Sally Field is a special lady, wonderful actress and a favorite of mine and probably, many others as well. No doubt, Big Pharma is counting on our affection for her; a family woman with the smiling face and a hit TV show (Brothers and Sisters). So when she talks about wanting to protect her body by taking “Boniva” because her doctor told her it would help to strengthen her bones even tho she has already experienced bone loss in spite of all the calcium she has been taking. She is sincere in wanting to take care of her body, who wouldn’t? But it literally breaks my heart – not only for her, but all those others who see this “ad” on TV and believe it.
The might and power of Big Pharma is beyond belief. These companies come up with new products; push their approval through the FDA with or without the proper testing, inconclusive results – no problem, there are always doctors around who will gladly “endorse” and provide suitable necessary words to get the job done. When it turns out that the new meds don’t really do much of a positive nature, cost a lot of money, have disturbing side effects and so on, the meds are already “in” the system, espoused by your doctor and mine and everybody else’s. It is sometimes years before we find out that the new med is in fact causing more damage to our bodies – sometimes irreversible, than the good it was purported to promise in the first place. This is a never-ending story. We all read about such things, year in and year out. We shake our heads and wonder “Who the hell is supposed to be minding the store?” Will things ever change in Washington? I can tell you – it NEVER WILL unless we as caring, informed citizenry make our voices heard – collectively. We have a right to that. We should not have to sue the government to get legitimate, fair and equitable protection in our rules and regulations. Especially when it comes to our food and the medical establishments and Medicines. We should not be having our choices in supplements and over-the-counter products slip thru the cracks beyond our ability to get what we need and are accustomed to buying freely and easily. (psst, Jan – you’re on the soap box again! Get back to the point you were trying to make.) Damn! . . okay.
I think I’ve got a few years on Sally Fields. While I may not look as fine as she does, I bet my bones are in better shape. Do you know what I take for my bones? Nothing special. Not too much in the way of vitamins, just a multi with the basic stuff and trace minerals. No calcium supplements. No DAIRY. Over the years I have subscribed to a rather sophisticated and even ‘elite’ regimen of supplementation. One CAN spend a fortune on such things. Since getting involved with Dr. Mc Dougall and his vegetarian teachings (books, tapes, newsletters) I have followed his lead that supplementation is truly not necessary if one just gives the body what it needs to begin with – - natural, whole foods. So that is what I do. A few years ago my doctor had me tested to determine whether or not I’ve experienced bone loss. Apparently I was fine and needed no calcium. Even so, he has recently suggested that I take Fosamax now as a precaution. I don’t think so – thanks, but no thanks! Regard the many large mammals, like cows, elephants, rhinos; none of them require calcium supplementation. Nature endowed them to develop and maintain those massive frames ingesting plant foods. Nature did the same for us. We thrive beautifully on a starch based diet.
For simplification, our food falls into 3 classifications: proteins, fats and carbohydrates. That’s it. Our body can handle any or all of the above as it is adaptable and will make do with what we can provide. Nice, huh? There are so many other things which enter into what makes a human organism function optimally, but for my purpose, I want to address only these three classes of food, proteins, fats and carbs.
The carb field is wide and varied with spectacular assortment. We primarily need some kind of complex carb (potatoes, rice, beans, legumes and grains (including corn), to satisfy hunger and stick to our ribs and give us energy. Our life-style and energy needs dictate choices as well as our ethnic ambient and locational existence. By and large, Asians prefer rices, Latin countries are heavily into grains and beans and many European nations have a penchant for potatoes of all kinds. We seem to be most fond of potatoes and grains here with a large hankering for noodles and pasta. The great wars have given us proof that we can exist safely and well, exclusively on potatoes. But in fact, we have a limitless array of vegetables and fruits to add variety and flavor accented with countless herbs and spices; it can get pretty exciting. Kiwi, mango, pineapple, guava, melons and berries – all fit for the Gods. The carb family is suitable to promote radiant health, robust energy, a balanced and well-functioning organism free of diseases. No cancer, diabetes, cardio-vascular problems, arthritis, foggy brain, MS, obesity and so on. Just great energy, flexibility and feeling good.
No, you say – we NEED protein! Well, there is protein in every cell of every structure – it is the basic building block, and it is just the right kind and the right amount we need to function well. Much of what we have been raised to believe is not factually correct. There are no cases of anyone dying from a lack of protein. On the other hand, because we have been sold this absurd distortion, Americans in particular are protein junkies – can’t get enough. Our statistics on our levels of health reflecting the condition of our bodies is all we need to prove the point. So many experts (one on every corner) are in unified agreement that we NEED protein – animal protein. And yet, there is no agreement as to how much or why. Many brilliant scientists tell us our ancestors were carnivores, while others advise that they were not – that grains have been found in the teeth of ancient human species to prove their point. All very interesting; makes for good discussion – but is it important? Can’t we just observe what seems to be working and accept that? Can’t we forget about Big Pharma, big brother, Madison Avenue, the Dairy industry, Agribusiness and the Livestock yards and Wall Street? We have as much right to be healthy and to make the decisions we choose for ourselves per our priorities as anyone else who is after making a profit..
There is no question that we can ingest and handle animal protein and the associated fat as well. We are adaptable as stated. Americans fall easily into over-proteinization due to our insatiable appetites. We feast like royalty every day of the week in America. This is to our detriment as it becomes an overload for our kidneys and liver whose job it is to filter out toxins and overloads and keep things running smoothly. Ingesting too much animal protein burdens these organs which in effort to filter and excrete excess material, requires extra calcium for the processing. When the supply is not enough, calcium is taken from the bones. This process puts our organs into distress and shortens the life span of them. What clues might we have that we are ingesting too much animal protein? We get fat, loose energy, our arteries become clogged – with that the cardio vascular system is impaired, oxygen is not carried to the cells as it should. For a pretty good picture of all this, why not check out the post I did 7-01-08 of Dr Mc Dougall being interviewed by Tim Russert (posthumously). Protein, fats, diet and so on are all being discussed beautifully and poignantly. Following all this, the body begins breaking down with all sorts of diseases. Why? As explained, this is a protein overload, more than our bodies can fully absorb and utilize. It does the best it can for as long as it can before everything starts falling apart – the acid/alkaline balance goes out of control as it becomes too acid producing the condition which is known to be the perfect soil for germinating and allowing the fullness of all sorts of disease. Acid is the soil for a litany of diseases to thrive. Quite a contrast to those dwelling on a starch-based diet, right? High protein equates to high fat for the diet for they seem inseparable. To this point, protein discussed that which is found in meat, fish or fowl. How about dairy? The dairy dilemma is the big one (for me).
Most of us would rather do anything rather than give up the “dairy;” the milk, cream, cream cheese, cottage cheese, sour cream, ICE CREAM, the butter, eggs, yogurt – - oh my God, there is nothing left to eat!
When one really looks at this industry and what we have actually received from it in it’s entirety (not just the taste-bud satisfaction), it becomes a story with a different message. Africans and Asians know the message well as they have an innate resistance due to the inability to tolerate lactose. . . .consequently, they live and thrive without dairy in their lives. The reality is however, humans in general do not do well ingesting dairy – it was never meant to be. But it came to be anyway, creative individuals that we are, we found ways to do it. This is not to say that we did not pay a great price for this indiscretion. There is hormonal interference for both sexes, but to be sure, the females of our species have paid more dearly. Our children enter puberty earlier and earlier. (all the internal and external markers) Menses is more problematic with hormonal/emotional fluctuations radically ranging all over the place; discomfort from dreaded monthly pain to radical incapacitation and seclusion; with irregularity in the monthly pattern being a further stressor and perhaps more importantly, dairy consumption causes the lining of the uterus to become thickened, which leads to heavier menstrual flow to the point of hemmorraging, increased pain and discomfort. Infertility problems increase preventing or delaying conception. In addition, milk consumption in children can lead to anemia. A strong but strange footnote to this is that the strongest bones in the world have been found in Asian and African population – - those who cannot consume milk/dairy and are primarily consuming a plant-based diet. Seventy year old people have bones as strong as twenty years olds. In our country we consume lots of calcium supplements, joyfully indulge all dairy products and still its not enough, we are given prescription bisphosphonates and with it all, our bone problems seem to grow worse. Houston, we have a problem.
I would ask seekers of fully-in-depth-information backed by references and facts to research in Dr. McDougall’s archives which are well documented, intelligently delineated and rewarding in the richness of detail and connections. Here, in this post I have attempted to touch on remembered truths and sometimes not connected too well. I have endeavored to cover those areas which are most relevant to me. Some of the facts as they became apparent were not acceptable and it is the way of “mind” to justify and to make any conclusions desired seem right. So in fact it took me longer to come around than most of Dr McDougall’s aspirants who once shown the path to wholeness and health were quicker to grasp, accept and act on what they found. Like many others, my life-long use of and fondness of ‘dairy’ found endless ways to justify continued use. Clues were everywhere but my family and physicians did not know. I had childhood anemia; adolescent acne (way into my 40′s); infertility problems with no apparent cause discernable; difficult menses with irregularity, pain and hemmorraging. It was finally the search for answers about why humans must endure the pain, deformity and incapacitation of arthritis, ending up invalidized and either in massive pain or drugged out of our skulls. This wasn’t right and seemed contrary to our overall design. Since I would not accept the drugs, my search forced me to deal honestly with the truth when I found it. Giving up animal protein stopped the pain ( literally overnight). The dairy was the last to go. (but still slips in once in a while).
(I retrieved this from McDougall archives because it is relevant to what is discussed here. Please have a look.)
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Vol. 7, No. 04
Patients Commonly Receive Misinformation on Osteoporosis Treatments
The ‘By the Way Doctor’ column in the February 2008 Harvard Health Letter ran questions from readers regarding the safety of the osteoporosis bisphosphonate drugs, such as Fosamax, Actonel, and Boniva. Dr. Anthony Komaroff M.D., Editor in Chief, responded to patient concerns about long term use and the risk of the side-effect of bone necrosis or bone death – particularly in the jaw. One of the correspondents had been taking Fosamax for 11 years. Bisphosphonates are now the first choice for treating and preventing osteoporosis and are widely prescribed worldwide to women and men who have low bone density and fear fragility fracture later in life.
Concerned by inaccuracies in the column, Gillian Sanson, author of ‘The Myth of Osteoporosis’ wrote the following to Dr Komaroff:
Gillian Sanson is a woman’s health educator and researcher in Auckland, New Zealand. She is the author of Mid-Life Energy and Happiness (Penguin Books NZ 1999) The Osteoporosis ‘Epidemic’: Well Women and the Marketing of Fear (Penguin Books NZ 2001) and The Myth of Osteoporosis (MCD Century Publications, MI 2003. Her web site is www.gilliansanson.com.
Gillian is currently making a documentary on bisphosphonate drugs that considers how they have seamlessly replaced HRT as the universal osteoporosis prevention strategy despite questionable effectiveness, lack of long term safety data and known serious risks and side-effects. The film includes interviews with osteoporosis authorities, representatives of the FDA, the NIH and the WHO, researchers, women’s health advocates, and consumers.
January 31, 2008
Dear Dr. Komaroff,
Although no doubt intended to be helpful, your advice in response to recent questions in the Harvard Health Letter regarding the use of bisphosphonates could be misleading for readers as it appears to overstate the benefits and underplay the risks.
Whether bisphosphonates make bones stronger, as you advise, is questionable. They do not re-build bone, and although remineralisation and bone density increase occurs, the evidence for anti-fracture benefit from the drugs is minimal. Fosamax for example, is claimed to reduce hip fractures by 50 percent in high risk women with low bone density and previous vertebral fracture, but the actual or absolute reduction is one percent. In real terms, 90 such women would need to be treated for three years to prevent one hip fracture in one of them.1 It is estimated that hundreds of women aged 50 years with low bone density alone would need to be treated for more than 3 years to prevent one hip fracture in one of them. 2
Studies have found vertebral fracture benefit with Fosmax, Actonel and Boniva in high risk individuals where bone density is very low and there has been a previous vertebral fracture. But even then the drug will not benefit the majority who take it. For example, some 22 older women in this category would need to take Fosamax for three years to prevent one vertebral fracture discernible by X-ray in one of them. 3
Although bisphosphonates may favorably influence bone density loss, there are concerns that because their mechanism of action suppresses the bone remodeling process, long term use may result in brittle bones that are prone to fracture. 4 Increased bone mineralization has been shown to increase micro-fracturing in animal studies. 5 Of note, a Connecticut woman has this week sued Merck & Co., claiming that Fosamax caused multiple stress fractures and suppressed bone regeneration in her legs. 6 She took the drug from 1996-2006.
Bisphosphonates have an indefinite half-life of at least 10 years duration so the effect of the drug continues for better or worse once stopped. The amount of drug within the bone will accumulate with use thus continuing its effect for better or worse. There is no known method of removing the medication from the bones. The reader who questioned you had already been taking the drug for eleven years. Surely it would be prudent for her to discontinue at this point?
You maintain that “many well designed studies involving thousands of women have found that – at least for 10 years- the effect of bisphosphonates like ibandronate is to strengthen bone and prevent fractures”. There has only been one trial of any bisphosphonate that has continued for more than 5 years – the Fracture Intervention Trial extension. 7 This extension to the original trial is considered by many to be of little clinical value as it was small and poorly designed – and particularly flawed as the ‘placebo’ group had previously taken Fosamax for three or more years. Although the study showed that bone mineral density continued to increase with up to 10 years of Fosamax use, it is not at all clear that this meant a reduction in fracture. The research that answers this question has yet to be done. The small numbers precluded any definitive evidence regarding long term safety.
The gastro-intestinal side-effects of bisphosphonates have been well documented, and you will be aware that the FDA has this month issued an alert about the previously lesser known side-effect afflicting many users of chronic, often severe, joint and bone pain, swelling of ankles and feet, muscles cramping and stiffness, and difficulty walking. There is also evidence from a paper in the January 15, 2008 Journal of Rheumatology that oral bisphosphonate drugs nearly triple the risk of developing bone necrosis. 8 They have also been found to double the risk of atrial fibrilliation. 9 The Systematic Review: Comparative Effectiveness of Treatments to Prevent Fractures in Men and Women with Low Bone Density or Osteoporosis in the February 8 2008 issue of Annals of Internal Medicine concluded that “data are insufficient to determine the relative efficacy or safety” of all the studied drugs. 10
A BMJ article this month (Jan 2008) warns that a series of recent scientific publications have exaggerated the benefits and underplayed the harms of drugs to treat pre-osteoporosis or “osteopenia”, potentially encouraging treatment in millions of low risk women. 11
In the absence of clear evidence for long term safety, and for benefits that outweigh the risks, the current practice of widely prescribing potent bisphosphonates needs to be reviewed. I am greatly concerned that the rush to provide costly and risky medical solutions for low bone density in healthy postmenopausal women is drawing attention away from the very important issues of preventing falls in the elderly, diagnosing genuine sufferers, and encouraging regular exercise and appropriate diet to maintain bone health.
1. Black DM. Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group. Lancet 1996;348(9041):1535-41.
2. Cummings SR. Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA1998;280(24):2077-82.
3. Black DM. ibid
4. Ott, S.M. Long-Term Safety of Bisphosphonates J Clin Endocrinol Metab.2005; 90: 1897-1899.
5. Mashiba T, et al. 2001 Effects of suppressed bone turnover by bisphosphonates on microdamage accumulation and biomechanical properties in clinically relevant skeletal sites in beagles. Bone 28:524–531
6. Won Tesoriero, Heather. Suit Alleges More Health Problems From Merck’s Fosamax Drug firstname.lastname@example.org
7. Ensrud KE, et al 2004 Randomized trial of effect of alendronate continuation versus discontinuation in women with low BMD: results from the Fracture Intervention Trial long-term extension. J Bone Miner Res 19:1259–1269
8. Etiminan M, et al. Use of Oral Bisphosphonates and the Risk of Aseptic Osteonecrosis: A Nested Case-Control Study. 2008. January 15 on-line Journal of Rheumatology http://www.jrheum.com/abstracts/abstracts08/13/0120.html
9. Black DM et al. Cummings SR et al. N Engl J Med 2007; 356:1809-1822,1895-1896
10. Maclean, C et al. Systematic Review: Comparative Effectiveness of Treatments to Prevent Fractures in Men and Women with Low Bone Density or Osteoporosis Annals of Internal Medicine 2008;148
11. Alonso-Coello, P at al. Drugs for pre-osteoporosis: prevention or disease-mongering? BMJ 2008; 336: 126- 129
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