DEAR DR. DONOHUE: Your column on osteoporosis medicine (Boniva) makes me think you are not on top of this subject. I have taken Boniva for a year. Last week I went to an oral surgeon to have two wisdom teeth extracted. He wanted me to sign papers that warned of possibly severe complications from Boniva. I chose not to have the teeth extracted. This is scary stuff. I asked if I stopped the medicine for three or four months if I could have the teeth pulled, but he said no. He said the drug can stay in the body for 12 years. More scary stuff. You should set your readers straight on the bisphosphonate treatment. – P.S.

ANSWER: Bisphosphonates – Fosamax (alendronate), Boniva (ibandronate), Actonel (risedronate) and the newer Zometa or Reclast (zoledronic acid) – are effective medicines for treating osteoporosis. The worst complication that might develop from their use is jaw osteonecrosis, the death of a part of the jawbone – not the whole jaw but a section, and usually occurring after dental extraction. This complication happens mostly to people who take these drugs in high doses intravenously for the treatment of cancer that has spread to the bone. It is a rare side effect for those taking the drugs for osteoporosis.

A balance has to be struck between the good these drugs do and the possible bad they can do. Osteoporosis can be an incapacitating and painful condition. It leads to broken hips and broken backbones. The complications of osteoporosis are common; the complications of osteoporosis drugs are rare.

If a person feels that these drugs are not worth the small danger that comes with their use, then there are other medicines for osteoporosis. Forteo is an example. It’s a self-injection drug, but the injection is not painful. It amounts to the same kind of shot that insulin-dependent diabetics take every day. And there are calcium and vitamin D; both can strengthen osteoporotic bones. Weight-bearing exercise is another excellent osteoporosis prevention and treatment.

As for the time it takes for the body to rid itself of these medicines, no one can say for sure. Twelve years is only an estimate.

DEAR DR. DONOHUE: I have osteoporosis. I take Fosamax that has vitamin D. I also take a vitamin pill with vitamin D and a calcium pill with vitamin D. Can a person overdose on vitamin D? What is a safe, daily intake of it? – M.S.

ANSWER: It’s possible to overdose on anything, including water. To overdose on vitamin D, you have to work hard to exceed the safe daily upper limit, which is 2,000 IU a day.

The recommended daily amounts of vitamin D are: 200 IU for adults between the ages of 19 and 50; 400 IU for those between 51 and 70; and 600 IU for those older than 70.

Many experts believe the daily dose should be in the neighborhood of 800 IU to 1,000 IU.

DEAR DR. DONOHUE: At 90, I am in pretty good shape except for achy-breaky knees. My doctor gives me a yearly checkup with an echocardiogram, a carotid artery test and a stress test.

Last year’s stress test left me a little off balance for an hour or so. I think I should quit it. What do you suggest? – G.C.

ANSWER: Unless the doctor has a reason for a yearly stress test that he hasn’t told you, I agree with you. A yearly stress test sounds a bit much.

DEAR DR. DONOHUE: Having moved south, I pay more attention to sun protection. I make sure that my cosmetics and daily moisturizers have at least an SPF of 15. Is there a difference between a moisturizing cream with an SPF of 14 and a suntan lotion that says SPF 15? – J.R.

ANSWER: The sun protection agent in moisturizing cream should be the same as in suntan lotion. SPF – sun protection factor – for both means the same.

I don’t know how often you use the moisturizer. Suntan lotions are reapplied frequently during the day.

DEAR DR. DONOHUE: You wrote about a vocal-cord dysfunction that mimicked asthma. I have a teenage daughter who suffers from what we thought was exercise-induced asthma. She does not respond to asthma medicine. Recently, during a theatrical production, her throat constricted, and she began wheezing. This brought to mind what you had written. What sort of specialist takes care of this problem? – J.C.

ANSWER: One giveaway for vocal-cord dysfunction is asthma symptoms that don’t respond to asthma medicine. The vocal cords open upon inhaling to allow air passage into the lungs. In people with this condition, the cords don’t open fully. There’s only a small passage that allows air to get into the lungs. The symptoms are much like asthma — wheezing, chest tightness, cough and breathlessness. You make a good case that your daughter has vocal-cord dysfunction.

A doctor can make the diagnosis by visualizing the closed vocal cords with a scope.

Ear, nose and throat doctors (otorhinolaryngologists), lung doctors (pulmonologists) and allergists are the specialists most experienced with this problem.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com