December 2004

Dear Friends,

It is always a delight to receive emails from readers and visitors to the website. Many of you tell stories in relation to your diagnoses of osteoporosis or low bone density and are frustrated by how limited the information is regarding the safety and effectiveness of bisphosphonate drugs like Fosamax. I am happy to offer support and direction where I can.

I recently had the privilege of meeting a courageous first-time mother who was diagnosed with post-pregnancy osteoporosis when her baby was about four weeks old. This is a rare condition where bones become mysteriously fragile and can break easily causing considerable pain and discomfort. The good news is that the fractures heal and women's skeletons seem to naturally recover their strength within months. It is almost certain that the condition will not recur with subsequent pregnancies. Because of this, and because of its potential influence on the skeleton of the unborn child, it is not usually recommended that potent drugs such as bisphosphonates are administered for this condition. More...

It has been a bad few weeks for the drug industry and the U.S. Food and Drug Administration as corruption and unethical practice has been exposed. The unravelling of the FDA's credibility over its handling of the Vioxx tragedy has created outrage and mistrust. In recent days David Graham, associate director in the FDA's Office of Drug Safety has courageously spoken out about the agency's failure to protect the public. He estimates that the arthritis drug Vioxx may have caused heart attacks or sudden cardiac death in up to 139,000 Americans and cites at least 5 other drugs that he believes are dangerous: Meridia, Crestor, Accutane, Serevant, and Bextra.

The parallels with the HRT scandal are significant – huge numbers of people have died from using drugs that were known to have serious risks associated with use, but were approved by the FDA anyway. The difference is that Vioxx and the other drugs are prescribed for existing conditions whereas HRT was prescribed most often to perfectly healthy women who believed the drugs were preventing future diseases like osteoporosis and heart disease.

Earlier in November the U.S. pharmaceutical company Pfizer issued a warning about a serious health risk to women who use their long-acting, injectable contraceptive drug, Depo-Provera. They warn doctors, women and adolescents who use Depo-Provera that the drug may cause a significant loss of bone mineral density, that the loss increases with duration, and that the loss may not be completely reversible.

This is not news – evidence that the contraceptive had this effect has been known for some thirteen years but Depo-Provera has nevertheless been widely prescribed to young women. Whether this loss of bone density increases the risk of fractures is not known, but there are real concerns that long-term use may seriously compromise bone health. Read more at the website of the Canadian Women's Health Network

These revelations remind us of the urgent need for accurate independent information and for consumer vigilance in questioning safety and effectiveness before accepting any type of drug therapy. I am reading (and thoroughly recommend) Marcia Angell's book The Truth About the Drug Companies: How They Deceive Us And What To Do About It. She is the former editor-in-chief of The New England Journal of Medicine - a perfect position from which to have observed the pharmaceutical industry's increasing “iron grip on Congress and the White House” and its enormous influence over what doctors are taught about drugs and what they prescribe. She delivers a searing attack on an industry that displays a cynical contempt for consumers by withholding unfavourable data, publishing biased research and promoting dubious and exaggerated diseases through direct-to-consumer advertising. Currently Americans spend a phenomenal $200 billion each year on drugs and the pharmaceutical industry enjoys a massive profit margin at least five times that of any other industry. Claims that it is high risk business requiring the spending of vast sums on research and development are hogwash says Angell. “The prices drug companies charge have little relation to costs and could be cut dramatically without coming anywhere near threatening R & D.”

Every aspect of modern medicine is disturbingly fallible. A recent review of U.S. medical statistics by the Nutrition Institute of America - a non profit organisation that has sponsored independent research over the last 30 years – concludes that conventional medicine is now America 's number one killer. This was not a lightweight review of data - the Nutrition Institute insisted that every ‘count' in this indictment be validated by published peer-reviewed scientific studies. As a result they claim that the total number of iatrogenic deaths in the U.S. – i.e. deaths induced inadvertently by a physician or surgeon or by medical treatment, drugs or diagnostic procedures - is 783,936 annually. That is equal to about five to six fully loaded jumbo jets crashing and killing all on board every day of the year! By comparison 699,697 Americans die of heart disease and 553,251 die of cancer every year.

It is all too easy to abdicate responsibility for our own health and treatment in favour of the apparent quick-fix. Lifestyle changes require effort and discipline but there is sound evidence that quitting smoking, minimising alcohol consumption, exercising daily and adopting healthy diets are far more effective ways of preventing disease than taking any ‘miracle cure' drug. Unhealthy lifestyles won't change as long as people keep placing their faith in the latest technology or the next wonder drug – a practice that is clearly becoming extremely dangerous.

If this all seems dire and negative, it isn't really. The exposure of dodgy drug company practice is long overdue. Hopefully it marks the beginning of a new era of medicine based on honesty, accountability and genuine concern for the consumer.

Warmest wishes

Gillian