Visit with Osteoporosis Specialist

Post by **tex** » Sat Apr 11, 2009 12:23 pm

I agree that it's always a good idea to retest something like this, because it's so easy for something unexpected to confound the results.

Incidentally, have you read this thread?

http://www.inspire.com/groups/national- ... e-effects/

Tex

Courtney · Post by **Courtney** » Fri Apr 17, 2009 3:39 pm

Hi all,

Looks like it's time for me to join this discussion. I had my first DEXA scan today and got a call from the doctor this afternoon. I don't have all the numbers, but he said I have osteopenia. My GP wants to start me on Fosomax and Calcium 1200mg/day, but after reading this thread I'm not so sure about the Fosomax and think I might do better longterm with Calcium/D and weight-bearing exercises.

What are some safe Calcium/D supplements for a GF, CF, SF person?

Thanks for any recommendations you have.

Love,

Courtney

Post by **tex** » Fri Apr 17, 2009 5:15 pm

Hi Courtney,

One of the most popular choices seems to be Caltrate 600 plus D. Here are the ingredients:

Serving Size: One Tablet

Amount per Serving: Vitamin D 400 IU (100% of Daily Value), Calcium 600 MG (60% of Daily Value).

Caltrate 600+D Ingredients:

Calcium Carbonate, Starch. Contains <2% of: Acacia, Cholecalciferol (Vit.D3), Sroscarmellose Sodium, dl-Alpha Tocopherol, FD&C Yellow 6 Aluminum Lake, Magnesium Stearate, medium-Chain Triglycerides, Polyethylene Glycol, Polyvinyl Alcohol, Sucrose, ** Talc, Titanium Dioxide, Tricalcium Phosphate. **Adds a trivial amount of sugar.

Note that in this country, the starch is almost certainly corn.

You may find it necessary to adjust your thyroid supplement dosage, since calcium carbonate with vitamin D can decrease the effectiveness of these meds:

Azole antifungals (eg, ketoconazole), bisphosphonates (eg, alendronate), certain cephalosporins (eg, cefpodoxime), iron, mycophenolate, quinolones (eg, ciprofloxacin), sodium polystyrene sulfonate, tetracyclines (eg, doxycycline), or thyroid hormones

http://www.drugs.com/cdi/calcium-carbon ... min-d.html

Also, be aware that:

Some people taking calcium supplements are concerned about lead content. The FDA maximum for lead intake is 6.0 mcg/day. Lead-free calcium supplements include Tums, Walgreen's, Equate, Nature Made, Sundown (all calcium carbonate) as well as Citracal (calcium citrate). Two well known calcium supplements that contain lead are, Caltrate (3.43 mcg/day) and OsCal (1.74 mcg/day). These amounts assume an intake of 1500 mg of calcium per day.

Sooooooo, if you're concerned about the lead, you may want to consider an alternative brand of calcium carbonate.

http://www.med.umich.edu/1libr/guides/calcium.htm

I agree with your choice of treatment programs. I think I would try strontium, before considering Fosomax. Note that the bisphosphonates are hindered by taking calcium carbonate, anyway, (that group of meds is in the list above). Why take a med that is negatively affected by the most important part of the treatment, (the calcium supplement)? There's something screwy about a treatment program where one component of the treatment is adversely affected by the other, if you ask me.

You could avoid the bisphosphonate conflict by taking calcium citrate, but note that calcium citrate is not recommended in combination with other types of calcium supplements, and it can also adversely affect vitamin D supplements, which might make it less desirable, for anyone serious about trying to prevent osteoporosis.

http://www.drugs.com/mtm/calcium-citrate.html

Love,
Tex

Gloria · Post by **Gloria** » Fri Apr 17, 2009 7:15 pm

Tex,
I did read that thread a while back. I've signed up to an osteoporosis board and am finding that I'm not the only one who had problems with strontium. Here is the thread on headaches which contains a few of my posts: http://www.healthboards.com/boards/show ... p?t=682231 I really appreciate the layout of this board after using another one.

It's nice that we don't have advertising - I have a feeling we have you to thank for that.

Courtney,
I agree that strontium citrate, if you don't have any side effects, might be a better solution. You might want to look at the board I posted above http://www.healthboards.com/boards/foru ... y.php?f=96 for other's experiences. One of the threads mentioned that strontium changes the structure of the bone from being round to being flat. Plus, the DEXA machine needs to be recalibrated when the person is taking scrontium in order to get an accurate reading. My osteoporosis MD said that they're not sure if the increased density is actually bone or a mineral from the strontium. So, it is still under trial a bit, but I think it is certainly a viable option.

That said, I've decided to go back on Fosamax. Not because it's a superior treatment, but because I felt so lousy the short time I was taking strontium and I could see from the other board that my experience wasn't unique. One woman said she tried it 6 different times using different doses and lengths of time and always had headaches. These are people, like me, who really wanted it to work.

I know that there are risks taking Fosamax, but I'm hoping that with my year or so break, I have reduced them. I'm also going to continue walking and exercising.

Polly · Post by **Polly** » Sat Apr 18, 2009 6:39 am

Courtney,

I am in the same boat as you. But I have decided not to take Fosamax, primarily becuase it is more likely to cause problems if one has dental problems, and I always seem to. Sigh. [Aside - I've always thought that many of my dental problems have been due to "soft" teeth (less enamel) which can be due to gluten sensitivity apparently].

Freeda vitamins online are great! They are free from virtually all offenders. I use their vitamin D. Also, they make a calcium carbonate POWDER (1/2 tsp=800 mg) which has no other ingredients in it. If you don't like to swallow those big calcium pills, you can mix the powder in a spoonful of applesauce.

Love,

Polly

Courtney · Post by **Courtney** » Sat Apr 18, 2009 7:49 pm

Tex, Polly, and Gloria,
Thank you all for the helpful guidance! I will have to look into all of this more closely and decide what's right for me. One reason I'm reluctant to take Fosomax is bc I am so young...I don't want to be on it my whole life! Or I should say, I don't want to depend on it when I could do more natural long-term therapies like diet and exercise.

Polly, it's really interesting that you say that about your teeth. I have had decalcified spots on my teeth since I was a child, and I've read in the celiac literature that that is a symptom of celiac/gluten intolerance. Some pediatric dentists seem to be keeping an eye out for that now. I've always had trouble with cavities despite brushing and flossing as recommended, avoiding sugary foods...everything they say you're supposed to do. I also have a receeding gumline, which is genetic as my mom has it, too. I've had a ton of dental work done over the past few months: 1 crown for a tooth that had fractured, and several fillings. Definitely hope that my appointment next week will be the last for awhile. This makes me even more reluctant to try Fosomax.

Love,

Courtney

Gloria · Post by **Gloria** » Sat Apr 18, 2009 8:42 pm

Courtney,
I agree that you are pretty young to be on Fosamax. You seem too young to have osteopenia! One of the books I read says that genetics is thought to account for 70-80% of osteoporosis. Life style contributes the remaining 20-30%. There isn't any reference to back that supposition, so it's hard to know how true it is.

You may want to read a website maintained by Dr. Susan Ott, MD:
http://courses.washington.edu/bonephys/optreatment.html

Healthy premenopausal women
I do not recommend any drug therapy, even if they have osteopenia (remember, by definition 16% of 25-year-old women have osteopenia). Nothing has been shown to be effective, and all drugs have risks. These young women should get calcium and exercise and avoid weight loss. However, if they have amenorrhea or oligomenorrhea they need estrogen, such as birth control pills with at least 35 mcg of estinyl estradiol. Depo-provera appears to enhance bone loss and should be avoided in women with high risk of osteoporosis.

Bisphosphonates should NOT be given to women who are planning to get pregnant.

Her site is very educational since she is a professor. You can read her curriculum vitae by clicking on her name on the main page. She seems to have quite an impressive resume.

It's very difficult to decide what to do, especially when it goes against your doctor's advice. I resumed taking Fosamax today, but I'm pretty sure if I were younger, I would have made a different choice.

Gloria

Courtney · Post by **Courtney** » Sun Apr 19, 2009 7:26 am

Hi Gloria,

Thanks for that information. That seems like a valuable site. I'd be willing to be that that book is right about the genetic factor, based on my own experience. Both of my grandmothers have osteoporosis, which of course is not rare, but I'm convinced that my paternal grandmother had it before menopause. It was sort of a joke that she could break a bone walking down the street. She once stepped down and broke an ankle. I think she was about 45 at the time. It was before I was born, but it's legendary in our family. She's 80 now and has had several falls recently, but she hasn't broken anything, fortunately.

I think I will go the diet and exercise and calcium route with this one. That should not be too hard, as I've had so much experience tweaking the diet, and I've been a fairly regular exerciser since high school. I will just have to step it up a notch and make sure I lift some weights, too.

Thanks for all your input.

Courtney

starfire · Post by **starfire** » Sun Apr 19, 2009 8:16 am

That is very young to start Fosamax. I hope you can find something that works instead.

When I started out late last year with an extensive dental work plan the first thing they asked was "Have you ever taken any of the bone density drugs?". They seemed pretty relieved when I said only for a couple of months several years ago.

Good Luck with it all.......

Love, Shirley

Post by **tex** » Sun Apr 19, 2009 10:24 am

Gloria,

That's by far the best article on the topics of osteopenia, osteoporosis, and their treatment, that I've ever seen. This sentence especially, caught my eye:

Bone biopsies from patients taking bisphosphonates show 95% reduction in the bone formation rate, so I usually stop after 5 years of treatment.

The red emphasis is mine, of course, but that's a mighty profound observation. It's difficult to visualize how bone strength can be improved, by using a drug that almost totally stops all new growth, (all but 5%)? That confounds normal logic.

Thanks for posting that.

Tex