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
There can be a HUGE difference in T-scores when changing machines. This is an issue we hear frequently. I would suggest that you have your testing done somewhere that is ISCD accredited. This is the gold standard for bone density testing. The ISCD is the International Society of Clinical Densitometrists. The medical director of the Osteoporosis Center where I work is on this board. We are also an accredited site. Bone Density testing is something that can be performed by basically anybody who wants to learn. Doesn't mean it's done correctly. There's a lot of misinformation about this. Because it's an easy way for places to make some money, lots of private offices will lease a machine, pull a clerk off a front desk for a day a week, give her a 6 hour online instruction course and away you go for your test.
Look at www.iscd.org for an accredited testing site near you. Have your testing done only there. You're too young to have numbers like this.
Next, why are you being tested every year? Testing is recommended to be done every two years as bone is very slow to respond to change. Being on prednisone for a chronic condition is the only reason to be tested more frequently. (Unless you have cancer, and you didn't mention that.)
Stress will certainly deplete your bone density. The stress hormone cortisol causes you to lose calcium. Alcohol too is a factor. It can also cause you to stumble and fall, which could result in a broken bone when your bone density is low.
Were your kidney stones calcium ones? Many aren't. If not, don't worry about the calcium supplement. If they were, I'd suggest maybe one supplement a day or every other day and then get what you can in your diet. Lots of foods now have calcium added. Read your labels. If it says 25% calcium, that's 250 mg. 30% = 300 mg.
You're right to spread it out. Absorption is difficult and the body can only process about 500 mg at a time. Make sure you're taking a Vit D supplement either in your multi, in your calcium pill or as a stand alone supplement. About 1000 IU a day.
As for exercise....with those low scores in your back, you should NEVER bend forward from the waist. Never. Doing so causes those tiny struts within the vertebrae to break. You don't feel it until the last one breaks and you have a compression fracture. Instead, pivot from the hips and do the golfer's stance for picking up stuff off the floor or dryer. You also don't want to twist side to side.
There's a really good booklet we use in our rehab classes called "Boning Up on Osteoporosis." You can order it from the National Osteoporosis Foundation (www.nof.org ) It's about $5. It will tell you everything you want to know and also gives illustrations of body movements and exercises to do and to avoid.
Forteo?? A very good drug. I think before I went on it though, I have another test (probably have to pay for it out of pocket) at an accredited site, take their numbers and start fresh. If they're low - more than -2.6 or so, I think I'd do the Actonel for two years, make the lifestyle changes, be retested then. If you're worse, do the Forteo. Worse is not defined by T-score either.
At your age, low bone density is not as critical as in someone older. Especially since you haven't broken a bone. In fact, men younger than 50 don't even get a clinical diagnosis. It may also be that when you were first tested, you hadn't finished forming your maximum bone mass and that's why your numbers were low. Why did you get tested then anyway? Very unusual for a man.
Get the book. Talk to your doctor about retesting. Be firm. You'd be surprised at how many doctors really don't understand bone density testing. They just look at T-scores. Then take it from there with the information you gView Thread
I guess calcium. You say your calcium levels are fine. I'm assuming you're referencing lab results. The blood calcium levels will almost always be fine unless you have an illness that affects that. The reason for this is that the body needs calcium to work properly. It regulates blood pressure, aids in wound healing, blood clotting, muscle contraction and a lot of other stuff. If there's not enough calcium in the blood to do these jobs, the body will take calcium from the bones. That's what causes bones to thin. So, of course your calcium levels will be fine. The body is beautifully designed to do this. This does not mean your bones have enough calcium. It's very important for you to put calcium into your body every day as I discussed in my other post.
Save our Bones...please don't rely on this. There is NO natural way to improve your bone density without medication. None. Vivian Goldschmidt makes a lot of money from people who want to avoid medication. Personally, I believe this is harmful to the many people who need a medication and are convinced they don't need it.
As we age (don't you hate that phrase?) the process of bone cell resorption speeds up, thereby upsetting the balance of bone building and bone resorption - the osteoclasts and the osteoblasts - that we had when we were younger. This leads to loss of bone density. The medications/bisphosphonates slow down the resorption of bone cells giving the body time to naturally rebuild. It won't do this without RX help. It won't.
I have to tell you, we see about 4000 osteoporosis patients a year. You wouldn't believe the stories people tell themselves to avoid taking a medication. "My body would tell me if something were wrong." "I won't put anything that's not natural into my body." Then they go smoke. "I feel really good and will consider something when I need it." I finally get to the point where I tell them, it is what it is. They're bones are crappy. If they don't want to take a medication that would help them stay upright and independent, it's OK by me. If they break a hip, I can still walk. Sounds crass, but we educate out patients for their good, not ours.
And in case you wonder, as many have, we don't prescribe medications. We are an osteoporosis testing and rehab center set within a hospital. Only their doctors can prescribe. We don't even steer them in the direction of a particular medication. We educate them on all their choices.
The parathyroid can be checked by your endo with lab work. If you're not having symptoms, it's probably not that.
Your Vit D certainly needs to be checked. You need at least 1000 IU/day. If your levels are low (20-30) your doctor will probably give you a huge booster dose of 50,000 IU or so. This is standard.
DXA testing...why did you have a test two years in a row? and why at a different place? Bone is slow to respond to change, so unless you're on steroid therapy or chemo or something similar, no need to test every year. You won't get the info you want. Be sure to pick one place for your test and stick with it. You can't compare tests from one location with another. People will say you can, but you can't. Tests that you have routinely done, like DXA, mammo, imaging should be done at the same place if possible in order to get the most accurate reliable information.
You sound like an active, informed interested person. My advice to you to help you stay active is to consume 1200 mg of calcium a day, have your D level checked, be on your feet 4 hours a day and get on an approved medication.
Thank you for your kind words and best of luck to you.View Thread
It may very well be that you never built your bone mass up to its full potential. Once you hit menopause you can lose up to 20% of your bone mass in that time. Did you go on hormone therapy after menopause? That helps tremendously.
I doubt the Synthroid is having much, if any, effect. The thyroid issue that most affects bone loss is hyperparathyroidism and hyperthyroidism.
The bone loss is your neck is in the femoral neck - that smaller bone that connects the hip bone to the pelvis. That's where the majority of hip fractures happen. Walking is good for that.
Have you had your Vitamin D level checked? Vitamin D is what puts the calcium in the bones. Ask your doctor next time you see him to order lab work to check if you haven't already.
Do you take a calcium supplement? Most people don't get enough calcium through their diet on a daily basis and need supplementation. You need 1200 mg a day. Be aware that the body only absorbs about 500-600 mg at a time - so if you eat calcium fortified cereal with milk, OJ with calcium added and a piece of cheese toast or yogurt for breakfast,you might think you've gotten 2000 mg already, but you really are only getting 500-600 mg and the rest you'll pee out.
Spread it out throughout the day. Take your supplements with meals for better absorption.
Read your labels carefully - especially the portion information.
As for medication - being postmenopausal and having a -2.9 T-score most certainly indicates a need for some type of medication.
You say you haven't gotten better. Have you gotten significantly worse? Have you fractured since being on the alendronate? If you answer "No" , then you're considered stable.
The Prolia doesn't work the same way as the bisphosphonates. Totally different type of drug. Might be worth trying. With a spine and hip in peril, no side effect of a medication is worse that having these areas fracture. That can instantly alter your life. With a vertebral fracture you become bent over, doubling your chances of having another fracture and enduring tremendous pain - and there's no correcting it.
Hip fractures steal your independence.
Keep walking. Get a good calcium supplement. Have your Vit D level checked. Open your mind about Prolia.
Ask your doctor about Forteo. Your scores are very low. You're right - being stable is better than losing, but you're still at high risk for fracture. If your doctor agrees about the Forteo, you could do the Evista after the 2 year treatment.View Thread
We don't do bone density testing on 18 year olds unless they have other illnesses that would compromise their bone growth. Your body continues to build bone until your mid-twenties or so. If we did a DXA on you, your bone mass would be low because you haven't completed your bone building.
You're smart to be concerned. You have some real risk factors there: lack of adequate calcium intake, low body weight, eating disorder, estrogen deficiency, family history.
The good news is that you still have time to build up your bones. The hormone treatment is a huge plus. Also the calcium and Vit D supplements. Your doctor should have told you to spread your calcium out throughout the day - don't take it all at once. Your body can only absorb about 500 mg at a time. The supplements are best taken with food.
Read labels carefully. A lot of food have calcium in them. Like you, I abhor milk and mild products. Look for OJ with calcium added. It actually has more calcium than a glass of milk. Also a lot of breads (like Earth Grain) have about 100 mg per slice. So, if you ate a grilled cheese sandwich,you'd get about 300 mg right there!
If you see a calcium amount posted as a percent, just drop the % sign and replace it with a 0 to get the mg of calcium. Ex: 25% = 250 mg of calcium
Did the doctor draw blood to determine your Vit D level? It may be that you're deficient in D. No big deal. For that the doctor usually gives you booster dose of 50,000 IU or so initiallay - to be followed with regular supplements.
You're on the right track and doing what you need to do.
You don't mention exercise. Weight bearing exercise (anything done on your feet) is good for the bones. Just don't overdo it as you can excrete calcium through your sweat.
You're a smart girl. Pass on this info to your friends who still have time to build up their bone density and aren't as aware as you are of the long term effects of neglecting their bones.View Thread
So sorry to hear about that. Yes, having a hip fracture will give you an automatic diagnosis of osteoporosis regardless of T-scores.
You certainly need to be on a med that will strengthen your bones. When you say the Fosamax hasn't helped - do you mean you haven't improved? Did you worsen? We consider a patient "stable in response to care" if her bone density remains basically the same. That is, no loss greater than the lowest significant change.
Did you manage to get in at least 1200 mg of calcium and 1000 IU of Vit D each day while you were on the Fosamax? Without it, the medication won't work. Also remember, calcium has to be consumed several hours apart as the body can't absorb more than 500 mg at a time.
It may be that Prolia would be a good choice for you. Call the drug manufacturer to see if they offer some financial help. I know Eli Lily does for the Forteo.
Also, being disabled, are you on Medicare or Medicaid? Medicare Part B pays for Prolia and Reclast since they have to be given in a hospital, doctor's office or infusion center. I don't know about Medicaid.
Make the NOF website (www.nof.org ) your new best friend. Lots of info and questions answered. You can also order their booklet "Boning Up on Osteoporosis" as a good source of information to have on hand. We use it in teaching our osteoporosis rehab classes.
Try to be on your feel at least 4 hours a day. doesn't have to be continuous. Being on your feet is weight bearing and strengthens the bones. I'm sure your therapist talked with you about this after your hip fracture. Worst thing you can do is sit or lie around all day.
Hope you're able to find something to work for you.View Thread
No, I'm sorry I can't decipher your BMD. That is entirely subjective, depending on the results of a precision study done on the machine which measured you. If your place of study didn't do a precision study, there's no way to accurately determine how great a loss or increase you've had. The precision study determines the LSC, or lowest significant change. That is the number, above which any change is considered significant. Below that number, you're considered stable.
If you have osteoporosis and/or are considered a high risk for fracture you certainly need to be on a medication. What were your T-scores? It may be that Prolia would be a good choice for you now if your bone density is too low. You could do that for a couple of years, retest, then maybe go back on the Evista to maintain. Prolia won't compromise your GERD or Crohns as it's an injection done twice a year.
I know it's a pain to get a new doctor, but if you're not confident in your current one then you're not getting what you need. Your healthcare is ultimately up to you. You need to be proactive and informed - as you certainly seem to be.
Make the NOF website (www.nof.org ) your friend. Lots of info and questions answered there. Order their booklet "Boning Up on Osteoporosis" if you want something to peruse at your leisure or a quick reference.
And, yes, I certainly understand about Obamacare! I work in a hospital and it's causing doctors to leave and patients to stay away because they can't afford the huge deductibles or premiums.View Thread