You're young for this. Has your doctor looked for a cause of your osteoporosis? Maybe it's secondary to something else. Forteo usually gives a better readout than this. However, T-scores don't indicate improvement and there are other factors to consider.
Family history of osteoporosis? Prednisone or antiseizure med use?
Lab tests are not good indicators of calcium for bone health. Your calcium would show in the normal range in your blood because the body takes from the bones to bring the blood calcium levels to what they should be.
You need 1200 mg of calcium each day. This should be taken at meal time, keeping in mind that the body will only be able to absorb 500-600 mg at a time - so spread it out.
I don't know if Prolia is a good choice for you or not. It's to be used only after all other meds have been tried. Talk to your doctor about it.
You were very young to have had such low numbers. I'm assuming you are not on hormone replacement. How old were you when you went through menopause?
It may very well be that you never really reached your full bone mass potential and when you started to lose bone, you lost rapidly because there wasn't a lot there.
I'd be real wary of the yoga and kayaking. Yoga is good for balance. Just be sure not to do any forward bending or side to side twisting of the spine. If I were you, I'd do something else besides kayaking. Just too risky and is not bone building either. The walking is good - no running. Gardening, just be careful, as with yoga, no forward bending or twisting of the spine.
Go on the NOF website for a lot more information. It's the gold standard of all things osteoporosis. www.nof.orgView Thread
First,your T-scores. When you say your spine is 2.9, is that a -2.9? I'm assuming it is.
How much height are you losing? Have you been properly measured? What we look at is 1.5" of height loss from your maximum reported height. Your height should be measured barefoot (don't laugh, you'd be surprised) and with your ears, shoulders and hips in a straight line.
You need 1200 mg of calcium each day in diet and supplements and 1000 IU of Vit D. You also need to be on your feet at least 4 hours a day.
Walking is a good exercise for you. It doesn't pound the spine like running does. No toe touches, crunches, jumping jacks or side twisting of the spine. I wouldn't do any weight lifting either unless it's 3 lbs or so.
As for meds...you meet the clinical criteria for a med. Your youth is in your favor because young people respond to medication better and don't fracture as easily as the elderly. That said, having one fracture makes you twice as likely to have another, and you've had two.
I think Prolia is being tossed about too cavalierly. It is to be used only after other meds have been tried with no success. Success is measured as a followup DXA (after two years on a med) showing no significant (as determined by the precision test done on the machine) loss of bone density or significant improvement. Just to look at T-scores does not give you this information. You can have a T-score of -2.9 and the next one of -3.0 and still be considered stable and responding to treatment.
If your testing center does not do a precision study to determine their LSC - Lowest Significant Change - go elsewhere for your testing as you have not been getting a quality test.
Yoga might be a good idea for you too as you say you work waaaay too hard. Stress produces Cortisol, which depletes bone density.
So, to summarize: 1200 mg of calcium spread throughout the day, 1000 IU of Vit D, be on your feet at least 4 hours/day, try some walking or yoga for balance, stress reduction and bone building, and talk to your doctor about which med to take.
I believe the NOF website (www.nof.org ) has a section on preparing for your doctor appointment if you want to check it out.View Thread
No. If you take a good multivitamin and calcium supplement with D, that's all that you need to do. And for heaven's sake - DO NOT take strontium supplements. They aren't regulated here, they're strontium citrate which isn't what you need if you take strontium, and they screw up your DXA results - giving you a false positive increase, while not actually helping your bone.
Very important not to do any forward bending or side to side twisting of the spine. Look at the National Osteoporosis Foundation - www.nof.org - for more fact based proven information.View Thread
Oops, looks like my page didn't load properly and I re-answered the initial post.
The Osteo drugs do not guarantee improving your T-score. That's not their purpose. The purpose is to reduce your risk of fracture. To say that you went from osteopenia to Osteoporosis is not enough information. Osteopenia can be as low as -2.4, whereas osteoporosis starts at -2.5, according to T-score only. If you've ever had a non-traumatic fracture, no matter your T-score, you have osteoporosis.
You may or may not have an absorption problem. Were you taking the Fosamax on an empty stomach with a full glass of water and staying upright for at least a half hour?
Also were you taking 1200 mg of calcium daily? If not, the Fosamax won't have anything to use to strengthen your bones.
The Prolia is a tricky med. It's to be used only as a last choice when all other meds have been tried. It's not one of the front line choices. Go on the NOF website for a lot of information about osteo meds. www.nof.org That's the gold mine of all things osteo.View Thread
You didn't have osteopenia. You had osteoporosis. Period. Diagnosis is made by the lowest score - not individual site scores.
Also change isn't measured by T-score, but by BMD according to a specific formula. Oftentimes, the T-score may be lower, but in actuality there is no change and that is considered stable.
The fact that you've had testing done at different places, plays a HUGE part in your results.
As far as that Fosamax rep is concerned, he is 100% wrong. All these osteo meds need calcium to work. To take a med without taking calcium would be like hiring a bricklayer and not giving him any bricks to work with.
If you have not had any fractures, then the Fosamax was doing its job. It is approved for the prevention and treatment of osteoporosis to reduce fracture risks. Sounds like it did. You are fortunate.
Does your doctor want you to go on the Forteo solely because of your T-score? You don't say how old you are or how much you weigh. That would figure into it to. What was your maximum height and what is it now? Have you ever been treated with corticosteroids for longer than 6 weeks? Did your mother/father/sibling have osteoporosis, break a hip or lose more than 1.5" of height? All these things would play into Forteo use. Forteo is a good drug and will build new bone. Then you would go on a bisphosphonate to strengthen that new bone. But you will need calcium - 1200 mg/day along with at least 1000 IU of Vit D. Your body will not absorb more than 600 mg of calcium at one time, so spread it out.
I'd love to have the Merck rep's name to follow up on his claim, if you'd be willing to share it.View Thread
What are your T-scores? Have you fractured a bone since age 40? Are you on or have ever been on for greater that 6 weeks, corticosteroids?
It is hard finding new doctors and sometimes the first one or two just aren't a good fit. Keep looking until you're comfortable. The NOF (National Osteoporosis Foundation) has a good website - www.nof.org - that has a section on how to talk to yur doctor about osteoporosis. It also has a lot of other information you might find helpful.
As for bone building after menopause...well...yes and no. As long as you're alive, your body makes new cells, including new bone cells. But, as I stated above, the body naturally will absorb those older cells faster than it can make new ones. That's why you lose bone as you age. Menopause and the loss of estrogen upset the balance of things.
Prolia will slow down the absorption and speed up the bone building. You have to be careful with it as you don't want to build up more bone than your body can handle. If the Reclast didn't work for you in letting your body rebuild it's bone at its own pace, then Prolia might be a good choice for you. The NOF website also goes into great detail about each of the osteo meds. It's worth checking out.
BTW, our medical director is also a rheumatologist and is on the board of the International Society of Clinical Densitometrists. I trust her judgment.View Thread
Our Osteoporosis Center medical director believes that Prolia should not be given cavalierly. That it should only be used when all other meds have been tried without success.
Reclast and the other bisphosphonates do not build bone per se. They slow down the body's resorption of bone, giving the body a natural way to catch up with its bone building.
When we're young the balance between bone building and bone resorption is equal. As we age, the process gets screwed up and the bone building is slower than the bone resorption. That causes thinning of the bones. If the meds slow down the resorption process, the body can make more new bone cells to waylay the loss of bone mass.
If your Reclast was working for you and you haven't fractured since taking it, I'd continue with it.View Thread
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