Biophosphonates have caused local irritation to the upper gastrointestinal system in a number of users.  In its perscription instructions for Fosamax, its maker, Merck, warns of esophagitis, esophageal ulcers and esophageal erosions.  Some of these instances have been severe enough to require hospitalization.  Other recent reports have linked its use to esophageal cancer.

Jaw Death is another troubling, if rare, biophosphonate side effect.  This occurs when the jaw fails to heal after minor trauma like tooth extraction.  This leaves exposed bone vulnerable to severe bacterial infection, eventually causing necrosis of the bone.  This requires removal of bone tissue or even large portions of the jaw.

Finally, recent studies have shown that long term biophosphonate use may double the risk of developing serious atrial fibrillation, a form of heart arrhythmia.  Symptoms include palpitations, chest pain, shortness of breath, and light headedness.  It can lead to fluid collection in the lungs, congestive heart failure and blood clots.

As discussed previously, it is important to remember that biophosphonates not only suppress bone resorption, where calcium is removed from the bone leaving hollow pits, but also osteoblastic bone building, where specialized cells enter those pits and fill them with new bone material.

The emerging concern is that this unnatural state of bone stasis does not actually make bones stronger, but merely makes them harder.  You can think of it as making your bones a little more like glass.  Glass is a very hard substance, but when subjected to intense pressure or stress, it lacks flexibility and tends to shatter dramatically.  This is not an ideal state for one’s bones.

The reason for this is that, under normal activity, bones develop microcracks.  These tiny fractures are a normal and healthy part of bone wear.  Under usual circumstances, osteblasts are activated, and the cracks in the bone are filled with new, stronger bone.  This actually keeps bones tough, strengthening them where they are weak.  When bone building no longer occurs, these microcracks remain unrepaired.  Over time, these cracks can widen and spread, causing increased bone weakness, even if the remaining bone material is still hard.  A study done at the University of Washington, Seattle, found that use of biophosphonates may be associated with a 20% reduction in bone toughness, or a bone’s ability to endure pressure without breaking.

Fractured bones aren’t the only danger associated with these drugs.  Next time, I’ll talk about some of the indirect problems associated with their long-term use.

One study conducted by the University of Texas Southwestern Medical Center observed women taking Fosamax who suffered bone fractures while engaged in normal daily activities.  Their healing rates were monitored, and the results were troubling.  In most of the women, bone healing was heavily slowed, causing bones to take months or even years longer to heal than would be expected.  When drug treatment was discontinued, bone healing occurred satisfactorily.

Perhaps most importantly, researchers found that the bones in the women taking Fosamax showed a severe depression in new bone formation.  In some, this rate was 100-fold lower than would be expected in healthy postmenopausal women.

Other studies and case studies have suggested that the lack of bone growth caused by biophosphonates may encourage bone fractures.  These fractures are low-stress fractures, indicating that the bones have increased hardness but decreased toughness.  The most frequent location of these fractures is the upper femur, usually one of the strongest bones in the body.

In the next entry, I’ll discuss the difference between hard bones and strong bones, and why promoting hard bones might be very dangerous.

The first step to recognizing the dangers of these products in the long term is understanding what they do.  Bisphosphonates are designed to mimic the effect of estrogen on the bones.  Estrogen prevents bone resorption, the process whereby bone calcium is broken down by osteoclasts and absorbed by the bloodstream, leaving tiny hollow pits in the bone.  These pits are then filled with osteoblasts, cells that fill in the pits with fresh, strong bone tissue.

The suppression of osteoclastic bone resorption is meant to strengthen bones by keeping the calcium in the bones and out of the blood stream.  However, there is a major potential problem with this regimen.  Osteoblasts remain inactive until osteoclastic activity occurs.  When osteoclastic activity is heavily suppressed, as it is with biphosphonate drugs, osteoblastic activity does not occur.  The body does not build new bone.

Next time, I’ll talk about the dangers of suppressing bone building, and what it could mean for long-term health.

Scientists at the University of California Los Angeles tracked nuclear factor-kappa B (NF-kB), a mediator that play a major role in inflammation, in the blood of subjects after sleep.  According to the researchers, “In the morning after a night of sleep loss, mononuclear cell nuclear factor-kappa B activation was significantly greater compared with morning levels following uninterrupted baseline or recovery sleep.”  They concluded, “These results identify NF-kappaB activation as a molecular pathway by which sleep disturbance may influence leukocyte inflammatory gene expression and the risk of inflammation-related disease.”

While researchers have long noted that sleep deprivation correlates with inflammatory disease, this study shines new light on how that relationship occurs.  Previous research has linked inadequate sleep with diabetes, arthritis, cardiovascular disease and even cancer.

I wish there were a way around it, but there just isn’t.  No matter how busy your life is, you must make time to get six full hours of uninterrupted sleep every night.  Your long-term health depends on it!

Gluten intolerence is on the rise worldwide, and people should be aware of the dangers wheat and other gluten-containing grains may cause them.  While most people benefit from reducing gluten intake, it is vital for those with gluten intolerance.  For more information about what foods contain gluten, refer to the chart I posted last week.

This time of year, I frequently hear my clients worry over the weight they’ve gained over the winter.  While it’s normal to gain a little weight over the winter, it’s also important to increase physical activity to counteract that effect.  Walking just twelve miles a week can help complete cut visceral fat accumulation, laying the foundation to losing those extra pounds.  And of course, there’s plenty of benefits in getting fresh air and sunlight, too, especially in keeping vitamin D levels up.  So make it a goal to find a new walking routine that you enjoy and can stick to.  It can make a lot of difference!

I’ve been spreading the good word about the health benefits of chocolate for years, but it’s always nice to see solid research that supports those benefits.