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
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
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