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Q
Fortical to Build Bones?

What are your thoughts on Fortical for osteopenia? I am 52. I've had no side effects, but I want your opinion on it.

A
Answer (Published 2/2/2010)

Fortical is a drug intended for treatment of osteoporosis, the loss of bone mass resulting in porous, brittle bones that are easily fractured. Our bones are constantly being remodeled, with bone tissue being broken down and rebuilt on a regular basis. Bone density usually increases until about the age of 30, but after that, more bone may be broken down than is being rebuilt.

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I have no experience with Fortical, so I discussed your question with Victoria Maizes, M.D., executive director of the Arizona Center for Integrative Medicine. She noted that Fortical is calcitonin, a peptide hormone produced in the body by specialized cells in the thyroid gland and that it is not indicated for the prevention of osteoporosis - only for its treatment and, specifically, for treatment of patients following debilitating fractures.

She made the point that osteopenia is “not a disease but a marketing fad.” The term is used to indicate bone mineral density that is below normal levels but not low enough to be diagnosed as osteoporosis. Drug companies would like women to believe that osteopenia is the “precondition” leading to osteoporosis and hip fractures.

Here are my drug-free recommendations for strengthening bones:

  • Get enough vitamin D. I now suggest that adults supplement with 2,000 IU daily.
  • Get enough calcium. Choose high-quality, organic dairy products such as yogurt and cheese. Eat more sardines (with bones), dark green vegetables such as collard greens, bok choy and broccoli, whole soy products like tofu, and calcium-fortified soy milk and orange juice. I suggest that women supplement with 500 to 700 mg of calcium citrate in two divided doses taken with meals for a total of 1,000-1,200 mg from all sources (including diet).
  • Decrease your sodium intake. Avoid salty processed foods and fast food. Don't salt your food before tasting it.
  • Eat plenty of vegetables and fruit. Potassium, magnesium, vitamin C and beta carotene (found in fruits and vegetables) have been associated with higher total bone mass.
  • Limit caffeine intake.
  • Avoid alcohol or drink only in moderation.
  • Increase weight-bearing activities, such as walking, weight training and calisthenics. Try to do at least 30 minutes of exercise most days of the week.
  • Eat magnesium-rich foods daily. These include spinach, tofu, almonds, broccoli and lentils. Pumpkin seeds and sunflower seeds are also good sources of magnesium.
  • Eat vitamin K-rich foods daily. The best sources are leafy green vegetables (see the calcium-rich greens listed above), but most vegetables will give you vitamin K. Anyone with osteopenia should also consider supplementing with 50-100 mcg of vitamin K2.

Andrew Weil, M.D.

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