Men with particular risk factors are recommended for DXA earlier than age 70. A DXA is recommended for all men age 70 or older, regardless of risk factors.
Height loss of 1.5"or greater is not part of the normal aging process. It can be an indication of compression fractures.
There are no symptoms of osteoporosis until you fracture. That's why it's important to recognize the risk factors you may have. There are standardized criteria for taking a medication for your bones. They are: a T-score of -2.5 or lower, history of vertebral or hip fracture, history of glucocorticosteroid treatment, a FRAX score of >than 20% for any fracture or 3% for hip fracture; a T-score indicating osteopenia along with the presence of another risk factor, such as failing the single stance test.
I'm attaching a link from the NOF on men's bone health. It should give you more information.
Do the Reclast. You have waaay too many risks going on. Do you know half of the people who have an osteoporotic hip fracture will die within one year of that fracture? And you worry about the Reclast????
Take your calcium. It also helps with GERD. If you don't do the calcium, no need to take any osteo med because it won't be effective.
Order the booklet "Boning Up on Osteoporosis" from the NOF (www.nof.org ) It will illustrate movements to make and not make. We use it as a teaching tool in our rehab classes.
Why did you have a DXA initially? That would be key to your bone health.
A man does not get a diagnosis until age 50. Women after menopause. So we look at your Z-scores instead of T-scores.
A 1.2% loss is considered stable on most machines. It's very important that your testing place calculate their LSC or Lowest Significant Change. That is basically a margin of error. Any result which falls within this LSC is considered stable. An increase or decrease in bone density outside of the LSC is considered change.
Why did you have a DXA after only one year? Are you on prednisone or have other health issues that would contribute to bone loss?
It is extremely rare for a man younger than 50 (or even in the 50's) to be tested in the first place and even rarer to have a subsequent test a year later unless something else is going on.
Your calcium blood level is not indicative of the calcium your bones are absorbing. That's because the body will take calcium from the bones to make sure there is enough in the blood to meet the body's needs.
You need to consume 1000 mg of calcium each day. Spread it out throughout the day as the body won't absorb more than 500 or 600 mg at a time. You also need 1000 IU of Vit D each day. The best way to assure that you're getting this is to take a calcium supplement with D. Take it at lunch and supper. Read the label carefully to determine if a full dose (600 mg) is one tablet or two.View Thread
Your body can only absorb 500-600 mg of calcium at a time. Anything more than that would be excreted in the urine. If you were taking in more than that amount in at one time, it's possible that's what was showing up in your urine test. If your other tests results were normal, I wouldn't be too concerned about it.
The early menopause and lack of HRT are huge contributors to bone loss. It also could be that you never built up your bone mass to its fullest potential, thus when you went through menopause, you rapidly loss from what you had.
The Evista is a good drug.
You need 1200 mg of calcium a day. Spread it out throughout the day. If you feel you get enough in your diet (few people do consistently) you can track your amounts by reading the food labels for one serving. If it's shown in a %, drop the % and add a zero to give you the mg. Ex: 25% = 250 mg.
If you aren't getting 1200 mg each day, take a supplement. They are best absorbed with food. If you don't get the calcium, the medicine won't work. You also need 1000 IU of Vit D. That sends the calcium to the bones.
If you have a history of calcium stones, you might want to talk with your doctor about it. All kidney stones are not calcium stones. If you don't have a history, it's not something to worry about.
What you do need to worry about is a compression fracture. Starting today, do not do any forward bending from the waist or twisting of the spine. These cause the tiny struts in the vertebrae (the honeycomb bone) to break. You don't feel this. When the last one within a vertebra breaks, the spine collapses. This is a compression fracture, and you sure do feel that!
Look online at the National Osteoporosis Foundation website for a lot of valuable viable information. www.nof.org They also offer a booklet in their store that we use in our osteoporosis rehab classes. It's called Boning Up on Osteoporosis and costs $5. It has everything you ever needed to know about osteoporosis, including illustrations of movements to avoid.
In two years, have a repeat DXA at the same place you had this one. If your bone density has not decreased significantly (usually more than 3% - depends on your testing center's precision study results) your Evista is working. Don't sweat it it if it doens't show an increase. The goal is not to get worse. If your bone density is significantly lower, I'd talk to the doctor about a different medicine. Don't be tested sooner than two years because your won't get an accurate picture of how the medicine is doing. Bone is very slow to respond to change. Give it time.View Thread
Have you gone through menopause? Your scores are pretty low and if you haven't gone through menopause, you can expect them to get lower. Your doctor is right that you need to do something now to halt this progress.
The good news is that, being as young as you are, the low T-scores in themselves, are not as critical as they would be in an older person.
Have you had a fracture as an adult? Do you take steroids on a regular basis? Do you have a family history of hip fracture or osteoporosis? Those factors would raise your risk of fracture.
I think with the GERD, your best option would be in the form of an IV infusion (Reclast) or injection (Boniva).
While I understand your fears, I can tell you any reaction or side effect you might have would be far less serious than having a hip or vertebral fracture. Don't let fear get in the way of treatment.
As for natural methods...well, there's been a lot of posting on this sight in the past about that as well as verified medical data. Bottom line is - there is NO natural way to reverse bone loss. None. By trying something "natural" you're wasting good time in which you could be doing something for your bones that's been proven to help. The USA practices Evidence Based Medicine. That means that they don't endorse any methods that have not been thoroughly tested and put through very structured clinical trials. Sure, there are side effects with medications. There are side effects with natural stuff too. Ever seen anybody with a peanut allergy?? or a broken rib from receiving CPR? Lots of medicines have side effects (Prednisone for one is horrible) but they save lives. You need to weigh your risk for a life altering fracture against the possibility of an unknown side effect.
If you don't want to do the Boniva or Reclast (which my 89 year old mother does and my 54 year old brother - with no side effects) there's Evista. Evista is basically a synthetic estrogen. It has no effect on breast tissue and is given to breast cancer patients. At your age, it might just work very well for you.
No matter what you decide, you need to consume 1200 mg of calcium, taken in no more than 600 mg consumption at a time. The body won't absorb more than that at a time. You need to work on your Vit D.
Also DO NOT do any forward bending at the waist. Bend from the hips, keeping the spine straight or do the golfer's stance. Watch how they pick up golf balls. No abs, crunches or Pilates. Also no twisting of the spine. These movements can cause tiny fractures within the vertebrae which can lead to a compression fracture - all with NO pain until the spine collapses. By that time, it'll be too late to take a medication that could have prevented it.
Go online at the National Osteoporosis Foundation website (www.nof.org ) for a lot more information. This is the gold standard site for everything osteoporosis. There's in-depth information about all the meds available as well as body mechanics.View Thread
What are your T-scores? Have you fractured before? Do you have a parent who had a hip fracture?
The fall you had from your bicycle is considered a violent fracture. That means anybody who had such a fall could have fractured. You low bone density probably made the fractures worse - or maybe not.
The Synthroid is for HYPOthyroidism. Not terribly risky. However, if you truly have HYPERthyroidism, that is a greater risk for bone loss.
If you were stable on Reclast, I'd stick with it. Keep in mind though that I'm not a doctor, nor do I know your health history. Reclast slows down the rate at which your body absorbs old bone cells, thereby giving the body time to make new ones. In this way it keeps you stable and can increase bone density.
The Forteo is the only drug that actually grows new bone. It is given to the frailest of the frail. If it is determined that you would benefit from this, I wouldn't worry about the bone cancer. It was only shown to appear in rats and then in only a few - bearing in mind that rats are not human and we can't always connect what happens to them as what will happen to a human.
Prolia is not really a possibility. It is to be given only after all other options have failed. Doesn't sound to me like your Reclast failed.
Are you consuming 1200mg of calcium a day, along with at least 1000 IU of Vit D? Without these, no medication you take will work effectively.
If I were you, I'd do the Reclast for two years, be retested and see how you are. Should you fracture again, do the Forteo. That's just my opinion as an osteoporosis professional who's worked in this area for 18 years.View Thread
Age is not the only determining factor in getting a DXA. We often do women your age and younger, if...1) they are on a high risk medication such as prednisone; 2) they have gone through menopause, 3) they have a low score on a heel screening test, 4) they've had a fracture.
Osteoporosis can happen quickly and with no symptoms. That's why it's called the silent disease. You can lose up to 20% of your accumulated bone mass during the 5 years leading into and through menopause. If you take hormone therapy, that helps to retain your bone mass.
Also, it's possible that you during your bone forming years (up to age 30 or so) you didn't consume enough calcium, vitamin D or get enough weight bearing exercise to reach your full potential of bone mass. If you never got that, once you start to go through menopause, your body can quickly use up what you have.
Consuming calcium is crucial, but is not the only factor. You need 1200 mg each day. The body will only asborb 500-600 at a time, so you need to spread it out over a few hours during the day. Read your food labels carefully. A glass of calcium OJ has about 350 mg. If you see the calcium shown as a %, you drop the % and add a zero to get the calcium amount. For example, 25% = 250 mg, 30% = 300 mg.
To have a diagnosis of severe osteoporosis (actually WHO doesn't recognize that diagnosis anymore) used to mean having a T-score of -2.5 or greater (-3.0, etc) coupled with the history of a nontraumatic fracture. A non traumatic fracture is one from a standing position and not involving auto accidents, etc. If you slip on ice and break your ankle, no matter how hard the fall, that's a nontraumatic fracture.
If you bone density is in the osteoporotic range or you've had a fracture, you need a medication. If your bone density is in the osteoopenic range and you have one other specific risk factor (high FRAX score, prednisone use, failing single leg stance, history of 1 or more falls) you need a medication.
If you have reflux, you can take the Reclast infusion. It's an annual infusion and is done in a hospital outpatient or doctor setting. It's covered by your health insurance (not drug insurance) because it must be given in one of those two places.
Go to the NOT website - www.nof.org . That's the National Osteoporosis Foundation. You'll find a wealth of information there relating to all of your questions.
The positive in this is that at your age, osteoporosis is not as threatening as it would be for an older person. Glad you found out now and can take steps to get it under control. It can be done, but not without medication. Please bear in mind that there is NO natural way to reverse your bone density without an RX. All you'd be doing is prolonging your improvement and making it harder to regain lost ground.View Thread
Our medical director does not put her patients on Prolia unless all other medications have been tried with no success. She firmly states that it is not just another option as an osteoporosis med.
Specifically, I don't know about the PTH connection. We really don't have many patients on Prolia. Maybe a handful.
The Reclast is a good drug. It is not being phased out, at least to my knowledge. My mother just had her injection last month.
If your T-score hasn't fallen more than the margin of error, you are considered stable - and that's a good thing. It sounds like it was working just fine for you. Like you, I'm more than a little suspicious as to the reason for the change.
If you don't want to continue the Prolia, you have every right to refuse it. The doctor shouldn't get angry, even if he had a good reason to suggest the change. Ask him why he changed you if the Reclast was working. Ask him about your findings regarding the PTH.
Being hyperparathyroid is a big osteoporosis risk in itself. It's something you should pay attention to. Like you, I'm curious as to yours being secondary to what? If you never had it before and have it now.....what's up with that?
If you were satisfied with the Reclast and your numbers were stable, tell your doctor that's what you want to do. Not Prolia. Even if the Prolia isn't the cause of your new symptoms, you would forever be connecting them in your mind and that would cause you angst that you don't need.
Just be sure to take the 1200 mg of calcium each day so that whatever medication you take has something to work with. Without calcium, they just aren't effective.View Thread
You have osteoporosis. The diagnosis is made by the lowest score.
So sorry about your pain; however, it won't be caused by the osteoporosis. Osteoporosis only causes pain when you fracture. That's why it's called The Silent Disease.
If your pain is in your back, you could have had a compression fracture. If it's in your hips, it could be arthritis or deferred pain from a spinal problem. Maybe a fracture, maybe not.
When you say so far nothing from the Reclast, what do you mean? Reclast isn't for pain. It's a drug to strengthen your bones.
I would suggest finding a good chiropractor. Before you go, tell him you have osteoporosis and ask if he takes care with those people who do. He should take x-rays before he even touches you. Ask if he does that.
I personally had extreme hip pain. It had gotten to the point where I couldn't always bear weight when walking up steps into my house. This went on for 3 years. I had physical therapy, massages, injections and pain pills.
Someone suggested a chiropractor who'd helped them. I was soooo reluctant and scared to do this. But I did.
I could not believe the difference it made in me. He took x-rays and told me my pelvis was rotated. It took 12 visits, 3x/week for 4 weeks, then once a week for another 4 weeks before the pelvis was rotated back in place. I went to him again when my father was dying and falling frequently. The lifting him off the floor got me all out of whack again. That was in April 2012. I've not needed to go back since and have had no pain.
It works for some people who've tried everything else. It just makes you feel so good.
It's very possible this could be something that would benefit you. I sure hope so. Constant pain affects all aspects of your life.View Thread