DEAR DR. GOTT: I’m an 83-year-old female. I take a weekly 70 milligrams alendronate sodium tablet for osteoporosis, 50 milligrams of blood-pressure medicine and 20 milligrams of a cholesterol medication. My doctor also has me on 600 milligrams calcium plus vitamin D two times a day to help build strong bones. My blood sugar since before I started taking alendronate was 108. Now it has jumped to 115. Do you think the medicine is the cause? I’m not too fond of that 70 milligrams sodium, and I don’t want to take it anymore. I figure it’s my body, and I say no.
I will see my doctor in August. She will not be happy, but I really do not care.
DEAR READER: The medication you have been prescribed (Fosamax) and the calcium with D supplement are both in the proper dosage to combat osteoporosis. I am sure your prescribing physician indicated that you should take the alendronate with a full glass of water a half-hour prior to your first food of the day. It should not be taken at bedtime with food, mineral water, coffee, tea or juice, as these beverages will reduce the absorption of the medication.
One inactive ingredient in the product is lactose, a sugar commonly found in milk that is used as a diuretic in some medications. I am uncertain exactly how much lactose is in alendronate but herein could be your problem. I read about one individual who was part of a 2009 study involving almost 50,000 men and women who indicated his or her sugar level rose 10 points and continued to rise while on alendronate. There was no further documentation or comment so I can only pass the information on to you. Beyond that observation, I have been unable to find any documented test studies that confirm elevated sugar levels in people who have been prescribed the medication.
I assume you have bone-density testing (DEXAs) on a timely basis and suggest you have another at the appropriate time. Determine any progress since being on the medication and then have a frank discussion with your primary-care physician about your concerns. If there is no improvement in your osteoporosis, perhaps she will be responsive to your discontinuance of the medication, even if it is only for a short trial period. In the interim, I cannot see that the calcium with vitamin D will do any harm and in fact, it might be just what the doctor ordered, if you will excuse the pun.
You have a right to make decisions regarding your health. Your doctor should either present an opposing view as to why the alendronate sodium should be continued, make a substitute to something you both agree upon, or she should go along with your decision. Perhaps an appointment with a nutritionist might even be appropriate.
If there is no other basis for your elevated sugar counts, express your concerns. I can understand and support a physician taking aggressive steps to prevent fractures in a woman your age. Yet, if there is a direct connection to it causing the elevation, the last thing you need is to replace one medical problem with another. In the interim, exercise as much as possible and eat a healthful diet rich in fruits and vegetables. If questions still remain in your mind, request a referral for a second opinion.
To provide related information, I am sending you copies of my Health Reports “Osteoporosis” and “Diabetes Mellitus.” Other readers who would like copies should send a self-addressed stamped No. 10 envelope and a $2 check or money order for each report to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title(s) or print an order form off my website at www.AskDrGottMD.com.
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