Osteoporosis Dx

<p>I just got the results of my first bone density scan (age 55) in the form of a letter from my doctor. I was shocked to read “osteopenia in the hip, osteoporosis in the spine.” Recommendations: weight-bearing exercise daily, calcium and vitamin D supplements 3 times a day.</p>

<p>I’m going to make an appointment to discuss this, because I have a large and growing list of questions: How bad is it? Can it be reversed at all? What dosage of calcium and Vit. D? Should I consider a prescription? What kind of exercise? (I can’t do regular long walks due to an unrelated ankle problem, so – weights? pilates? yoga?) What should I avoid? (I do toe-touches to stretch my hamstrings, which I’m reading is bad for my spine.)</p>

<p>I’m still trying to process this, but I’m interested to hear your experiences, what you’re doing, what works for you and what doesn’t, any reliable non-alarmist websites. Also anything I haven’t thought of to ask the doctor about. Thanks.</p>

<p>(And please no scary horror stories about what happened to 95-year-old Aunt Gertie. :slight_smile: )</p>

<p>I am surprised that the recommendation does not include medication. </p>

<p>My test results (four years ago, at 51) were osteopenia in both the hip and spine – which means that my bone loss in the hip is similar to yours and my bone loss in the spine is less than yours. And my situation is a lot like yours in that my ability to exercise is limited (due to an unrelated knee problem). In addition to calcium and vitamin D, I was immediately put on Fosamax after the doctor received the test results (which has given me no trouble whatsoever, despite the scare stories you will hear about side effects).</p>

<p>I think that medication should definitely be on the list of questions when you speak to your doctor. </p>

<p>As for calcium and vitamin D, I have never heard of anyone taking them 3 times a day. I think most people take a calcium-plus-vitamin-D supplement (probably 600 mg calcium plus the D) twice a day with meals. The “with meals” part is important because calcium is absorbed better when you take it with food. If your vitamin D levels are low, your doctor may also want you to take an additional vitamin D supplement, which you would also take with a meal. </p>

<p>Your test results are not a dire emergency, but you’re doing the right thing by following up on them and taking them seriously.</p>

<p>I am on my way out the door, but I started a thread a year or more ago about this. It might have had “Bone Density” in the title. I have been/am going through this, too. I relented and went back on Boniva (once a month) with no promise to do it long term. I actually had an osteoporosis diagnosis in spine (I think) along with the osteopenia in hip. I am thin, strong and a marathon runner. So much of it is genetic. They claim the Boniva can reverse some of it. We’ll see.<br>
I am in the camp that doesn’t worry too much about this. There is a lot of controversy about the whole thing. Small bones are NOT a plus in this case…</p>

<p>There was a report in the papers yesterday that said that calcium supplements increase risk of stroke and heart attack, perhaps by causing hardening of the arteries.</p>

<p>There are countless reports of problems with Fosamax, Actonel, Boniva and so on. If you do want to take them, you can do an injection every 3 months, once a year, or take pills daily,weekly, monthly…Look into what to do before dental work, because jaw bone necrosis has happened to a few w/dental work. They say that using these drugs for 5 years is safe, but they do change the quality of the bone, making the bone more brittle, so some are having femur breaks while on the drugs.</p>

<p>There is also a spray called calcitonin that I would ask about,. I can’t take it because I am allergic to salmon, but it would be my first choice. Another drug is Forteo, an injection, but it has a chance of causing bone cancer, and is reserved for more advanced cases.</p>

<p>In Europe, women are using strontium and vitamin K, but that form of strontium the ranelate form, is not available here. However, other forms are available. (One other thing, strontium increases the bone density reading on a scan, but it is a false reading in the sense that strontium is read as calcium/bone.)</p>

<p>If you are reluctant to do mainstream meds, you can see an integrative medicine doctor for this. Using soy, for instance, may be an option for helping a little, if not a lot. There are ways to affect hormones in gentle ways. You could consider bioidentical progesterone cream, or even estrogen preparations. Some say bioidential creams do not have the same side effects.</p>

<p>Some doctors say that balance is the most important thing, and avoiding falls. However, I am also careful with lifting, opening windows, hugging,that kind of thing. Do you have pain?</p>

<p>There are gentle exercises for osteoporosis. Find a targeted exercise book, class or yoga class, or even physical therapy to get you started.</p>

<p>Buy the book “The Myth of Osteoporosis.” It will make you feel better. The drug companies really have whipped up some hysteria, and the diagnosis and medication of osteopoenia is relatively new, the diagnosis and medication of osteoporosis also relatively recent in human history.</p>

<p>Take Vitamin D, 1000-2000 units/day, the higher amount in sunless months. Go in the sun for 15 minutes in the middle of the day if you can, instead of a supplement. Sun screen. combined with indoor jobs, is going to cause an epidemic of osteoporosis in coming years!</p>

<p>There are a lot of us out here with osteoporosis in our 50’s. I am not taking anything, frankly. There is not an option that I like. am consulting an MD about strontium, because right now, it makes me very nauseous.</p>

<p>p.s. there is no sense in taking 600mg calcium at a time: your body absorbs only 300-400 (sorry, I forget which; I take 300) at a time. The extra may actually cause you problems as described above, with no benefit. Magnesium and calcium compete, as does strontium, so separate any of those three by a couple of hours.</p>

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<p>I have the same DX. I took the Fosomax for about a year until I developed jaw bone issues…and was told to stop. This IS a side effect you need to be aware of. </p>

<p>I just had my second bone density and my doctor was thrilled…no change…not worse in anyway. Yay.</p>

<p>I’m suprised you didn’t get a phone call.
My doc called with the diagnosis and immediately prescribed Fosomex which I’ve been taking with no problems for over a year now.
BTW thumper1…are you taking any rx? I recently asked my doc if I would have to take Fosomex or something for the rest of my life and she said yes.</p>

<p>Ask your doctor to check your vitamin D level with a blood test. Many people are finding that they are very deficient especially if you use sunscreen or live in the northern states. I found that my vitamin D level was extremely low so I took prescription levels for 8 weeks before moving to over-the-counter daily supplements. </p>

<p>Pilates and light weight training can definitely help reverse the bone loss and would be a good way to start an exercise program.</p>

<p>I would definitely take this seriously and follow up regularly to make sure it is not worsening so your treatments can be adjusted.</p>

<p>My mother suffered from severe osteoporosis and it really debilitated her for the last few years of her life, with multiple spine fractures and a break near her hip. She had always been a thin, active woman, and the doctors didn’t really flag it with her like they should have and she didn’t know enough to be more proactive about it until it was too late.</p>

<p>Good luck-</p>

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<p>Both my doctor and dentist told me to STOP taking this drug. With regards to “taking it the rest of my life”…my doctors said that there is concern with taking it for over five years. I had been taking it for two. Believe me…the pain I was having was not worth it…I couldn’t eat.</p>

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<p>While I do not have bone issues (I do some fairly impressive weight lifting with a trainer), I have been a new convert of integrative medicine in the less than the past month. I have a good friend, who is a P.A. in Texas who I spent some time with, who just practices integrative medicine now (was trained conventionally). She convinced me to find someone who practices it in my area (I have some gyne symptoms that needed follow up). When I went to my gyne, it ends up that, since I last saw her a year ago, she has also become a convert of bioidentical hormones. She went so far as to tell me that she feels like a fraud for having prescribed Fosomax for so many women because it’s so bad for you (it builds bone in the pelvis area, but actually weakens bones in the thigh area). Luckily, as I mentioned, I do not have bone issues, but she was so adamant about the Fosomax (just mentioning it to me as an example). </p>

<p>My gyne actually went to NYC to train with Dr. Erika Schwartz, who mentored Christiane Northrup (who has written many books about women’s health). Dr. Schwartz is considered the sort of pioneer of much of today’s current practices with bioidentical hormones. Then I found out my P.A. friend in Texas sees all of Northrup’s ‘entourage’ who live in her area and want to follow her recommendations. She totally agrees with what my gyne is recommending for me (remember, they were both trained conventionally), so I feel like I’ve sort of gotten a second opinion on this stuff.</p>

<p>Thanks thumper1
I don’t like the idea of taking this long term although I don’t any problems.
I was pretty suprised to find out I had osteoporosis as I had been taking calcium supplements for many years (1200mg daily) and have always eaten dairy products daily.
They say it’s hereditary and my mom (who died in 2005) was never diagnosed with it.</p>

<p>I am taking an injection of Prolia twice a year. I also take calcium w/ Vit D twice a day. I was on once a month Acetonal but found it to be a PITA. I have had no side effects from either (yet.)</p>

<p>Be sure to ask the doc to check your blood calcium and PTH levels. A tumor on the parathyroid gland will prevent calcium absorption, and can be fairly easily removed. I found mine when my first bone density test came back with bad results. Now I’m in the process of trying to reverse the trend.</p>

<p>I’m proof that osteoporosis can be reversed. In my case, the “secret” – not a secret, but I guess the “cure” – is to lift heavy things over my head. I’ve been doing this very seriously for almost six years now, and my bone density tests just keep getting better and better. (I have another one this coming Monday. Fingers crossed.) Naturally, one can’t start out lifting heavy things overhead; you need to start with relatively light weights and ease into it. I started with three and five pound weights almost six years ago and I now routinely lift 25 and 35 pound barbells. It’s hard to do, but that’s the point: You need to stress your muscles and your bones, and then new bone will form. </p>

<p>I also take 600 mg of calcium twice a day, and 600 mg of Vit D twice a day. I took Actonel for nine years but have been off it for a year and a half now. I also use an estrogen patch, because I am at such high-risk for osteoporosis (family history and small stature).</p>

<p>This is my most signficant health risk, so I work really hard at keeping it at bay. Good luck.</p>

<p>Just FYI…I am not handing out medical advice!!! BUT whenever you are prescribed medications, it is MY OPINION you should inquire about side effects and long term use. And find out what happens if you start the medication and need to discontinue it due to side effects. Just good consumer practice.</p>

<p>I was diagnosed about 1 & 1/2 years ago.
No meds. I am 53- premenopausal. ( my maternal grandmother didn’t have it- died at 85, my mother may have had a little touch,undiagnosed, died at 75- so mine is an aberration- but it reminds me- I am petite- but not unusually so- my oldest bikes, which isn’t weight bearing and she has * teeny, tiny* hand & feet, so she is at risk more than her sister who is 7" taller & runs)
I take vitamin D3 , but my arthritis & fibromyalgia interfere with doing as much weight bearing exercise as I would like. ( also- double jointed which increased risk of arthritis)
The only meds I am on, is something for pain/fibro that I take at night about 1/2 the time, because otherwise I would never sleep.</p>

<p>I work all the time in my yard, took out all my sod by myself & replanted with trees/shrubs so outside most days about 5 hrs since if I am not home I am teaching workshops or volunteering in restoration.
Active, non menopausal- but still the osteo.
:stuck_out_tongue:
Still I have never broken anything-knock on wood. That actually kind of scares me, cause I am a klutz ( I have poor depth perception & am always tripping on things)</p>

<p>Im thinking of trying out crossfit there is a gym by my house & it sounds kinda fun.</p>

<p>What a timely thread, as I just had a repeat DEXA and found out that I have osteoporosis in my wrist (T-2.7), mild osteopenia in my hip (T-1.1; unchanged from 2 years ago) and a normal spine. I have been taking Vit D and tums for 2 years now, and I know my Vit D reading is finally in the low end of normal (2000 IU daily), but I guess this isn’t enough. My doctor suggested I consider Fosamax, but she would hold off for now (maybe in 2 years). From what I have read, in addition to the bad side effects, Fosamax might increase bone density but there is no decrease in the numbers of fractures in women who are treated with it, so I’m not quite sure what the point would be.</p>

<p>Complicating this is the fact that my treatment for thyroid cancer is to keep me in a hyperthyroid state, which has osteoporosis as a side effect. So I will be calling my endocrinologist, in another state, to discuss lowering my dosage of thyroid hormone.</p>

<p>What form does everyone take their calcium in?</p>

<p>Martha, I take the calcium pill with D in it. 600mg 2x day.</p>

<p>Calcium/magnesium/vitamin D3/vitamin K2 are all interrelated when it comes to your bones, possibly along with boron. </p>

<p>My doctor has told me that many people are deficient in magnesium, and it can be hard to get enough K2 without supplements (your body can convert K1 into K2, but it is inefficient).</p>

<p>I’ve seen it argued (sorry don’t have the link any more) that if your Mg/D3/K2 are optimal, Ca supplementation is not needed, you will get enough from your diet.</p>

<p>I would urge everyone to get their vitamin D levels checked, especially if you live in the north. 1000-2000 IU is not enough for many if not most people to get to an optimal level.</p>

<p>If you look at supplements like AOR Bone Basics or Jarrow Bone-up you can see what ingredients the more advanced makers are combining. AOR in particular has some interesting verbiage around their sups: [url=&lt;a href=“http://www.aor.ca/html/products.php?id=35]Vitamin”&gt;http://www.aor.ca/html/products.php?id=35]Vitamin</a> supplements and health products list at AOR.ca<a href=“click%20on%20the%20Research%20tab”>/url</a>.</p>

<p>@LasMa</p>

<p>I received my MD from Drexel University School of Medicine in Philadelphia and did my residency training in Nuclear Medicine at the UC Davis Medical Center in Sacramento and for the past seven years have been in private practice in Elk Grove, CA and specialize in osteoporosis.</p>

<p>A diagnosis of osteoporosis is given to anyone with a T-score of -2.5 or lower in a central site such as the lumbar spine and both hips. That means that bone mineral density is 2.5 or more standard deviations below the average for a 20 year old woman who should be at her peak bone mineral density (BMD). A T-score of higher than -2.5 but lower than -1.0 is considered to be osteopenia. A T-score of -1.0 or higher is considered to be in the normal range. Knowing your T-scores for your spine and each hip can give you an idea of how advanced your disease is. It is also useful to have a vertebral fracture assessment which checks your spine for possible compression fractures.</p>

<p>Women usually reach their peak BMD at about age 20 and it remains fairly stable until they enter menopause. The decline in estrogen production that characterizes menopause usually causes a loss in BMD since estrogen inhibits the activity of osteoclasts which are cells that break down bone. During the first 5 to 7 years after menopause women experience their most rapid decrease in BMD and can develop osteopenia or osteoporosis.</p>

<p>Certain medications can also cause a loss in BMD, particularly steroids such as prednisone, anti-coagulants such as coumadin and anti-seizure medications like dilantin.</p>

<p>Normally, when the T-score drops below -2.5 in any central site and a diagnosis of osteoporosis is made, the disease is considered to be too advanced to treat with just calcium and exercise alone. Usually the patient will be prescribed a Bisphosphonate which is a class of drugs that includes Fosamax, Boniva and Actonel. For patients who have fractures in addition to low BMD the anabolic agent Forteo may be prescribed for a period of up to two years. Other drugs used to treat osteoporosis include the Selective Estrogen Reuptake Moderator Evista and calcitonin taken as a nasal spray.</p>

<p>I have seen many cases where these medications not only stop bone loss but also reverse it and result in increased BMD. However, bone mineral density changes slowly even with a good response to treatment and going from osteoporosis to normal will take years of therapy.</p>

<p>Preventing falls is very important. Usually the most severe complication of osteoporosis occurs when a patient falls and suffers a hip fracture which is always life altering and too often, life ending.</p>