To Your Health

Useful tips on counteracting the side effects of Fosamex

Q. I've been taking Fosamax for osteoporosis for several years now without problems in my esophagus, but I'm having some other symptoms that really bother me, such as diminished short-term memory. Are there nutrients I could take to counteract these side effects?

A. With approximately three million women taking Fosamax, there are remarkably few reports of side effects. Other than new or worsening heartburn, most often these symptoms are something like mild nausea, abdominal cramps, flatulence, diarrhea, or constipation. More severe problems are seen, like eye problems, or generalized muscle, joint, and bone pain, but these are relatively rare. Fosamax is a powerful drug that works by killing certain cells in your bone called osteoclasts, which actually remove bone. But they work in conjunction with other cells known as osteoblasts to allow bone to be rebuilt. Without speculating on why there might be a connection, it has been observed that low bone mineral density in the elderly is associated with impaired verbal memory (American Journal of Epidemiology, Nov. 1, 2001, pp. 795-802).

If you have been taking Fosamax for several years, there may be explanations for memory loss other than Fosamax use. Often people entering their Fifties will start to report that their memories are slipping, but the good news is that such memory loss is normally reversible. Experts agree that the best way to keep your brain fit is to keep using it, by staying intellectually and socially engaged. Also, forgetfulness may simply indicate that you have too much on your mind, so slow down, avoid multitasking, and focus on the assignment at hand.

For most of us the greatest worry, when we realize our memory is not what it used to be, is that we have the beginnings of Alzheimer's disease. There is no definitive way to pinpoint Alzheimer's other than at autopsy, but there are some ways to distinguish normal memory loss from early Alzheimer's. There appear to be two basic types of memories: those that can be stated in words and those that cannot, such as how to ride a bicycle. It is mostly the first type that declines with age, while with Alzheimer's all memories gradually disappear. For instance, forgetting where you parked your car is not unusual but forgetting how to drive a car is serious. Or you may forget a person's name (and remember it later), but if you permanently forget you ever knew a particular person that you should know, this probably indicates that you need help.

For years researchers have searched for a correlation between vitamin B12 and folate levels and their relation with memory. Results are still controversial and there are recent observations that elevation of the toxic amino acid homocysteine, possibly resulting from deficiency of vitamin B12 and folate, may contribute to memory problems in addition to the contribution of these vitamin deficiencies to memory loss. Supplements of vitamin B12 and folate tend to aid the mental performance of frail elderly persons, either directly or by lowering homocysteine levels. Choline, a dietary component of many foods that is considered an essential nutrient by some people, functions in the same metabolic system as homocysteine and choline supplements may help those with impaired memory.

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