Osteoporosis

[marion wheaton]

I'm newly diagnosed with osteoporosis. 2 doctors have recommended I start alendronate (Fosamax). Both doctors expressed concern with the oral medication and at the same time are uncertain about the IV form. Is there any reliable information on celiac disease and the use of alendronate for the treatment of osteoporosis?

[trents]

Welcome to the forum, @marion wheaton!

Can you be more specific about why the doctors were concerned about you taking the medication? Was there a connection between their concern and you having celiac disease?

Edited December 10, 2024 by trents

[marion wheaton]

They are concerned about the GI side effects and malabsorption of the medication.

[trents]

Both are valid concerns IMO. I developed osteopenia from celiac disease and was taking alendronate for a time. Honestly though, I can't remember if it was before diagnosis or after diagnosis of celiac disease. I was diagnosed over twenty years ago. I don't remember having any problems with the med itself but I do remember stopping it because I was concerned about the mechanism of its action. Namely, it slows down the resorption of old bone cells rather than speeding up the production of new ones. My concern was that it might increase bone mass but actually result in softer bones. That may have been a dated concern but back then it was a reservation held by some in the medical community. And then there are all the potential side effects and drug interactions associated with it.

I think once the villous lining of my small bowel began to heal and nutrient absorption improved, the bone demineralization problem at least stabilized. I am now 73 and have had no problems with fractures but I did develop kyphosis (forward curvature of the upper spine) and a little scoliosis previous to the celiac diagnosis which, of course, are irreversible. I have some occasional problems with nerve impingement in the neck as a result of the original demineralization but all in all, not as many problems as I expected. At least to this point. I do some modest weight lifting pretty regularly so I think that has helped restrengthen my bones. 

My experience may not be normative, however, and there is also the difference between male and female hormones and their effect on bone health.

Found this: https://www.drugs.com/tips/alendronate-patient-tips

Edited December 10, 2024 by trents

[RMJ]

I’ve been taking oral alendronate for 4 years.  I haven’t had any doctors be concerned about it.  My dentist recommended against the related iv medications because of potential adverse effects on the bones in the jaw - osteonecrosis.  Supposedly rare side effect but he had seen it several times.

I originally had the same concern as @trents - slowing resorption instead of building new bone.  I learned that that was a problem with the original bisphosphonates but not so much with alendronate and other newer ones.

[trents]

@marion wheaton, are you on vitamin and mineral supplements that are appropriate for bone health in order to offset the malabsorption problem until your gut heals thoroughly? I'm talking about supplements more potent than an adult multivitamin. We routinely recommend to newly diagnosed celiacs to be taking a high potency B-complex, 5-10k of D3, Magnesium glycinate or Magnesium citrate, and zinc picolinate. All supplements need to be gluten free of course.

[RMJ]

Vitamin K is also thought to help bone health, although not all scientific studies agree.