Bone density in the city

[kainasar]

Trying to figure out what to ask the MO or PCP about lack of bone density, degeneration in spine and feet. Nuclear bone scan also shows bone density in top edge of hip bones.

I am currently using alendronate and .025 Estradiol patch twice weekly with 1200mg calcium/D3 daily, and weekly Vit K, w/ a bit of iron.

I think I need to jump to Zometa or denosumab soon.

(Currently also using lupron and nubeqa for HSPC or CRPC)

[GP24]

You use a DXA scan to measure bone density, not a bone scan. my.clevelandclinic.org/heal...

[kainasar in reply to GP24]

Thanks - thought I would get another from the last in 2019, after I was on Estradiol patch for a while.

[Tall_Allen]

On a DXA scan, what are your T scores?

[kainasar in reply to Tall_Allen]

Bone To Young Age-Adjusted

Region Density Normals Normals

(gm/cm2) (T-Score) (Z-Score)

S.D. S.D.

----------------------------------------------------------------------------------------

AP Spine (L1, L3, L4) 0.802 -2.6 -1.8 Osteoporotic

Femoral Neck (Left) 0.740 -1.4 -0.3 Osteopenic

Total Hip (Left) 0.855 -1.2 -0.6

This is from 2019

[Tall_Allen in reply to kainasar]

So with positive T-scores, you should not be taking anything.

[kainasar in reply to Tall_Allen]

Thanks Senor Allen, Well its been 5 years, and a recent CT scan, Bone scan, show "degeneration" in spine.

[petercraig2]

I've been on high dosage transdermal estrogen and with x2 500mg calcium and 10,000iu Vitamin D3 daily. Last bone scan was perfect with absolutely no loss of bone density after 7 years with <.004 testosterone

[London441]

How much do you exercise and what kind?

[kainasar in reply to London441]

Was walking, doing squats with small weights, and light workout on machines until docs found hernia.

[London441 in reply to kainasar]

youtu.be/GNFjprSd57E?si=K7p...(Not working as expected?)

Consider this information. Get that hernia healed and get back to squatting. The drugs are vastly inferior to the purpose.

[janebob99]

Your estradiol dose is way too low! Increase it to 3-4 patches of strength= 0.1mg E2 applied simultaneously, and changed twice weekly. That is the dosage used by the PATCH phase-III trials. You will definitely grow net bone doing that.

My bone mineral density was measured last week by DEXA scan, and my forearm density increased by 10% over the previous scan that was done 8 months ago. I'm taking enough estradiol to get my E2 levels greater than 300 pg/ml, which is about ten times the reference level for a healthy man without prostate cancer.

You should also get your estradiol levels measured regularly while taking supplemental E2.

I pay (out of pocket) $1 per day for my estradiol gel.

[kainasar in reply to janebob99]

Study or no study the risk is too high. But appreciate your kind support.

[janebob99 in reply to kainasar]

What risk are you concerned about?

[kainasar in reply to janebob99]

Read the Russell paper. Thanks.

[janebob99 in reply to kainasar]

If you are worried about blood clots and CVE's, the 14 year PATCH study of high-dose estrogen found that there was no difference in the rate of blood clots and CVE's when comparing Lupron (etc. ) ADT to estradiol patch ADT. Both were equally the same. In that sense, high-dose estradiol patches are just as safe as Lupron ADT.

[kainasar in reply to janebob99]

Thanks. I see some studies indicate some improvement in cardio. But we might also consider risk of fractures, no?

[janebob99 in reply to kainasar]

The risk of fractures is higher with men taking Lupron, because the bone mineral density decreases over time due to osteoporosis. For men taking replacement estradiol, the BMD increases over time, which reduces the fracture risk proportionally.

Estradiol is also given in tramautric head injury cases, because it's a vasodilator. It also is used to treat ischemia in men who have had strokes, etc.

[j-o-h-n]

And you question is? (And your answers to members questions are?)

Good Luck, Good Health and Good Humor.

j-o-h-n

[kainasar]

Here's an update - from recent Dexa that may be of interest.

Bone Density -

BMD BMD Change BMD Change

Site (g/cm2) T-score Z-score Since (Baseline) Since (Prior Scan)

--------- ------- ------- ------- ------------------- -------------------

AP Spine

L1 L3 L4 0.871 -2.0 -1.0 8.6% (10/22/2019) -4.7% (07/22/2022)

Left Hip

Fem Neck 0.741 -1.4 -0.1 None (10/22/2019) 8.7% (07/22/2022)

Total 0.878 -1.0 -0.3 None (10/22/2019) None (07/22/2022)

--------- ------- ------- ------- -