Men's Osteoporosis Support Group
Bisphosphonates work best with high vitamin D levels; and resistance training
An article on Medscape.com highlighted at the American Society for Bone and Mineral Reseearch (ASBMR) 2011 Annual Meeting, and coauthored by Richard S. Bockman, MD, PhD,, cites research that found only 47% of women treated long-term with a bisphosphonate for osteoporosis had a favorable response to the medication. A serum vitamin D level of 33 ng/mL or higher was the significant factor in promoting a favorable response to bisphosphonates, such as Fosamax (Alendronate), Actonel (risedronate) or I.V. Aclasta (zoledronate). [Note: this Medscape article is free, but you will have to register or sign in if you have already registered].
Dr. Bockman noted that, “ . . . the results may help explain discrepancies in responses to bisphosphonates seen in controlled studies compared with the real-world environment.”
Editor's comments. This study's results would suggest that everyone taking a bisphosphonate for osteoporosis should have their serum vitamin D level tested before treatment, and during treatment, if not responding to therapy. Note that according to Dr. Michael Holick, an authority on vitamin D, “. . . vitamin D deficiency, insufficiency and sufficiency are defined as <20, 21 to 29, and > 30 ng/mL, respectively.” According to this definition, the people in the ASBMR study had unfavorable results with bisphosphonate therapy with “sufficient” vitamin D levels.
There is a recent Update that cited a study done in Hawaii on young, healthy adults who spent at least three hours per day in the sun, often without sunscreen, yet 51% in the study had low vitamin D status. Thus you can't just assume you have adequate serum vitamin D if you spend time in the sun or take supplements. Get tested to be certain you are maximizing your chances of responding to therapy.
Bottom line. Know your serum vitamin D status if you are taking bisphosphonates for osteoporosis, especially if you aren't responding to therapy.
Adv Prev Med. 2011;2011:984683. Epub 2010 Dec 13. Resistance Training Is an Effective Tool against Metabolic and Frailty Syndromes. Sundell J. PMID: 21991450. This abstract describes the importance of resistance training against metabolic and frailty syndromes. There is also free full text available here. I think most readers will find interesting details in this full article about what type of, and how often to perform, resistance training as a means of treating/preventing osteoporosis as we age.