Does cow’s milk make weak bones?

Dear Dr. Roach: I read that cow’s milk weakens the bones. Is that true? — A.H.

The preponderance of the evidence is that dairy intake increases bone strength and reduces fracture risk. However, there is not the highest level of evidence to support this. In absence of interventional data (where one group is given cow’s milk and the other given something else), we have to rely on other kinds of evidence, all of which have some potential for bias. Some of these have shown benefit from drinking cow’s milk; others have not. A 2018 study from the U.S. estimated a 6 to 8 percent reduction in fracture risk from consuming cheese or milk daily. Regular exercise is another way to reduce risk of osteoporosis and fractures. Unfortunately, some people will still be at risk for fractures despite an excellent diet and regular exercise, so those at high risk should be screened, and may require medication. You can reduce your chances of needing medication through a good lifestyle, preferably beginning in young adulthood.

Dear Dr. Roach: I am an 89-year-old widow trying to stay in my home. Six months ago, I had a bad fall. A neurologist said I had two or three aneurysms in my head but treatment might cause more harm than good. Now home, my primary doctor is trying to help my anxiety. He gave me Zoloft but I got depressed. He wants to try Effexor, but the instruction sheet mentioned that bleeding might occur. — J.M.G.

Venlafaxine (Effexor) has been shown to increase the risk of bleeding, with only a slight risk for most people. However, bleeding from a brain aneurism is very dangerous, so I think I would avoid that particular drug. There are alternatives that don’t have that risk. Even if the risk is slight, worrying about a drug’s possible side effects isn’t going to make your anxiety better.