<p>OK- The great distance runner here (moi) just got diagnosed with Osteoporosis based on the latest bone density test. My hips (osteopenic) improved somewhat since the last test (2 years ago) but my spine is worse. T-score on spine is -2.8 and hip -1.3 and femoral Neck -2.2. I am being referred to an endocrinologist.</p>
<p>About 4 years ago I took Boniva, but stopped it when it allegedly interfered with the healing of the knee fracture from a skiing accident. (There is a reason for this, but don’t get me to trying to explain it.) I did about 6 months of Forteo injections, which are expensive and, well, involve needles. Not to mention the Forteo has to travel around with an ice pack if you go anywhere. So, since I am “special” and all this can’t possibly relate to MY life since I am a competitive distance runner, I decided I was fine. It appears that I am not. (Yes, family history, but it’s a little hard to translate because mother had polio and has been non-weight bearing for years.)</p>
<p>I am good about my Vit D but haven’t been good about calcium supplements. I drink about 2 Diet Colas a day. Pretty good about dairy.</p>
<p>I am wondering about treatment experience out there in wise CC land. I know a little about the options and haven’t liked what I hear about any of them. Seems like you can fix your bones, but then you have a breast cancer or stroke risk. I am not one of these people who refuses all medication, but I do worry about side effects and it seems like stuff always affects my running in some way.</p>
<p>If it were me, I’d stop drinking Diet Coke:</p>
<p>[Cola</a> Raises Osteoporosis Risk For Women Regardless Of Calcium Intake And Age](<a href=“http://www.medicalnewstoday.com/articles/53642.php]Cola”>Cola Raises Osteoporosis Risk For Women Regardless Of Calcium Intake And Age)</p>
<p>I know- I did that at one point but decided I could counteract it with all my running. I suspect I will have to give it up (all Cola drinks) but don’t think that is going to be enough.</p>
<p>I am on the biphosphonate Actonel for osteopenia diagnosed in 2007 after I underwent intensive chemotherapy plus follow-up medication (tamoxifen, aromatase inhibitor) for aggressive breast cancer that had spread to my lymph nodes. The osteopenia may have been caused by the cancer medicine or may have been pre-existent, as I was too young at the time of diagnosis to have received a routine DEXA scan. I have a small frame (5’ 6," 120 lbs) and like you had hoped to keep bone problems at bay with lots of weight-bearing exercise.</p>
<p>Since getting on Actonel, my “numbers” haven’t improved but they haven’t gotten worse either. I also take daily calcium and magnesium supplements and try to eat a lot of yogurt etc. An endocrinologist sees me every 6 months. She has told me that if things start going downhill I will have to be put on Forteo.</p>
<p>I can’t imagine that Actonel makes a person more prone to breast cancer, because in that case it wouldn’t have been prescribed for me. Some people though take estrogen supplements to protect their bones, which is out of the question in my case.</p>
<p>I think it is the HRT (hormone replacement) that has the cancer risk. The Actonel (same class as Boniva???) has a problem with the jaw fractures and non-healing of other bone fractures.</p>
<p>My sis is taking Evista for osteopenia and her bones are much better now. She is very active, 5"2", good weight. Evista carries risks and protections. She has been eating organic and taking vitamins for years. So much is inherited.</p>
<p>I am much taller, had great bones until I went on Arimidex due to breast cancer which has in two years taken my bones to osteopenia. I will start zometa, twice a year to counteract what has happened to my bones. It carries jaw risk. I have two more years on Arimidex and will do this infusion for two years. I eat organic, take my vitamins and walk daily. My BMI is good.</p>
<p>Remember calcium is in the veggies more than the dairy. I have been retrained in my diet by going to a dietician for a year. You have to mix and match foods, go for a plate of vegetables and have lots of variety. I think variety is key and not getting stuck in a rut of the same old thing. I don’t eat processed foods, grow herbs to add flavor and eat mostly home cooking or homemade foods.</p>
<p>I gave up colas four years ago. They are harmful. I loved my daily diet coke. Don’t miss it at all now.</p>
<p>Best wishes for making the best decision for your own situation. It can be tough.</p>
<p>Listen to this. It was an eye opener for me
[How</a> A Bone Disease Grew To Fit The Prescription : NPR](<a href=“http://www.npr.org/templates/story/story.php?storyId=121609815]How”>How A Bone Disease Grew To Fit The Prescription : NPR)</p>
<p>My wife just started Forteo- can you comment on your experience with it. Thanks.</p>
<p>Interesting article, Kelowna. I was very comfortable refusing drugs for osteopenia, but I have more doubts now that I have moved to the osteoporosis range.</p>
<p>Tom- My experience with Forteo was pretty good, although I didn’t get re-tested after the 6 months. I found the needles pretty bearable (and I HATE needles). It requires a lot of discipline, though and you can’t forget the injection. As I said, my orthopedist felt that the Boniva possibly interfered with the proper healing of a tibial plateau fracture that I got from a skiing fall. I wound up having surgery to repair the fracture, after a lot of non-weight bearing weeks. He thought Forteo would be a good idea. The insurance company balked, but I DID get it covered (except for a big co-pay every month). The video (which you have probably seen) that explains how to do the injections is hilarious and made me feel 100 years old. Forteo is NOT aimed at 55 year olds, it turned out. My understanding is that you can only take it for a year (maybe 2 years now) and that it is the best drug on the market for improving bone density. I suspect I will be seeing it again as I age.</p>
<p>My wife had been on prednisone for many years as well as various other drugs. She has been diagnosed with severe osteoporosis and the plan is to use Forteo for up to two years. I believe that is the outer limit of use that the drug has been approved. My wife is very frail- about 100 lbs-5’3 or so and was a runner in college. She has battled her illness (multi-connective tissue disease) since graduate school and will now battle the side effects of the various medications she has had to take over the years. I have heard that Forteo has provided positive results- the needles are not a problem since she is use to all kinds of injections.</p>
<p>Speak to your endocrinologist about Reclast. It is a once per year drug that is administered over about 15 minutes of IV in the doctor’s office.</p>
<p>Evista, like any HRT, carries a risk of developing blood clots.</p>
<p>Forteo cannot be used by anyone who is prone to kidney stones.</p>
<p>Tom, I hope the forteo works out. I really do think it is a good drug.
twinmom- Thanks. I’ll ask about that, although I hate IVs. (God knows how I managed to get a tattoo)</p>
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<p>Yes. </p>
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<p>Yes, the jaw problems have been reported with bisphosphonates but it is very rare. Jaw problems are a remote possibility, but fractures and other osteoporotic symptoms (such as “widow’s hump”) are a very real possibility with a -2.8 sd spinal reading.</p>
<p>^^ BUT- the healing problem with fractures is also a real possibility and happened with ME! There is something about it interfering with regenerative bone growth even though it helps “new” growth (I could have this backwards).
So the issue is sort of “it helps prevent you from breaking something, but it you do, it might not heal properly”. As a runner who also tends to hit the pavement knee, hand or face first on occasion, this concerns me.</p>
<p>MOWC, I know you are a distance runner, and that has undoubtedly helped you considerably. I’m sure your numbers would be much worse if not for all your running. But IMHO (and I’m no doctor – just a very petite person with a terrible family history of osteoporosis who has reversed hers), you need to do several things:</p>
<ol>
<li>Take the Actonel. I took it for nine years and am now on a “holiday” from it (which they recommend every five years)</li>
<li>Lift weights. While running is good, lifting heavy things over your head is good for your entire skeleton, especially the spine. Work with a trainer at the beginning and don’t be afraid to increase the weights as your muscles get stronger.</li>
<li>Take around 1500 mg of calcium every day – in divided doses – as well as ~1200 of Vitimin D. </li>
</ol>
<p>I wouldn’t worry about the two cans of Diet Coke – if you’re doing everything else right, it shouldn’t have that much of an influence.</p>
<p>I have a cousin (same body type as me – tiny) who did Forteo for two years and it signficantly improved her numbers. She thought the daily injection was a non-issue, since the needle was so tiny.</p>
<p>Edit: It is NOT a fact that the Boniva affected your knee’s healing – just your doctor’s theory. Ask other doctors.</p>
<p>And another edit: I also use an estrogen patch. I recognize there’s a small (VERY small) increase in the risk of breast cancer, but my risk of breaking a hip is much much higher than my risk of breast cancer – so I’m willing to use the patch. It’s not for everyone.</p>
<p>Thanks. I do lift weights and do pushups.
I’ll see what the doctor thinks is the best treatment option. I have other objections to the Forteo (for me) besides the needle (which I did survive before). It is very expensive and it might be something I do in later years. Traveling with Forteo is a pain in the butt due to the need to keep it refrigerated. Travel is enough of a pain these days without ice packs and needles on the plane.
The estrogen patch might be an option, but I do have a family history of breast cancer, too.</p>
<p>If you like seafood then buy the little cans of wild red sockeye salmon at Trader Joe’s. I have them a couple of times a week. The salmon is pressure cooked and the bones are totally soft and part of the meat so you actually ingest the salmon bones. Sounds icky but actually delicious in a salad (if you like seafood). Great source of calcium.</p>
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<p>The women in the study were drinking as little as four servings of cola per week. The study found that women who drank at least one serving of cola per day had a bone mineral density that was 5% lower than women who rarely drank cola.</p>
<p>MOWC, can you substitute some other drink for the diet cola? Iced tea, maybe?</p>
<p>[Women</a> warned to stop drinking cola to avoid brittle bones | Mail Online](<a href=“Women warned to stop drinking cola to avoid brittle bones | Daily Mail Online”>Women warned to stop drinking cola to avoid brittle bones | Daily Mail Online)</p>
<p>So glad I found this thread, as this issue is #1 for me right now. I completely understand your problem with the bisphosphonates, MOWC. I’ve been researching as much as I can because my oncologist (prior BC) wants me to go on them for osteo. My spine is -27 and hip is -28, and I’m also on an aromatase inhibitor. Last July I had hyperparathyroid surgery due to a tumor on my parathyroid that likely contributed to my abnormal bone loss. According to the surgeon, my bone density should naturally improve over the next 10 years now that the parathyroid isn’t draining the calcium from my bones any longer. I really wanted to wait and see if I could improve my bones naturally at this point- exercise, eating a very strict low acid and high mineral diet, and taking a high quality bone supplement.<br>
My doc insisted that if my next Dexa scan shows any more loss, that I go on intravenous Boniva. (I tried taking the oral two years ago, and it made me ill)
I’m very worried about the jaw issue, and also the way that these drugs work. The do stop not only the resorption, but also the growth after a period of time because the growth is stimulated by the resorption. So the drug just piles the calcium over old bone- which is why they can become brittle after many years.</p>
<p>I’ve been reading everything I can about the issue- Susan Otts website is very informative. She is basically not in favor of these drugs except in the more severe cases. She’d probably consider me pretty severe, especially because I’ll need to continue my aromatase inhibitor for another 2 years. She does recommend that her patients stop taking the drug after 5 years. Most of the problems (broken femurs, jaw problems) occur after women have been on the drug for a longer period. ) Statistics show no increase in fracture for women who stopped taking the drug after five years vs those who stayed on it beyond 5 years. Same fracture risk.
I’m still really nervous, though. The one thing that tips me toward taking the drug is that studies have been done that show 30-50% lowered risk for breast cancer recurrence to the bone for those who have previously had BC. Apparenlty the drug makes the bones a pretty inhospitable place for the cancer to survive.</p>
<p>The one thing I’ve come to understand about this disease is that diet plays a huge role in the health of our bones- as much or more than exercise. It’s not just calcium and minerals that are important, but the condition of our entire system. People who have a highly acidic system lose more bone.
A diet heavy with foods like cola, sugar, white breads and pasta, and meat (all the obvious stuff) can, over time, cause our body to buffer the blood acidity with the calcium from our bones in order to maintain the PH balance that is necessary for life.
The right diet for bones is the green leafy one. You get the minerals, and the alkalizing with vegetables. The recommendation is 4-1: four alkaline foods to one acid food. </p>
<p>I really hope my Dexa isn’t worse in the next couple of months. Even if it holds, I may try to postpone the Boniva. Except then the BC cancer to the bone prevention stats haunt me. Ugh. It’s a dilemma.</p>
<p>Another thing: if you are taking calcium supplements you may want to read the label and make sure you are getting calcium citrate. Calcium carbonate is more common (and cheaper) in supplements, but it can also be constipating.</p>