Osteopenia help needed

[Spaceman210]

Osteopenia developed after I cut dairy for 2 years. Help on how to improve density significantly without the supposedly harmful calcium supplements, dairy, omega-3's etc. that have been otherwise recommended? I do weight bearing exercise but always have, so not enough. M.O. has been talking about ADT potential need, so big worry there. I have requested bone doc consult at City of Hope. I wonder if medications can be used early, before ADT and before osteoporosis. Everything seems at cross-purposes to turn this around.

[ctarleton]

Some post-menopausal women with thinning bones and without cancer or bone mets use the occasional dose of Prolia, which is based on the drug Denosumab, which is the same drug that men with advanced prostate cancer with bone mets take in the form of the brand name injectable drug Xgeva. Ask your doctor.

Other drugs in the simpler osteoporosis context are:

Alendronate (Fosamax)

Risedronate (Actonel)

Ibandronate (Boniva)

Zoledronic acid (Reclast)

Note that the last one, Zoledronic Acid, is often given to men with advanced prostate cancer and mets to bones in the form of the IV drug Zometa.

Again, ask your doctor about your options.

Charles

[Spaceman210 in reply to ctarleton]

Thank you Charles

[Schwah in reply to ctarleton]

I’m on low dose zometa for bone density but I add Celebrex. Clinical trials have shown that the two together reduce deaths by over 20%. It’s a no brainer.

[cujoe in reply to ctarleton]

Anyone on long-term (four years or more) use of Bisphosphonates for osteopenia/osteoporosis should be aware of the possibility of "atypical bone fractures", usually of the femur. My sister had this happen to her (well after the FDA black box label was added) and ended up with titanium rods in both legs. IMO, negligence on the part of her MO for not recognizing the risk and taking her off the drugs for a holiday period. If her MO had been paying attention, she would have not had to endure the surgery and continued leg pain she had for the next five years.

Atypical Fractures and Bisphosphonates

americanbonehealth.org/bone...

My understanding is that in making bone stronger this class of drugs also makes them brittle. The meds shut down a natural process that repairs hairline fissures in bones and long-term use, as a result, can lead to the fractures. Going off the meds for six months allows the bone repair function to restart and do its thing, after which it is OK to begin taking the drugs again.

Pays to be informed. (i.e., always read ALL the printed material for any prescription or OTC drugs.) It is also most important to be your own health care advocate, as your life may someday depend on it. Be Well - cujoe

PS Spaceman, I've been on a progressively no-meat/no-dairy diet for last 9 years. I also try to limit my daily calcium intake to LESS than the RDA. With an aging population bombarded about their risk for osteoporosis, I find I have to search for products (like non-dairy "milk" substitutes) that do not have boosted calcium content. And while I never have had a bone density test, my blood calcium levels have stayed at mid-range normal for as far back as I have lab results. (16 years) I eat at least one big salad with lots of kale/spinach per day and do resistance strength-training 5+ times a week. We are all different, but this has worked for me, so far. Good Luck!

[Spaceman210 in reply to cujoe]

Hey thanks a lot, great info

[ctarleton]

This page might also give you some fresh ideas of things to perhaps increase/decrease in one's diet, in the context of osteoporosis. It's really easy to get into old habits of eating the same old things for year after year. Might be fun to mix things up a little bit, here and there. Maybe put some different color foods on the plate, etc.

nof.org/patients/treatment/...

Charles

[Hidden in reply to ctarleton]

Good info .Thanks

[pjoshea13]

Spaceman,

You say that "Osteopenia developed after I cut dairy for 2 years", which implies that your diet is now deficient in calcium. Leafy greens are a good source. A low-dose supplement is worth trying if you can't stomach the greens.

There are minerals other than calcium that are need for bone health too: magnesium, zinc, boron, etc, etc.

Vitamin K is essential for calcium transport to bone [1]. {Vitamin K2 (as all-trans menaquinone-7) is essential IMO} Without K, calcium will be deposited in arterial walls.

While on ADT, the loss of testosterone [T] will mean that your estradiol [E2] will also be much lower. It should not be under 12 pg/mL, or there will be bone loss. A low-dose E2 patch will correct that problem. Target E2 should be 20 pg/mL IMO. E2 should not go above 30 pg/mL - IMO. E2 should be monitored.

-Patrick

[1] lifeextension.com/Vitamins-...

[Hidden in reply to pjoshea13]

I take vit K with nattokinase supplement. Magnesium too, mostly for heart health. Good to know about E2 and bone loss.

[Magnus1964]

Take calcium + D3 supplements.

[Spaceman210]

Nal, it was only from my concerns reading that calcium, dairy promotes the cancer.

[cujoe]

Here is an excellent overview of the processes involved in bone health and detailed info (with sources) for the micronutrients and lifestyle activities involved.

Bone Health In Depth

lpi.oregonstate.edu/mic/hea...

There will NOT be a quiz later. Be Well - cujoe

[j-o-h-n]

Plain homemade Greek Yogurt -or-

Chocolate chip ice cream (two scoops) daily.

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 03/17/2019 2:26 PM DST