ktnap
04-10-2007, 11:41 AM
I asked my doctor for a bone density test since my insurance covers it and because I have some osteoperosis risk factors (caucasian, perimenopause, thin - 95 lbs.).
Knowing I am at risk, I have also strived to continue some sort of weight-bearing exercise but am finding it more difficult to do much variation since I have had back problems for the past 10 years. I walk (aerobics-paced) at least a cumulative 2 miles a day, sometimes also doing low-impact step aerobics.
After the bone density test, the doctor sent me the following cryptic summary statement "early bone loss consistent with osteopenia" and a prescription for 70 mg. Fosamaxx.
I am not the type of person to just start taking a medication on the whim of a doctor so I started researching it and am horrified at the possible side effects (particularly the issue with the jaw bone loss since I have had several gum graftings due to existing bone loss without that medication!) My dentist has been very concerned about this for at least the past five years.
At any rate, I am soon to be 49 years old and I do not want to hasten the loss of my teeth due to medications.
Could someone please elaborate on their own experience with osteopenia/osteoperosis(?) and what course of action is warranted at this point in my life?
I would most certainly appreciate your input!
Knowing I am at risk, I have also strived to continue some sort of weight-bearing exercise but am finding it more difficult to do much variation since I have had back problems for the past 10 years. I walk (aerobics-paced) at least a cumulative 2 miles a day, sometimes also doing low-impact step aerobics.
After the bone density test, the doctor sent me the following cryptic summary statement "early bone loss consistent with osteopenia" and a prescription for 70 mg. Fosamaxx.
I am not the type of person to just start taking a medication on the whim of a doctor so I started researching it and am horrified at the possible side effects (particularly the issue with the jaw bone loss since I have had several gum graftings due to existing bone loss without that medication!) My dentist has been very concerned about this for at least the past five years.
At any rate, I am soon to be 49 years old and I do not want to hasten the loss of my teeth due to medications.
Could someone please elaborate on their own experience with osteopenia/osteoperosis(?) and what course of action is warranted at this point in my life?
I would most certainly appreciate your input!
Sponsor
osteoblast
04-10-2007, 06:53 PM
Katnipped-A good place to start to understand your situtation is to get your dexa numbers from the dr. Do you have the numbers?
DesertBloom
04-10-2007, 07:01 PM
Hi Katnipped: Welcome to the group:)
I'm glad you asked for a dexa scan that's a really *good* first step. Unfortunately, most people think that osteoporosis and osteopenia is something that doesn't occur until your much older than you, which isn't always the case.
Luckily you've done your reading and have started out well. Your exercise routine sounds great, and you're able to vary the routine which will help a lot. Are you taking any supplements? Like calcium, vit d, magnesium, k, manganese etc, the bone building vitamins? If you don't have any problems with your mineral levels you need to take the RDA of the above to help with bone loss and building.
I understand your reluctance to take fosamax, I took actonel for a little over a year and it didn't help. I didn't get the usual side effects, but it did cause some bone pain and also didn't raise my t-score any.
Since you already have some dental issues you'll want to be careful with those drugs, even though most people with this problem have other risk factors, like cancer where they used the iv form of the drug. Since no one knows for sure how osteonecrosis starts I would steer clear of it *if* you can. But of course this would be your decision. There are many people who take this med without any problems, so it just depends on your pre-existing conditions and metabolism. I understand that you don't want to hasten your tooth loss, but the same goes for your bone loss as well. Fortunately there are other treatments out there to choose from.
If you have your t-score it would help to know where you are on that scale, since mild osteopenia v high would help you to decide which treatment to go with. There are natural alternatives, that I'm not real familiar with, like OTC strontium citrate that you could consider, and I'll let those more familiar with this explain.
If I had known when my osteopenia had started and had treated it, I wouldn't have osteoporosis now. I went through early non-surgical meno, have a strong family history of osteo, and also have back problems like you. I've had many back surgeries that failed due to poor bone strength. I've had rods and screws fail from falling out of porous bone, so I wish there had been treatment for me when this happened. My bone probs started in my late 20's and I'm now 53. My t-score was -3.6 the last time it was checked and I'm on forteo, which I hope is working well. According to my NTx test, my bone is increasing so hopefully my next dexa will be much better.
Below is a good link explaining all the answers to your questions, except which treatment you should use, because that's up to you. Many people with osteopenia do well with the vitamins/exercise alone, but it would depend on your t-score and how close you are to osteoporosis. Osteopenia is a term for bone loss, and osteoporosis is a bone disease. We all have bone loss, at some point, but what we do to prevent it from getting worse is the key. Again I wish I had known when I was osteopenic, like you, because I believe I could have alter my entire life.
Keep up the exercise and good luck on your decision for treatment.
http://courses.washington.edu/bonephys/opbmd.html#WHO
This link starts you off at the t-scores, but if you click on the Home page at the bottom after reading the page, it will explain many things about osteopenia, treatment, testing, vitamin intake etc.:wave:
I'm glad you asked for a dexa scan that's a really *good* first step. Unfortunately, most people think that osteoporosis and osteopenia is something that doesn't occur until your much older than you, which isn't always the case.
Luckily you've done your reading and have started out well. Your exercise routine sounds great, and you're able to vary the routine which will help a lot. Are you taking any supplements? Like calcium, vit d, magnesium, k, manganese etc, the bone building vitamins? If you don't have any problems with your mineral levels you need to take the RDA of the above to help with bone loss and building.
I understand your reluctance to take fosamax, I took actonel for a little over a year and it didn't help. I didn't get the usual side effects, but it did cause some bone pain and also didn't raise my t-score any.
Since you already have some dental issues you'll want to be careful with those drugs, even though most people with this problem have other risk factors, like cancer where they used the iv form of the drug. Since no one knows for sure how osteonecrosis starts I would steer clear of it *if* you can. But of course this would be your decision. There are many people who take this med without any problems, so it just depends on your pre-existing conditions and metabolism. I understand that you don't want to hasten your tooth loss, but the same goes for your bone loss as well. Fortunately there are other treatments out there to choose from.
If you have your t-score it would help to know where you are on that scale, since mild osteopenia v high would help you to decide which treatment to go with. There are natural alternatives, that I'm not real familiar with, like OTC strontium citrate that you could consider, and I'll let those more familiar with this explain.
If I had known when my osteopenia had started and had treated it, I wouldn't have osteoporosis now. I went through early non-surgical meno, have a strong family history of osteo, and also have back problems like you. I've had many back surgeries that failed due to poor bone strength. I've had rods and screws fail from falling out of porous bone, so I wish there had been treatment for me when this happened. My bone probs started in my late 20's and I'm now 53. My t-score was -3.6 the last time it was checked and I'm on forteo, which I hope is working well. According to my NTx test, my bone is increasing so hopefully my next dexa will be much better.
Below is a good link explaining all the answers to your questions, except which treatment you should use, because that's up to you. Many people with osteopenia do well with the vitamins/exercise alone, but it would depend on your t-score and how close you are to osteoporosis. Osteopenia is a term for bone loss, and osteoporosis is a bone disease. We all have bone loss, at some point, but what we do to prevent it from getting worse is the key. Again I wish I had known when I was osteopenic, like you, because I believe I could have alter my entire life.
Keep up the exercise and good luck on your decision for treatment.
http://courses.washington.edu/bonephys/opbmd.html#WHO
This link starts you off at the t-scores, but if you click on the Home page at the bottom after reading the page, it will explain many things about osteopenia, treatment, testing, vitamin intake etc.:wave:
ktnap
04-11-2007, 01:33 PM
Hey thanks to both of you, I really appreciate the information! I had not received the T-score, z-score so I called the dr. office when I read your replies. I received the DXA results summary today. One was for the Lumbar spine (Total t-score = -1.4, Total z-score=-.8), the other was for the Left hip (Total t-score = -1.8, Total z-score=-1.4) There is another line on the Hip summary after the Total line for Ward's...? I'm not sure what this means (ward's t-score = -1.8, Total z-score=-.7).
I wish I had time to research this further but unfortunately i'm leaving on a trip starting tomorrow. does anyone have a "quick and dirty" explanation...?
I'm not sure what the #s mean or where this places me in terms of risk. There is a BMD graph at the bottom of the DEXA summary showing where I place for persons of my age but from the information given, I'm not sure if its showing me worse than others diagnosed with osteopenia or better...?
Again, I really appreciate your time in assisting me. Desertbloom, I checked out that URL, it looks like it's a great site. Hope to delve in deeper soon...!
I wish I had time to research this further but unfortunately i'm leaving on a trip starting tomorrow. does anyone have a "quick and dirty" explanation...?
I'm not sure what the #s mean or where this places me in terms of risk. There is a BMD graph at the bottom of the DEXA summary showing where I place for persons of my age but from the information given, I'm not sure if its showing me worse than others diagnosed with osteopenia or better...?
Again, I really appreciate your time in assisting me. Desertbloom, I checked out that URL, it looks like it's a great site. Hope to delve in deeper soon...!
DesertBloom
04-11-2007, 02:37 PM
Hi katnipped: When you get a chance that site from the Univ of WA is excellent, it's really long, but worth the time. I still don't think I ever read the whole thing and I've known about it for several years.
As far as your scores go here's what the World Health Org says:
Normal bmd: Anything better than -1
Osteopenia: Anything between -1 and -2.5
Osteoporosis: Less than -2.5
As you can see your scores are not bad... You still need to prevent further bone loss, but you're not that far from normal. Osteopenia is a term for bone loss, and osteoporosis is a bone disease.
The RDA for calcium is 1000-1500 mg daily in divided doses
Vitamin D 400-1000 daily for people with poor sun exposure
Add magnesium, etc (listed in other post) and look up amounts.
Exercise with a weight bearing routine.
Confirm this with your Dr, to be sure.
Good Luck...
As far as your scores go here's what the World Health Org says:
Normal bmd: Anything better than -1
Osteopenia: Anything between -1 and -2.5
Osteoporosis: Less than -2.5
As you can see your scores are not bad... You still need to prevent further bone loss, but you're not that far from normal. Osteopenia is a term for bone loss, and osteoporosis is a bone disease.
The RDA for calcium is 1000-1500 mg daily in divided doses
Vitamin D 400-1000 daily for people with poor sun exposure
Add magnesium, etc (listed in other post) and look up amounts.
Exercise with a weight bearing routine.
Confirm this with your Dr, to be sure.
Good Luck...
TrinityRose
04-13-2007, 06:32 PM
Just a note on the different meds. When in my 50s I was diagnosed with full blown osteo.My scores were -3.5. I didn't take it seriourly enough the first few years and just took my fosamax periodically because it was a pain remembering not to eat, drink etc before taking the pill. No excuse just the way it was. I now have been on boniva (the once a month pill) since it became available and have TRUELY improved my scores. Good luck.
TrinityRose
04-13-2007, 06:38 PM
Just a note on the different meds. When in my 50s I was diagnosed with full blown osteo.My scores were -3.5. I didn't take it seriourly enough the first few years and just took my fosamax periodically because it was a pain remembering not to eat, drink etc before taking the pill. No excuse just the way it was. I now have been on boniva (the once a month pill) since it became available and have TRUELY improved my scores. As far as the possible jaw problems I think we each have to weigh the good and bad with all meds. I personally want to continue being able to walk without pain for as long as possible. My Mom just recently fractured her spine due to osteo and is in awful pain.
DesertBloom
04-13-2007, 11:20 PM
Hi TrinityRose welcome... I agree with you on the good and the bad, and have mentioned many times that osteo scares me more than osteonecrosis. I watched my grandmothers and aunts suffer so with this and the C curve in the spine (widows hump), that I just can't let that happen to me, if possible.
Oral surgeons have told me though, that they have seen a few cases of osteonecrosis in patients with osteoporosis, but they were all on the high nitrogen rich iv form of bisphosphonates (boniva, actonel, fosamax etc). If you have some dental problems you need to be careful, and have your work done before starting the med or stopping it while having *invasive* procedures, even though they all have varying half lives (actonel is the shortest). I'm glad your doing very well on boniva :wave:
Oral surgeons have told me though, that they have seen a few cases of osteonecrosis in patients with osteoporosis, but they were all on the high nitrogen rich iv form of bisphosphonates (boniva, actonel, fosamax etc). If you have some dental problems you need to be careful, and have your work done before starting the med or stopping it while having *invasive* procedures, even though they all have varying half lives (actonel is the shortest). I'm glad your doing very well on boniva :wave:
taape
04-14-2007, 02:14 AM
Hi TrinityRose,
I'm glad your getting improvement from Boniva, how long have you been taking it? I'm trying to decide what to do since I've been off Forteo for 6 months now. I'v been to Hayfork before, what a nice area.
I'm glad your getting improvement from Boniva, how long have you been taking it? I'm trying to decide what to do since I've been off Forteo for 6 months now. I'v been to Hayfork before, what a nice area.
barb70
04-14-2007, 04:14 PM
I started out with full Osteoporosis and after taking Fosamax for several years it has steadily improved and is now Osteopenia. I also take 2000 mg. of calcium and 800 mg of Vitamin D. These two come in the four pills a day I take. I have had no problems with any kind of side effects from this. I used to take Fosamax every day, but now take it once a week. There are meds for once a month, but since this has been working for me I hesitate to change. I wish you well with whatever choice you choose.
I know that weight bearing exercises are good for you -- I do a bit of yoga.
I know that weight bearing exercises are good for you -- I do a bit of yoga.
taape
04-14-2007, 06:52 PM
barb70,
Your one of the few people I've met who didn't have stomach complications either right away or after long term use of bisphosphonates. That's great it's working for you.
Your one of the few people I've met who didn't have stomach complications either right away or after long term use of bisphosphonates. That's great it's working for you.
ktnap
04-22-2007, 12:09 PM
I'm still reading through some of the material mentioned in other threads on this board, as well as looking into the things suggested to me from those who have responded to this thread (thank you! I'm very grateful for any information), in addition to some library books I've checked out regarding Osteopenia and Osteoperosis.
I still haven't made any decisions regarding the Fosamaxx but am leaning towards NOT going on it as I don't feel something that could have such drastic side effects/consequences is warranted at this time (i.e. the jaw thing I'm still very nervous about considering my already substantial bone loss there..I don't feel comfortable enough that it only pertains to the i.v. bisphosphonates)
When I first got this "diagnosis", it kind of depressed me. I've always been small-framed and when doctors would tell me I needed to gain weight, they never really explained that building up bone would be the way to do it (and how I could go about that) because over the years I already did eat a lot, but tried to hold to lower fat intake although I wasn't really that strict about it but I would reign in myself if I started to gain weight. Only recently have I really begun to watch what goes in my mouth (i.e., less junk/greasy food, more of a balanced diet).
ANYWAY, the question I have today is regarding a bit I read in one of the books about chelated calcium. How the carbonate isn't as readily absorbed... so I'm thinking great, here I thought I was doing well on my calcium intake via low-fat dairy and supplements and now thinking it's just not even benefiting me.
So, being the soldier I am, I was looking on the shelfs where I normally buy supplements (just the good ol' grocery store chains) and could find NO chelated calcium. So, I looked at the online drugstore I sometimes use when they have good deals and they do have chelated calcium (with magnesium and zinc) but not the Vitamin D that seems to come in every other calcium supplement I ever bought.
So then I'm thinking that if I have to buy Vitamin D, it would need to be chelated too(???) I also take potassium, vitamin c, vitamin e and fish oil supplements (for omega-3). Do all supplements we take need to be chelated???
Can anyone share there knowledge with one confused Kat? :confused:
I still haven't made any decisions regarding the Fosamaxx but am leaning towards NOT going on it as I don't feel something that could have such drastic side effects/consequences is warranted at this time (i.e. the jaw thing I'm still very nervous about considering my already substantial bone loss there..I don't feel comfortable enough that it only pertains to the i.v. bisphosphonates)
When I first got this "diagnosis", it kind of depressed me. I've always been small-framed and when doctors would tell me I needed to gain weight, they never really explained that building up bone would be the way to do it (and how I could go about that) because over the years I already did eat a lot, but tried to hold to lower fat intake although I wasn't really that strict about it but I would reign in myself if I started to gain weight. Only recently have I really begun to watch what goes in my mouth (i.e., less junk/greasy food, more of a balanced diet).
ANYWAY, the question I have today is regarding a bit I read in one of the books about chelated calcium. How the carbonate isn't as readily absorbed... so I'm thinking great, here I thought I was doing well on my calcium intake via low-fat dairy and supplements and now thinking it's just not even benefiting me.
So, being the soldier I am, I was looking on the shelfs where I normally buy supplements (just the good ol' grocery store chains) and could find NO chelated calcium. So, I looked at the online drugstore I sometimes use when they have good deals and they do have chelated calcium (with magnesium and zinc) but not the Vitamin D that seems to come in every other calcium supplement I ever bought.
So then I'm thinking that if I have to buy Vitamin D, it would need to be chelated too(???) I also take potassium, vitamin c, vitamin e and fish oil supplements (for omega-3). Do all supplements we take need to be chelated???
Can anyone share there knowledge with one confused Kat? :confused:
DesertBloom
04-22-2007, 04:28 PM
Hi Katnipped: It sounds to me like you have everything covered to fight your bone loss. You're exercising, taking vitamins and minerals, and you have decided against fosamax. If I had t-scores like yours I wouldn't take fosamax either. You have osteopenia, according to your scores, and your Dr has said the same thing. Since you're taking a multi vitamin it should have the additional bone building vitamins in it, so I think you're covered. Osteopenia means bone loss and osteoporosis is a bone disease, which you don't have TG!!!
Normal bone: score better than -1
Osteopenia: score between -1 and -2.5
Osteoporosis: score below -2.5
Since your scores are -1.4 and -1.8 you're osteopenic. To prevent further bone loss you would do the things you are already doing, to *prevent osteoporosis*. Chelating minerals makes them more absorbable, so if you want to take that type go for it.
Good Luck...
Normal bone: score better than -1
Osteopenia: score between -1 and -2.5
Osteoporosis: score below -2.5
Since your scores are -1.4 and -1.8 you're osteopenic. To prevent further bone loss you would do the things you are already doing, to *prevent osteoporosis*. Chelating minerals makes them more absorbable, so if you want to take that type go for it.
Good Luck...
ktnap
04-22-2007, 05:03 PM
Do you know why the "chelating" types of vitamins/minerals don't seem to be as readily available as the (carbonate?) types? (it seems like I should be looking for any supplement I take as "chelating" if more of it is absorbed...?)
DesertBloom
04-22-2007, 06:26 PM
Hi Katnipped: I'm not sure why you would have trouble finding chelated forms of calcium etc. I know they have it at health food/vitamin stores. I don't remember how much I paid for chelated minerals, but they might be more expensive than non-chelated. It's also possible that they aren't widely known either, but that's just a guess. If you find them at a vitamin store I would ask about the difference between chelated and non-chelated minerals.
If you don't have trouble absorbing calcium, then you wouldn't need the chelated form, so maybe people buy non-chelated because they feel they can absorb it normally, and it might be less expensive.
If you look up chelation, it should explain what is and isn't chelated and why.
Keep up the good work, and also check your t-score as often as you can, to make sure it isn't going any lower.:wave:
If you don't have trouble absorbing calcium, then you wouldn't need the chelated form, so maybe people buy non-chelated because they feel they can absorb it normally, and it might be less expensive.
If you look up chelation, it should explain what is and isn't chelated and why.
Keep up the good work, and also check your t-score as often as you can, to make sure it isn't going any lower.:wave: