Prednisone & Bone loss

[ZCorn]

I have been taking Prednisone and Abiraterone for about 1 year. I just had a bone density scan and am told I now have osteoporosis. From what I read, it's a side effect of Prednisone. Any feedback on what the lowest useful dose can be of Prednisone?

I.e., They are proposing I take > "initiate Alendronate treatment for your osteoporosis." and Alendronate (Fosamax) to prevent bone fractures.

My strong preference is to minimize the cause [Prednisone] rather than add layers of new medicine.

Feedback welcome, before I talk it over with the MO and pharmacy. Thanks.

[tallguy2]

Are you still on ADT? (Eligard, Lupron, etc.). If so that the likely cause of the osteoporosis. Have you considered Prolia?

[ZCorn in reply to tallguy2]

I'm on Lupron. Hmm, I'll check into it. Thanks.

[Hidden in reply to ZCorn]

I started prolia seven months ago .. just had my second of four six months shots. I too didn’t want any more layers of pharma. Nearing the end of last shot I developed a rash on my arms mostly. Im taking Zyrtec to help it and putting a creAm on . I think it’s a side effect to the prolia . I asked my new NP on my last visit about it and she said take Claritin or another and gave me a second shot anyway . Now It’s in me for six months . Itchy ! Don’t deter because of my reaction .. Most don’t have this problem .. From five years adt plus RT I’m in osteopenia. Are you in joint pain ? I am ,and placebo or not ,the prolia I believe helps my hip pain .. Once we start the modern med train it’s tuff to stop it ..also I started bone nutrients at the same time. Need calcium ,magnesium and boron ..I might be the only one taking strontium also ? Hopefully that is helping me too ?. I’m just trying to extend my play and enjoy a bit of life along the way . Good luck with Drs and the osteo . I felt that I must do the prolia although there are problems with it as with all of our treatments ..

[ZCorn in reply to Hidden]

Thanks, Wimpy. BTW - No pain just bone density loss.

[Tall_Allen]

It is a side effect of high dose prednisone, but you are only taking a low replacement dose, which probably has no effect on your bone mineral density (BMD). The culprit is ADT (with Zytiga), which is known to reduce BMD. Because you are metastatic, you should be able to get Zometa or Xgeva. Be sure to monitor blood calcium and Vitamin D levels while taking it. Alternatively, you can discuss estrogen patches instead of ADT to help preserve BMD.

[ZCorn in reply to Tall_Allen]

Hmmm, thank you.

[pjoshea13]

Estradiol [E2] is essential for bone health. With very low testosterone, your E2 may be <12 pg/mL. A low-dose E2 patch can correct that. Get an E2 test.

Best, -Patrick

[ZCorn in reply to pjoshea13]

Thanks Patrick

[Magnus1964]

I think you should look into xgeva. I have been on it for over 3 years. No side effects.

[ZCorn in reply to Magnus1964]

Thanks.