Trusted treatments you'd never suspect could be stealthily chipping away at your bone health. A 2021 review compiles extensive data on 7 drug classes that studies connect to a significant deterioration of skeletal integrity, density, and shockingly higher fracture rates.

Unintended side effects of commonly prescribed medications may insidiously undermine bone integrity over months or years, in some cases profoundly increasing the risk of being diagnosed with osteopenia or osteoporosis, and even bone fracture. Research increasingly illuminates the magnitude of this issue, sounding an alarm to the clinical community.

One important topic that must be addressed whenever the issue of osteopenia or osteoporosis emerges, is the overdiagnosis of the condition, due to the fact that an inappropriate standard is being applied to both adults and even children: namely, the young adult based T-score, which compares the bones of a healthy woman at peak bone mass to that of any age, which ignore the natural fact of aging, gender, ethnicity, and other factors that are accounted for with the more scientifically valid, yet seldomly used Z-score. To learn more about this epidemic of wrongfully diagnosed "bone diseases," read our report on the topic here: The Manufacturing of Bone Diseases: The Story of Osteoporosis and Osteopenia.

That said, drug-induced degradation of bone health and integrity is a growing problem, and in a recent review, experts examined extensive data on pharmaceuticals diminishing bone health as a secondary cause of real cases of osteoporosis (Pizzorno, 2021). These drugs exact severe skeletal costs via mechanisms disrupting hormones, nutrient absorption, inflammation regulation, and tissue integrity. However, strategic interventions may frequently safeguard bone strength.

1) Aromatase Inhibitors: Up to 75% Fracture Risk Rise

Anti-estrogen aromatase inhibitors like anastrozole potently suppress estrogen production in an attempt to impede so-called 'hormone-positive' breast cancer progression. However, the resultant severe estrogen deficiency can accelerate bone loss to an extreme degree, dramatically escalating fracture risks. Studies show aromatase inhibitors hike fracture rates up to a staggering 75% over just 3-5 years of use (Binkley et al., 2021). So-called selective estrogen receptor modulators like tamoxifen may match oncological efficacy without such perilous bone consequences in appropriate patients (Yu et al., 2018). Yet, tamoxifen is itself classified as a potential carcinogen, and natural SERMs exist that may do the trick without the side effects associated with conventional chemotherapy drugs. One such natural SERM includes flaxseed, as an example, which also has proven anti-breast cancer activity. Read our report on the topic here: Eating Flaxseed May Reduce Breast Cancer Mortality By Up To 70%.

2) Anticonvulsants: Up to 50% More Bone Loss  

Antiseizure anticonvulsants like phenytoin ease epilepsy and mood disorders but substantially block absorption of bone-essential vitamin D and K stores by up to over 50%, depleting critical bone nutrients (Verrotti et al., 2021). Checking levels helps guide dosage increases to compensate for malabsorption. While natural substances are generally not used for seizures, there are lead compounds that have been researched and are indexed on Greenmedinfo.com which might be used in the 'medicine of the future' and which have side benefits relevant to bone health. You can view them here.

3) Benzodiazepines: 2X Osteoporosis Risk Rise

Sedative benzodiazepines can dramatically raise prolactin while suppressing sex hormones that facilitate bone remodeling. Studies link longer-term use with a more than doubling of osteoporosis risk. Phytonutrient botanicals like lemon balm and passionflower provide anxiety relief without this degree of hormonal disruption (Lopresti, 2017). For an extensive list of natural anti-anxiety compounds consult our database on the subject here.

4) Antidepressants: Over 80% More Spine Fractures  

Like benzodiazepines, standard antidepressants significantly increase prolactin while dowregulating osteoprotective hormones, slowing bone turnover to a hazardous degree. Analyses reveal selective serotonin reuptake inhibitors in particular escalate spinal fracture risks by over 80% long-term, demanding preventative vigilance (Mazziotti et al., 2017). The medicinal spice saffron demonstrates comparable mental health benefits without such skeletal risks (Lopresti & Drummond, 2014). For a wide range of natural substances studied for depression, view our database on the subject here.

5) NSAIDs: 70% Boost in Fragility Risks 

Anti-inflammatories like celecoxib provide temporary pain relief but may fuel uncontrolled inflammation driving accelerated bone loss over time. Studies connect substantial NSAID use with a 70% heightening of fracture probabilities if resolution pathways are not concurrently supported (Pirozzi et al., 2018). There are a broad range of natural anti-inflammatory agents studied for pain relief which may be beneficial to bone health which you can view here.  

6) Blood Sugar Medications: 400% Rise in Fractures

Insulin-remodeling diabetes drugs like Actos prompt adipocyte dominance over bone-building osteoblast formation. In some analyses, they elevate fracture likelihood 4-fold through pathological fat accumulation and poor bone quality (Alemán-González-Duhart et al., 2016). Lifestyle therapy proves highly effective at reversing diabetes and associated skeletal deterioration without medications in motivated patients (Bispo et al., 2017).  For alternative natural blood sugar approaches, visit our database here.

7) Proton Pump Inhibitors: 25%-50% Fracture Risk Escalation

Acid blockers like Prilosec and Nexium cut nutrient absorption drastically by curtailing stomach acid output. Over just a few annual courses, these drugs dose-dependently compound fracture chances by at least 25% to over 50% (Moosavinasab et al., 2019). Folate, zinc, magnesium and melatonin provide natural alternatives supporting digestion without detriment (Wang et al., 2018).  Natural proton pump inhibitors exist, and a wide range of substances have been studied for acid reflux symptoms you can view here.

8) Diuretics: Up to 6X Higher Hip Fracture Incidence

Hypertension diuretics like furosemide treat fluid retention and elevated blood pressure but also deplete nutrients integral to bone elasticity like calcium and potassium by triple digit percentages. Studies accordingly connect thiazide diuretic usage with a 500-600% rise in hip fracture incidence compared to the general population (Rejnmark et al., 2011). Stress moderation and dietary sodium restriction provide bone-protective, non-pharmacological hypertension aids as applicable (Maalouf et al., 2016).

In summary, the murky influences of pervasive prescription medications demand an elevated degree of caution and multifaceted preventative strategies to mitigate severe unintended risks of drug-induced fragility, fractures, and heightened osteoporosis odds. Identifying and leveraging evidence-based nutrient and lifestyle alternatives also empowers clinicians to maximize bone support even when pharmaceutical use proves clinically essential.  

To view our extensive database on natural approaches to osteoporosis, view our database here.

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References

Alemán-González-Duhart et al. (2016). Current Advances in the Biochemical and Physiological Aspects of the Treatment of Type 2 Diabetes Mellitus with Thiazolidinediones. PPAR Res, 2016.

Binkley et al. (2021). Diagnosis and management of osteoporosis in survivors of adult cancers with nonmetastatic disease. J Natl Compr Canc Netw, 19(6), 664-677.

Bispo et al. (2017). Effectiveness of lifestyle interventions to reduce type 2 diabetes and cardiovascular disease risk factors among youth in low-and middle-income countries: A systematic review. Nutrition Reviews, 75(8), 615-631. 

Lopresti A. L. (2017). The mental health benefits of lavender (Lavandula angustifolia) essential oil: A systematic review. Asian Journal of Pharmaceutical and Clinical Research, 379-383.

Lopresti & Drummond (2014). Saffron (Crocus sativus) for depression: a systematic review of clinical studies and examination of underlying antidepressant mechanisms of action. Hum Psychopharmacol, 29(6), 517-527.

Maalouf et al. (2016). Short-term and long-term efficacy of the DASH diet in individuals with the metabolic syndrome: a systematic review and meta-analysis. Nutrition Reviews, 74(7), 407-418.  

Mazziotti et al. (2017). Drug-induced osteoporosis: mechanisms and clinical implications. Am J Med, 130(10), e507–e518.  

Moosavinasab et al. (2019). The association between proton pump inhibitor use and fracture risk: A review article. Journal of Cellular Physiology, 234(6), 8091-8099. 

Pirozzi et al. (2018). Common pharmaceuticals alter osteogenic commitment of human tendon stem cells: Their involvement in tendon pathology? Connective Tissue Research, 1-10.

Pizzorno J. (2021). Integrative Medicine, 20(2), 8–15. 

Rejnmark L. et al. (2011). Fracture risk in patients treated with loop diuretics. J Intern Med, 270(1),117-127.

Verrotti et al. (2021). Bone involvement in pediatric epilepsies. Eur J Paediatr Neurol, 33, 28-36.  

Wang et al. (2018). Melatonin supplementation for sleep disorders and neurodegenerative diseases: A meta-analysis and systematic review of RCTs. Ther Adv Chronic Dis, 9(10), 195–204.  

Yu et al. (2018). Adjuvant endocrine monotherapy for postmenopausal early breast cancer patients with hormone-receptor positive: a systemic review and network meta-analysis. Breast Cancer, 25(1), 8-1‹6.