-being. Each plays a crucial role:

• Vitamin D3: Enhances calcium absorption and supports immune function
• Vitamin A: Regulates bone remodeling and protects against Vitamin D toxicity
• Vitamin K2: Directs calcium to bones and away from soft tissues

Balancing act. The ideal ratio of Vitamin A to D is between 4:1 and 8:1. This balance helps prevent toxicity from either vitamin while maximizing their benefits. Vitamin D3 is best obtained through sunlight exposure (15-20 minutes daily) or supplementation, aiming for blood levels of 60-80 ng/mL. Vitamin A can be found in organ meats, egg yolks, and colorful vegetables.

5. Many common medications negatively impact bone health

SSRIs include citalopram (Celexa), dapoxetine (Priligy), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft) and the like. In the most recent observational cross-sectional study on this subject published in the journal Osteoporosis International, the link between Selective Serotonin Reuptake Inhibitors (SSRIs) and bone health decline continues to be found.

Hidden bone dangers. Many commonly prescribed medications can have detrimental effects on bone health, often unknown to patients and doctors alike. Some of the most problematic include:

• SSRIs (antidepressants): Increase fracture risk and impair bone formation
• PPIs (acid reflux medications): Reduce calcium absorption, increasing fracture risk by up to 60% after long-term use
• Corticosteroids: Can cause rapid bone loss, leading to osteoporosis
• Blood thinners (e.g., warfarin): Interfere with Vitamin K metabolism, affecting bone formation
• Diabetes medications: Some increase fracture risk significantly

Awareness is key. Patients taking these medications should be aware of their potential impact on bone health and discuss alternatives or mitigation strategies with their healthcare providers. In many cases, natural alternatives or lifestyle changes can reduce or eliminate the need for these bone-damaging drugs.

6. Sleep and sunlight exposure play important roles in bone strength

Get adequate sleep, at least 6 hours, preferably 8 hours, which is a real problem for many today.

Sleep's hidden power. Adequate sleep is crucial for maintaining healthy bones, yet its importance is often overlooked. During sleep, the body repairs and regenerates tissues, including bone. Chronic sleep deprivation can lead to decreased bone density and increased fracture risk.

Sunlight and Vitamin D. Regular sunlight exposure is essential for Vitamin D production, which is crucial for calcium absorption and bone health. Key points:

• Aim for 15-20 minutes of direct sunlight exposure daily, without sunscreen
• If sun exposure is not possible, supplement with Vitamin D3
• Optimal blood levels of Vitamin D are between 60-80 ng/mL
• Vitamin D3 supplementation can reduce overall fracture risk by 33% and hip fracture risk by 69%

Balancing adequate sleep and sunlight exposure can significantly improve bone health without the need for medication or extensive supplementation.

7. Natural supplements can effectively improve bone density and quality

Taking serious side-effect risks simply isn't necessary to protect your bones.

Nature's bone builders. A variety of natural supplements can effectively support bone health without the risks associated with prescription medications. Key supplements include:

• Magnesium: Balances calcium and supports bone structure
• Copper: Essential for collagen formation in bones
• CoQ10: Supports energy production in bone cells
• Boron: Helps normalize calcium and magnesium levels
• Zinc: Crucial for collagen synthesis and bone mineralization
• Potassium: May help reduce fracture risk
• Nettle: Can increase free testosterone, supporting bone formation

Holistic approach. Combining these supplements with a nutrient-rich diet and lifestyle changes can significantly improve bone health. Focus on whole foods rich in these nutrients, such as leafy greens, nuts, seeds, and high-quality animal products. Remember that supplements should complement, not replace, a healthy diet and lifestyle.

8. Bone density scans (DXA) may not accurately predict fracture risk

DXA scans can only give BMD results. BMD does not measure bone quality, only density. Low BMD alone as an effective predictor of elevated fracture risk, although commonly used in clinical practice as the gold standard, is not considered proven, only "associated" with fracture risk, and is in fact debated as an effective predictor of fracture among medical community members, as this link to an article in the peer-reviewed medical journal Bone shows.

Beyond density. While bone density scans (DXA) are widely used to assess fracture risk, they provide an incomplete picture of bone health. Bone quality, which includes factors like flexibility and internal structure, is equally important in determining fracture risk. DXA scans measure only bone density, not quality.

Limitations of BMD. Studies have shown that:

• Many fractures occur in people with normal or only slightly low bone density
• Increases in bone density from medication don't always correlate with reduced fracture risk
• Bone quality factors like collagen structure and mineral composition are not captured by DXA scans

A more comprehensive approach to assessing bone health should include consideration of lifestyle factors, nutrient status, and potentially more advanced imaging techniques that can assess bone quality as well as density.

9. The pharmaceutical industry influences medical advice on bone health

By setting up limits on which tests or surgical procedures will (or will not) be paid for or at what rate, or how much the prescription cost for each medication will be according to their formulary, they significantly influence how medicine is practiced by physicians today. In fact, in almost every meaningful way, insurance companies are the ones that are effectively practicing medicine now, instead of the doctors.

Follow the money. The pharmaceutical industry exerts significant influence over medical education and practice, particularly in the field of bone health. This influence can lead to an overreliance on drug-based treatments and a lack of awareness about alternative approaches.

Key points:

• Drug companies fund much of the continuing medical education for doctors
• Pharmaceutical representatives often provide biased information to physicians
• Insurance companies influence treatment decisions through coverage policies
• The FDA's funding structure creates potential conflicts of interest

Critical thinking required. Patients and healthcare providers need to be aware of these influences and seek out unbiased information from independent sources. Questioning the standard of care and exploring alternative approaches can lead to better outcomes and fewer side effects.

10. A holistic approach to bone health is more effective than drugs alone

"First, do no harm."

Beyond medication. A comprehensive approach to bone health involves more than just taking prescribed medications. It includes:

1. Nutrition: Focus on a balanced diet rich in vitamins K2, D3, A, and minerals like calcium, magnesium, and zinc.
2. Exercise: Regular weight-bearing and resistance exercises stimulate bone formation.
3. Lifestyle: Adequate sleep, stress management, and sunlight exposure all contribute to bone health.
4. Supplements: Strategic use of natural supplements can support bone density and quality.
5. Medication review: Assess and potentially reduce bone-damaging medications.

Empowered patients. By taking a proactive, holistic approach to bone health, individuals can often achieve better results with fewer risks than relying on medications alone. This approach requires patients to be informed and engaged in their healthcare decisions, working in partnership with healthcare providers who are open to integrative approaches.

Last updated: September 7, 2024