After Your Operation

Should I take Fosamax or Boniva?


This is another really good question and the right answer depends on how bad your bones are and how much osteoporosis you have. We know that if you have hyperparathyroidism then these drugs don’t help. Said differently, if you have been taking these drugs when your calcium was over 10.0 mg/dl (2.5 mmol/l) then the drugs probably didn’t do a thing. The PTH is far too powerful and it overcomes any good these drugs can do (including Boniva, Prolia, Fosamax, Actonel, Zometta, etc).

Another factor to remember is that several good studies have shown that the average patient gains significant bone density for several years after parathyroid surgery, and the bones get better just by taking calcium and a multi-vitamin. There have never been any studies that show taking one of these “osteoporosis medicines” will increase bone density in parathyroid patients or increase the rate of improvement after parathyroid surgery. This doesn’t mean they won’t help, it just means it hasn’t been proven scientifically.

The bottom line is that this is a decision for you and your doctors back home to make. Some of you will have excellent endocrinologists and they will want to work with you on this long-term. We are not a big fan of these drugs, unless you have pretty significant osteoporosis. Otherwise, we like to suggest that you wait a year or two and see how much progress you are making now that the parathyroid tumor is gone. If your bones are getting better without these drugs, then that is what we would recommend. Again, ask your doctor for advice here too.