Fracture traced to osteoporosis medication

Q. Two weeks after I suffered a thighbone fracture that had started as a hairline stress fracture, a friend alerted me to your column citing an article in The Journal of the American Medical Association (Feb. 18, 2009).

I showed it to my doctors, and we all agreed that my fracture was caused by long-term use (12 years) of Fosamax. My surgeon said that this was the strangest fracture he had ever seen; that the femur looked normal, but that it had broken in a location and at an angle that was extremely odd.

There is no warning on the Fosamax label of such a possible side effect. I think it is important for women taking osteoporosis drugs to get more information about side effects. My surgeon is seriously considering doing a hip replacement at the first sign of another hairline fracture.

A. When an article was published in the New England Journal of Medicine (March 20, 2008) suggesting that drugs intended to strengthen bones might cause fractures instead, it created quite a stir. The controversy rages on, and experts are still arguing about the risk.

Some scientists speculate that long-term use of drugs such as Actonel, Boniva, Fosamax and Reclast may suppress bone turnover and could lead to brittle bones and stress fractures. Anyone on such medications who experiences thigh pain should be evaluated.

We discuss this issue in greater detail in our new Guide to Osteoporosis, which also covers other options for treatment. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (61 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. U-92, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our Web site: www.peoplespharmacy.com.

Q. When my internist noted a low-normal thyroid value, he suggested a thyroid supplement. I suspected I had an iodine deficiency from years on a low-salt diet. I proposed a trial of sea kelp, and he agreed. Two 100 mg tablets a day brought up the thyroid value to normal and warmed my cold toes. I also noted my foot fungus receded 90 percent.

A. Using iodine to treat an underactive thyroid gland is controversial. Very few Americans get too little iodine, though your years of avoiding iodized salt might have resulted in an inadequate iodine intake for you.

In a case report, a woman who used kelp as an iodine supplement aggravated her thyroid disease (Journal of General Internal Medicine, June 2006). We’re glad you worked with your doctor and got good results, but we don’t generally recommend this approach.

Q. My 16-year-old son has had problems with acne for years. He kept asking me to buy Proactiv. I kept putting it off and telling him to try cheaper stuff.

Then I read your column about using milk of magnesia for acne. I printed the article (for proof for my son) and bought the MoM and cotton balls.

He has used it, and his face is much better. He has even mentioned that MoM has helped a lot.

A. Proactiv contains benzoyl peroxide, a time-honored and Food and Drug Administration-approved OTC acne treatment. Milk of magnesia (magnesium hydroxide) is an oral laxative that has not been approved for acne treatment. Nevertheless, many readers tell us that when applied topically to the face every night, it helps clear blemishes.

XIn their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of The Vindicator or e-mail them via their Web site: www.PeoplesPharmacy.com. Their newest book is “Favorite Home Remedies From The People’s Pharmacy.”

2009 King Features Syndicate Inc.